Register Name Mobile Date Time 6:30 PM Number Of People I Accept Self Declaration ( Your Honest Response will ensure your safety and it will help control the spread of COVID-19 ) 1. I am not Suffering from flu-like symptoms: Fever, cough, Breathlessness, Sore throat, Etc 2. I have not travelled domestically or internationally in the last 14 days. 3. I have not come in contact with any COVID-19 case in last 14days. 4. My age and the people who are being registered using my number aren’t below 10 years of age and are not above 65 years of age. Send
