Name Full Name * Email * Phone No. * (Preferably Mobile No.) Preferred Date (SUNDAY CLOSED) * No. of Members to be vaccinated: * Select (Vaccine) * COVISHIELD COVAXIN (Beneficiaries will be notified when the stock is available) Select Branch and Time Slot * RxDx Whitefield (COVISHIELD) RxDx Whitefield (COVAXIN - out of stock) RxDx Kadugodi (COVISHIELD) RxDx Bellandur (COVISHIELD) RxDx CHANDY, Siddapura (COVISHIELD) RxDx SAMANVAY, Malleswaram (COVISHIELD) Brief description (optional)
