Borivali
+91 9136665305
Mulund
+91 9136665105
REGISTRATION
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Email
Phone Number*
Alternate Number
Age
Address
Gender
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Do you stay in a well ventilated single room
with attached bathroom and toilet?
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Comorbidities
Diabetes
Hypertension
CKD (Chronic Kidney Disease)
COPD/Asthma/Pneumonia
IHD (Heart Disease)
Cancer
HIV
Hepatitis B
Stroke (Paralysis)
32+ week Pregnancy
Obesity
Tuberculosis
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