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Pendaftaran Tes Swab Antigen bagi Santri di Kab. Sampang
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Nama Lengkap :
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Your answer
Jenis Kelamin :
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Laki-laki
Perempuan
NIK / No. KTP :
Your answer
Umur : (Tahun)
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Your answer
Alamat Tempat Tinggal :
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Your answer
Nama Kecamatan :
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Choose
Sreseh
Jrengik
Torjun
Pangarengan
Sampang
Tambelangan
Kedungdung
Robatal
Camplong
Omben
Ketapang
Karang Penang
Banyuates
Sokobanah
Nama Desa/Kelurahan :
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Your answer
No. HP
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Your answer
Pilih Puskesmas Tempat Tes Swab Antigen :
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Choose
SRESEH
TORJUN
PANGARENGAN
KAMONING
BANYUANYAR
CAMPLONG
TANJUNG
OMBEN
JRANGOAN
KEDUNGDUNG
BANJAR
JRENGIK
TAMBELANGAN
BANYUATES
BRINGKONING
ROBATAL
KARANGPENANG
KETAPANG
BUNTEN BARAT
BATULENGER
TAMBERU BARAT
Pilih Jadwal Tes Swab Antigen :
*
Rabu, Jam 08.30 - 11.00 WIB
Kamis, Jam 08.30 - 11.00 WIB
Jumat, Jam 08.30 - 11.00 WIB
Sabtu, Jam 08.30 - 11.00 WIB
Keterangan
Membawa Fotokopi KTP/KK
Kapasitas: 50 Orang per Hari
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