COVID 19 REGISTRATION FORM - CUSTOMER


 
 
 
M
F
X
 
 
 
YES
NO
 
YES
NO
 
YES
NO
 
 
YES
NO
 
YES
NO
 
YES
NO
 
YES
NO
 
YES
NO
 
YES
NO
 
YES
NO
 
YES
NO
 
YES
NO
 
YES
NO
 
YES
NO
 
YES
NO
 
YES
NO
 
Referred by friends
By passage.
Via internet - social media.
Others.
 
YES
NO
 
YES
NO
 
YES
NO
 
 

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