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COVID-19 Survey Form
Name
Gender
Address
Pincode
District
choose your district
Thiruvananthapuram
Kollam
Alappuzha
Pathanamthitta
Kottayam
Idukki
Ernakulam
Thrissur
Palakkad
Kannur
Kasaragod
Do you have any of the following symptoms
Fever
Cough
Headache
Fatigue
Sore Throart
Body Pain
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