Covid-19 Student Entry

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* 1. What is your first & last name?

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* 2. Contact Details

Cell Number

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* 3. Do you have a cough?

Yes

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* 4. Do you have a cold?

Yes

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* 5. Do you have diarrhea?

Yes

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* 6. Do you have a sore throat?

Yes

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* 7. Are you experiencing any body aches?

Yes

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* 8. Do you have a headache?

Yes

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* 9. Do you have redness of eyes?

Yes

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* 10. Do you have loss of taste or smell?

Yes

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* 11. Are you nauseous?

Yes

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* 12. Are you having any difficulty breathing?

Yes

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* 13. Are you experiencing any fatigue?

Yes

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* 14. Have you traveled recently during the past 14 days?

Yes

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* 15. Any travel history to a Covid-19 infected area?

Yes

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* 16. Have you had any direct contact or taken care of a positive Covid-19 patient?

Yes

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* 17. Do you have a fever? (Temperature of 37.8 or above)

Yes

Covid-19 Student Entry

Question Title

* 1. What is your first & last name?

Question Title

* 2. Contact Details

Question Title

* 3. Do you have a cough?

Question Title

* 4. Do you have a cold?

Question Title

* 5. Do you have diarrhea?

Question Title

* 6. Do you have a sore throat?

Question Title

* 7. Are you experiencing any body aches?

Question Title

* 8. Do you have a headache?

Question Title

* 9. Do you have redness of eyes?

Question Title

* 10. Do you have loss of taste or smell?

Question Title

* 11. Are you nauseous?

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* 12. Are you having any difficulty breathing?

Question Title

* 13. Are you experiencing any fatigue?

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* 14. Have you traveled recently during the past 14 days?

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* 15. Any travel history to a Covid-19 infected area?

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* 16. Have you had any direct contact or taken care of a positive Covid-19 patient?

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* 17. Do you have a fever? (Temperature of 37.8 or above)

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* 18. What is your current temperature? (Kindly get your reading from reception)