REGISTRATION FOR FREE VACCINATION-2ND DOSE
Sl.NO
Particulars
Remarks
1
NAME
2
ROLL NUMBER (Skip if not applicable)
3
TYPE OF VACCINATION
Select
Covidshield
Covaxin
4
COMPLETION OF NO. OF DAYS FROM THE DATE OF 1ST DOSE OF VACCINATION
Select
84 days
28 days
5
DISTRICT
Select
Bagalkote
Bengaluru
bengaluru Rural
Belagavi
Bellary
Bidar
Bijapur
Chamrajnagar
Chickballapur
Chickmangalur
Chitradurga
Davanagere
Dharwad
Gadag
Gulbarga
Hassan
Haveri
Kodagu
Kolar
Koppal
Mandya
Mysore
Raichur
Ramanagaram
Shivmoga
South Canara
Tumkur
Udupi
UttarKannada
Yadgiri
6
TALUK
7
PLACE OF PRACTICE
Select
Afzalpur
Aland
Alur
Anekal
Ankola
Arakalgud
Arasikere
Athani
Aurad
Babaleshwar
Badami
Bagalkot city
Bagepalli
Bailahongal
Banahatti
Bangarpet
Bantwal
Basavakalya
Basvana Bagewadi
Belagavi City
Bellary City
Belthangady
Belur
Bengaluru City
Bhadravathi
Bhalki
Bhatkal
Bidar City
Bilagi
Birur
Brahmavara
Byadgi
Byndur
C.B.Kalaburgi
Chadacha
Challakere
ChamarajaNagara City
Channagiri
Channapatna
Channarayapatna
Chickamagalur
Chikkballapur
Chikknayakanahalli
Chikkodi
Chincholi
Chintamani
Chitaguppa
Chitradurga City
Chittapur
Dandeli
Davangere City
Deodurga
Devanahalli
Dharwad City
Doddaballapura
Gadag City
Gajendragad
Gangavathi
Gokak
GOWRIBIDANUR
Gubbi
Gudibande
Guledagudda
Gundlupet
Gurmitkal
HagariBommannaHalli
Haliyal
Hangal
Hanur
Harapanahalli
Harihar
Hassan City
Haveri City
HCK Dharwad
Heggadadevankote
Hirekerur
Hiriyur
Holalkere
Holenarasipura
Honnali
Honnavar
Hosadurga
Hosanagar
Hoskote
Hospet
Hubballi
Hukkeri
Humnabad
Hunasagi
Hungund
Hunsur
Huvina Hadagalli
Ilkal
Indi
Jagalur
Jamakhandi
Jewargi
Joida
K.G.F
Kadaba
Kadur
Kalaburgi
Kalaghatagi
Kalagi
Kanakapura
Karatagi
Karkala
Karwar
Khanapur
Kittur
Kolar
Kollegala
Koppa
Koppal City
Koratagere
Krishnarajanagar
Krishnarajpet
Kudligi
Kumta
Kundapura
Kundgol
Kunigal
Kurugodu
Kushalnagar
Kushtagi
Lakshmeshwar
Lingasugur
Maddur
Madhugiri
Madikeri
Magadi
Malavalli
Malur
Mandya
Mangaluru City
Manvi
Maski
Molakalmur
Moodabidri
Mudaligi
Muddebihal
Mudhol
Mudigere
Mulbagal
Mundargi
Mundgod
Mysuru City
Nagamangala
Nanjangud
Narasimharajapura
Nargund
Navalgund
Nelamangala
Nippani
Pandavapura
Pavagada
Periyapatna
Ponnampet
Puttur
Raibag
Raichur City
Ramadurg
Ramangaram City
Ranebennur
Ro
Sagar
Sakaleshpur
Sandur
Sankeshwar
Saundatti
Savanur
Sedam
Shahabad
Shahapur
Shiggao
Shikaripura
Shirahatti
Shiralkoppa
Shivamogga City
Shorapur
Siddapur
Sidlaghatta
Sindagi
Sindhanoor
Sira
Sirguppa
Sirsi
Somwarpet
Sorab
Sringeri
Srinivaspura
Srirangapatna
Sullia
T-Narasipura
Talikote
Tarikere
Thirthalli
Tiptur
Tumakuru
Turuvekere
Udupi
Vadagera
Vijayapura city
Virajpet
Yadgiri City
Yedrami
Yelandur
Yelburga
Yellapur
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BAR ASSOCIATION
Select
Bagalkote - Badami
Bagalkote - Bagalkot city
Bagalkote - Banahatti
Bagalkote - Bilagi
Bagalkote - Guledagudda
Bagalkote - Hungund
Bagalkote - Ilkal
Bagalkote - Jamakhandi
Bagalkote - Mudhol
Belagavi - Athani
Belagavi - Bailahongal
Belagavi - Belagavi City
Belagavi - Chikkodi
Belagavi - Gokak
Belagavi - Hukkeri
Belagavi - Khanapur
Belagavi - Kittur
Belagavi - Mudaligi
Belagavi - Nippani
Belagavi - Raibag
Belagavi - Ramadurg
Belagavi - Sankeshwar
Belagavi - Saundatti
Bellary - Bellary City
Bellary - HagariBommannaHalli
Bellary - Hospet
Bellary - Huvina Hadagalli
Bellary - Kudligi
Bellary - Kurugodu
Bellary - Sandur
Bellary - Sirguppa
Bengaluru - Bengaluru City
bengaluru Rural - Anekal
bengaluru Rural - Devanahalli
bengaluru Rural - Doddaballapura
bengaluru Rural - Hoskote
bengaluru Rural - Nelamangala
Bidar - Aurad
Bidar - Basavakalya
Bidar - Bhalki
Bidar - Bidar City
Bidar - Chitaguppa
Bidar - Humnabad
Bijapur - Babaleshwar
Bijapur - Basvana Bagewadi
Bijapur - Chadacha
Bijapur - Indi
Bijapur - Muddebihal
Bijapur - Sindagi
Bijapur - Talikote
Bijapur - Vijayapura city
Chamrajnagar - ChamarajaNagara City
Chamrajnagar - Gundlupet
Chamrajnagar - Hanur
Chamrajnagar - Kollegala
Chamrajnagar - Yelandur
Chickballapur - Bagepalli
Chickballapur - Chikkballapur
Chickballapur - Chintamani
Chickballapur - GOWRIBIDANUR
Chickballapur - Gudibande
Chickballapur - Sidlaghatta
Chickmangalur - Birur
Chickmangalur - Birur
Chickmangalur - Chickamagalur
Chickmangalur - Kadur
Chickmangalur - Koppa
Chickmangalur - Mudigere
Chickmangalur - Narasimharajapura
Chickmangalur - Sringeri
Chickmangalur - Tarikere
Chitradurga - Challakere
Chitradurga - Chitradurga City
Chitradurga - Hiriyur
Chitradurga - Holalkere
Chitradurga - Hosadurga
Chitradurga - Molakalmur
Davanagere - Channagiri
Davanagere - Davangere City
Davanagere - Harapanahalli
Davanagere - Harihar
Davanagere - Honnali
Davanagere - Jagalur
Dharwad - Dharwad City
Dharwad - HCK Dharwad
Dharwad - Hubballi
Dharwad - Kalaghatagi
Dharwad - Kundgol
Dharwad - Navalgund
Gadag - Gadag City
Gadag - Gajendragad
Gadag - Lakshmeshwar
Gadag - Mundargi
Gadag - Nargund
Gadag - Ro
Gadag - Shirahatti
Gulbarga - Afzalpur
Gulbarga - Aland
Gulbarga - C.B.Kalaburgi
Gulbarga - Chincholi
Gulbarga - Chittapur
Gulbarga - Jewargi
Gulbarga - Kalaburgi
Gulbarga - Kalagi
Gulbarga - Sedam
Gulbarga - Shahabad
Gulbarga - Yedrami
Hassan - Alur
Hassan - Arakalgud
Hassan - Arasikere
Hassan - Belur
Hassan - Channarayapatna
Hassan - Hassan City
Hassan - Holenarasipura
Hassan - Sakaleshpur
Haveri - Byadgi
Haveri - Hangal
Haveri - Haveri City
Haveri - Hirekerur
Haveri - Ranebennur
Haveri - Savanur
Haveri - Shiggao
Kodagu - Kushalnagar
Kodagu - Madikeri
Kodagu - Ponnampet
Kodagu - Somwarpet
Kodagu - Virajpet
Kolar - Bangarpet
Kolar - K.G.F
Kolar - Kolar
Kolar - Malur
Kolar - Mulbagal
Kolar - Srinivaspura
Koppal - Gangavathi
Koppal - Karatagi
Koppal - Koppal City
Koppal - Kushtagi
Koppal - Yelburga
Mandya - Krishnarajpet
Mandya - Maddur
Mandya - Malavalli
Mandya - Mandya
Mandya - Nagamangala
Mandya - Pandavapura
Mandya - Srirangapatna
Mysore - Heggadadevankote
Mysore - Hunsur
Mysore - Krishnarajanagar
Mysore - Mysuru City
Mysore - Nanjangud
Mysore - Periyapatna
Mysore - T-Narasipura
Raichur - Deodurga
Raichur - Lingasugur
Raichur - Manvi
Raichur - Maski
Raichur - Raichur City
Raichur - Sindhanoor
Ramanagaram - Channapatna
Ramanagaram - Kanakapura
Ramanagaram - Magadi
Ramanagaram - Ramangaram City
Shivmoga - Bhadravathi
Shivmoga - Hosanagar
Shivmoga - Sagar
Shivmoga - Shikaripura
Shivmoga - Shiralkoppa
Shivmoga - Shivamogga City
Shivmoga - Sorab
Shivmoga - Thirthalli
South Canara - Bantwal
South Canara - Belthangady
South Canara - Kadaba
South Canara - Mangaluru City
South Canara - Moodabidri
South Canara - Puttur
South Canara - Sullia
Tumkur - Chikknayakanahalli
Tumkur - Gubbi
Tumkur - Koratagere
Tumkur - Kunigal
Tumkur - Madhugiri
Tumkur - Pavagada
Tumkur - Sira
Tumkur - Tiptur
Tumkur - Tumakuru
Tumkur - Turuvekere
Udupi - Brahmavara
Udupi - Byndur
Udupi - Karkala
Udupi - Kundapura
Udupi - Udupi
UttarKannada - Ankola
UttarKannada - Bhatkal
UttarKannada - Dandeli
UttarKannada - Haliyal
UttarKannada - Honnavar
UttarKannada - Joida
UttarKannada - Karwar
UttarKannada - Kumta
UttarKannada - Mundgod
UttarKannada - Siddapur
UttarKannada - Sirsi
UttarKannada - Yellapur
Yadgiri - Gurmitkal
Yadgiri - Hunasagi
Yadgiri - Shahapur
Yadgiri - Shorapur
Yadgiri - Vadagera
Yadgiri - Yadgiri City
9
MOBILE NO (WhatsApp Number)
10
AADHAR NUMBER
11
EMAIL
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