Fields marked with * are required, they must be filled before submitting the form. Reporting for : Do you have a thermal gun or temperature ? * Select your response Yes No Enter body temperature in degrees : Have you developed fever ?* * Select response Yes No Have you developed cough ? * Select response Yes No Do you have difficulty in breathing ? * Do you have a fever? Yes No Additional comments : Submit
Enter phone number to search for existing details. Starting with the country code (e.g +254700000000) Phone Number : * Valid Select the correct country code first. Submit
