Booking PCR TEST PHUKET CENTER

Please fill out the correct information as per your passport for use in the RESULT Report And Fit to Fly medical certificate. Thank you.

First Name *

Middle Name

Family Name *

Gender *

Date of Birth *

Passport Number *

Nationality *

Email *

Flight Date *

Flight Time *

Flight Destination *

Service Promotion Online *

Test at *

Hotel-room or Address

Appointment Date *

Appointment Time *