| SL No. | Questions | Yes / No |
|---|---|---|
| 1 | Are you completely good health now? | |
| 2 | Have your weight incresed or decreased for list five years? | |
| 3 | Have you taken leave more than one week for last five years? | |
| 4 | Have you any unfitness organ? | |
| 5 | Have you suffered by pox any time? | |
| 6 | When have you taken the vaccine for pox? | |
| 7 | Are you Smocker? | |
| 8 | COVID-19 vaccination? |
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