Community Health Worker Registration
First name:
*
Last name:
*
Username(Phone Number):
*
Enter a valid phone number start with 07.....
National ID Number:
*
National ID must be 16 digits
Date of Birth:
*
Gender:
*
---------
Male
Female
Other
Rather not say
Address:
*
Hospital:
*
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Kibagabaga
Health center:
*
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Remera Hc
kacyiru Hc
kagugu Hc
RWN.HC
kinyinya Hc
Gatsata Hc
Gihogwe Hc
Jali HC
kabuye HC
Nyacyonga HC
Nduba HC
kayanga HC
Gikomero HC
Rubungo HC
kacyiru HC
Solece HC
Hospital id:
*
Email:
Password:
*
Password confirmation:
*
Enter the same password as before, for verification.
I agree with the
Terms and conditions
.
Register
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