ភាសារខ្មែរ
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English
Covid-19 Register
Questions
1. Which country that you want to go?*
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Democratic Republic of the Congo (Kinshasa)
Congo, Republic of (Brazzaville)
Cook Islands
Costa Rica
Côte D'ivoire (Ivory Coast)
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor (Timor-Leste)
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Rep. (North Korea)
Korea, Republic of (South Korea)
Kosovo
Kuwait
Kyrgyzstan
Lao, People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federal States of
Moldova, Republic of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar, Burma
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian territories
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Island
Poland
Portugal
Puerto Rico
Qatar
Reunion Island
Romania
Russian Federation
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia (Slovak Republic)
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Swaziland (Eswatini)
Sweden
Switzerland
Syria, Syrian Arab Republic
Taiwan (Republic of China)
Tajikistan
Tanzania; officially the United Republic of Tanzania
Thailand
Tibet
Timor-Leste (East Timor)
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City State (Holy See)
Venezuela
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna Islands
Western Sahara
Yemen
Zambia
Zimbabwe
2. Did you arrived cambodia during these 14 days (05-Oct-2024 )?*
Yes
No
មិនដែលចេញចូលក្រៅប្រទេស
3. If yes, what country?*
Cambodia
Thailand
NA
Chines
KOREA
JAPAN
USA
China
SINGAPOR
PHILIPIN
ENGLAND
NETHERLANDS
SWEDEN
CONADO
KOREA (OZ)
NEPAL
India
LAOS
បារាំង
vietnam
អ៊ីតាលី
MALAYSIA
NIGERIAN
CANADA
DEUTSCH
AUSTRALIAN
អេស្សីប
ស្វីស
KUWAITI
indo
អ៊ិនដូណេស៊ី
TAIWAN
PAKISTAN
MALAY
arab
BRITISH CITIZEN
DOHA
SHANGHAI
HK
UGANDA
មីយ៉ាន់ម៉ា
MALI
JORDAN
BELGIEN
MYANMAR
BANGLADISH
BKK
THAIVAN
GHANA
SRILANKAN
SOVIET
AFRICA
MALY
AFICAN
PHUKET
DUBAI
KOLALUMPORE
SWITZERLAND
NEW ZEALAND
ហុងគ្រី
PERU
TAJIKISTAN
KL
KUWAITI
BELGIUM
COLOMBIA
UZBEKISTAN
LIBERIAN
RUSSIAN
SOMALY
TOUKY
IRAQ
DANSH
ISRAELI
HONG KONG
BRAZIL
NO
ZAMBIA
KAZAKHSTAN
MOROCCO
agentina
EGYPT
IVOIRIENNE
ESTONIA
A
INDIA
SODAN
4. If yes, what date?*
5. Have you taken the Second Test yet?*
Yes
No
6. Where did you take the Second Test?*
Khmer Soviet Friendship hospital
Chak Angre Health Centre
Write the name of the hospital that you test
Personal Information
**Please input english language only.
** All Information must be the same as your passport.
** All Information that you entry it will be show on Certificate and lab Result. In case if you entry wrong information we don't responsible with it.
Full Name (Please put as like your passport) *
Date of birth*
Sex*
Male
Female
Nationality*
Phone Number*
Passport Number*
Current Residence
**Please input english language only.
Province*
Unknown
Banteay Meanchey
Battambang
Kampong Cham
Kampong Chhnang
Kampong Speu
Kampong Thom
Kampot
Kandal
Kep Ville
Koh Kong
Kratie
Krong Pailin
Mondul Kiri
Odor Meanchey
Tbong Khmom
Phnom Penh
Preah Vihear
Prey Veng
Pursat
Rattanakiri
Siem Reap
Sihanouk Ville
Stung Treng
Svay Rieng
Takeo
Unknown
District
Commune
Village
Other
Submit
Launch Warning Modal
បញ្ចូលព័ត៌មិនត្រឹមត្រូវ / Incorrect Information / 输入错误信息
×
One fine body…
សូមបញ្ជាក់ / Please Confirm / 请确认
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One fine body…