Vaccination Registration for foreigner
Title
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Mr.
Ms.
Mrs.
Firstname
Lastname
Gender
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Male
Female
Phone Number for SMS
Email
Date of Birth
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Day
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January
February
March
April
May
June
July
August
September
October
November
December
Month
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2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
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1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
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1971
1970
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1968
1967
1966
1965
1964
1963
1962
1961
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1950
1949
1948
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1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
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1933
1932
1931
1930
1929
1928
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1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
1910
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1908
1907
1906
1905
1904
1903
1902
1901
1900
1899
1898
1897
1896
1895
1894
1893
1892
1891
1890
1889
1888
1887
Year
Passport Country
Please Select
AFGHANISTAN (AFG)
ALBANIA (ALB)
ALGERIA (DZA)
AMERICAN SAMOA (ASM)
ANDORRA (AND)
ANGOLA (AGO)
ANGUILLA (AIA)
ANTARCTICA (ATA)
ANTIGUA AND BARBUDA (ATG)
ARGENTINA (ARG)
ARMENIA (ARM)
ARUBA (ABW)
AUSTRALIA (AUS)
AUSTRIA (AUT)
AZERBAIJAN (AZE)
BAHAMAS (BHS)
BAHRAIN (BHR)
BANGLADESH, PEOPLES REPUBLIC OF (BGD)
BARBADOS (BRB)
BELARUS (BLR)
BELARUSSIAN SSR (BYS)
BELGIUM (BEL)
BELIZE (BLZ)
BENIN (BEN)
BERMUDA (BMU)
BHUTAN (BTN)
BOLIVIA (BOL)
BOSNIA HERZEGGOVINA (BIH)
BOTSWANA (BWA)
BOUVET ISLAND (BVT)
BRAZIL (BRA)
BRITISH DEPENDENT TERRITORIES (GBD)
BRITISH INDIAN OCEAN TERRITORY (IOT)
BRITISH NATIONAL (GBN)
BRITISH OVERSEAS CITIZEN (GBO)
BRITISH PROTECTED PERSON (GBP)
BRITISH SUBJECT (GBS)
BRITISH VIRGIN ISLANDS (VGB)
BRUNEI (BRN)
BULGARIA (BGR)
BURKINA FASO (BFA)
BURUNDI (BDI)
CAMBODIA (KHM)
CAMEROON, UNITED REPUBLIC OF (CMR)
CANADA (CAN)
CANTON AND ENDERBURY ISLANDS (CTE)
CAPE VERDE (CPV)
CAYMAN ISLANDS (CYM)
CENTRAL AFRICAN REPUBLIC (CAF)
CHAD (TCD)
CHILE (CHL)
CHINA (CHN)
CHRISTMAS ISLAND (CXR)
COCOS (KEELING) ISLANDS (CCK)
COLOMBIA (COL)
COMOROS (COM)
CONGO DEMOCRATIC REPUBLIC (COD)
CONGO REPUBLIC OF (COG)
COOK ISLANDS (COK)
COSTA RICA (CRI)
COTE D'IVOIRE IVORY COAST (CIV)
CROATIA, REPUBLIC OF (HRV)
CUBA (CUB)
CYPRUS (CYP)
CZECH REPUBLIC (CZE)
DENMARK (DNK)
DJIBOUTI (DJI)
DOMINICA, COMMONWEALTH OF (DMA)
DOMINICAN REPUBLIC (DOM)
DRONNING MAUD LAND (ATN)
EAST TIMOR (TMP)
ECUADOR (ECU)
EGYPT (EGY)
EL SALVADOR (SLV)
ENGLAND (ENG)
EQUITORIAL GUINEA, REPUBLIC OF (GNQ)
ERITREA (ERI)
ESTONIA (EST)
ETHIOPIA (ETH)
FAEROE ISLANDS (FRO)
FALKLAND ISLANDS (FLK)
FIJI (FJI)
FINLAND (FIN)
FRANCE (FRA)
FRANCE, METROPOLITAN (FXX)
FRENCH GUIANA (GUF)
FRENCH POLYNESIA (PYF)
FRENCH SOUTH TERRITORY (ATF)
GABON (GAB)
GAMBIA (GMB)
GEORGIA/SANDWICH ISLANDS (SGS)
GEORGIA, REPUBLIC OF (GEO)
GERMAN DEMOCRATIC REPUBLIC (DDR)
GERMANY, FEDERAL REPUBLIC OF (DEU)
GHANA (GHA)
GIBRALTAR (GIB)
GREECE (GRC)
GREENLAND (GRL)
GRENADA (GRD)
GUADELOUPE (GLP)
GUAM (GUM)
GUATEMALA (GTM)
GUINEA (GIN)
GUINEA-BISSAU (GNB)
GUYANA (GUY)
HAITI (HTI)
HEARD AND MCDONALD ISLANDS (HMD)
HONDURAS (HND)
HONG KONG (HKG)
HONG KONG (BDT)
HUNGARY (HUN)
ICELAND (ISL)
INDIA (IND)
INDONESIA (IDN)
IRAN (IRN)
IRAQ (IRQ)
IRELAND (IRL)
ISRAEL (ISR)
ITALY (ITA)
JAMAICA (JAM)
JAPAN (JPN)
JORDAN (JOR)
KAZAKHSTAN, REPUBLIC OF (KAZ)
KENYA (KEN)
KIRIBATI (KIR)
KOREA DEMOCRATIC PEOPLES REPUB (PRK)
KOREA, REPUBLIC OF (KOR)
KUWAIT (KWT)
KYRGYZSTAN, REPUBLIC OF (KGZ)
LAO PEOPLE'S DEMOCRATIC (LAO)
LATVIA, REPUBLIC OF (LVA)
LEBANON (LBN)
LESOTHO (LSO)
LIBERIA (LBR)
LIBYAN ARAB JAMAHIRIYA (LBY)
LIECHTENSTEIN (LIE)
LITHUANIA, REPUBLIC OF (LTU)
LUXEMBOURG (LUX)
MACAU (MAC)
MACEDONIA (MKD)
MADAGASCAR (MDG)
MALAWI (MWI)
MALAYSIA (MYS)
MALDIVES, REPUBLIC OF (MDV)
MALI (MLI)
MALTA (MLT)
MARSHALL ISLANDS REPUBLIC OF (MHL)
MARTINIQUE (MTQ)
MAURITANIA (MRT)
MAURITIUS (MUS)
MAYOTTE, TERRITORIAL COLL OF (MYT)
MEXICO (MEX)
MICRONESIA FEDERATED STATES OF (FSM)
MOLDOVA, REPUBLIC OF (MDA)
MONACO (MCO)
MONGOLIA (MNG)
MONTSERRAT (MSR)
MOROCCO (MAR)
MOZAMBIQUE (MOZ)
MYANMAR (MMR)
NAMIBIA (NAM)
NAURU (NRU)
NEPAL (NPL)
NETHERLANDS (NLD)
NETHERLANDS ANTILLES (ANT)
NEUTRAL ZONE (NTZ)
NEW CALEDONIA (NCL)
NEW ZEALAND (NZL)
NICARAGUA (NIC)
NIGER (NER)
NIGERIA (NGA)
NIUE (NIU)
NORFOLK ISLAND (NFK)
NORTHERN MARIANAS (MNP)
NORWAY (NOR)
OMAN (OMN)
PAKISTAN (PAK)
PALAU, REPUBLIC OF (PLW)
PALESTINIAN AUTHORITY (PSE)
PANAMA (PAN)
PAPUA NUI GUINI (PNG)
PARAGUAY (PRY)
PERU (PER)
PHILIPPINES (PHL)
PITCAIRN ISLAND (PCN)
POLAND (POL)
PORTUGAL (PRT)
PUERTO RICO (PRI)
QATAR (QAT)
REFUGEE OTHERS (XXC)
REFUGEE STATUS (XXB)
REUNION (REU)
ROMANIA (ROM)
RUSSIAN FEDERATION (RUS)
RWANDA (RWA)
SAMOA (WSM)
SAN MARINO (SMR)
SAO TOME AND PRINCIPE (STP)
SAUDI ARABIA (SAU)
SCOTLAND (SCO)
SENEGAL (SEN)
SERBIA (SRB)
SEYCHELLES (SYC)
SIERRA LEONE (SLE)
SINGAPORE (SGP)
SLOVAK REPUBLIC (SVK)
SLOVENIA (SVN)
SOLOMON ISLANDS (SLB)
SOMALIA (SOM)
SOUTH AFRICA (ZAF)
SPAIN (ESP)
SRI LANKA (LKA)
ST HELENA (SHN)
ST KITTS NEVIS ANGUILLA (KNA)
ST LUCIA (LCA)
ST PIERRE AND MIQUELON (SPM)
ST VINCENT AND THE GRENADINES (VCT)
STATELESS PERSON (XXA)
SUDAN (SDN)
SURINAME (SUR)
SVALBARD AND JAN MAYEN ISLANDS (SJM)
SWAZILAND (SWZ)
SWEDEN (SWE)
SWITZERLAND (CHE)
SYRIAN ARAB REPUBLIC (SYR)
TAIWAN (TWN)
TAJIKISTAN REPUBLIC (TJK)
TANZANIA, UNITED REPUBLIC OF (TZA)
TOGO (TGO)
TOKELAU (TKL)
TONGA (TON)
TRINIDAD AND TOBAGO (TTO)
TUNISIA (TUN)
TURKEY (TUR)
TURKMENISTAN (TKM)
TURKS AND CAICOS ISLANDS (TCA)
TUVALU (TUV)
UGANDA (UGA)
UKRAINIAN SSR (UKR)
UNITED ARAB EMIRATES (ARE)
UNITED KINGDOM (GBR)
UNITED NATIONS AGENCY (UNA)
UNITED NATIONS ORGANISATION (UNO)
UNITED STATES OF AMERICA (USA)
UNITED STATES VIRGIN ISLANDS (VIR)
UNSPECIFIED NATIONALITY (XXX)
URUGUAY (URY)
US MINOR ISLANDS (UMI)
UZBEKISTAN, REPUBLIC OF (UZB)
VANUATU ACTIVE 09 JAN 2005 (VUT)
VATICAN CITY STATE (HOLY SEE) (VAT)
VENEZUELA (VEN)
VIETNAM (VNM)
WALES (WAL)
WALLIS AND FUTUNA ISLANDS (WLF)
WESTERN SAHARA (ESH)
YEMEN (YEM)
YEMEN, DEMOCRATIC (YMD)
YUGOSLAVIA (YUG)
ZAIRE (ZAR)
ZAMBIA (ZMB)
ZIMBABWE (ZWE)
Passport Number
Passport Expired
Please Select
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3
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5
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7
8
9
10
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12
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28
29
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31
Day
Please Select
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please Select
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
Year
VISA Type
Please Select
Non-Immigrant B Visa.
Non-Immigrant IB Visa.
SMART Visa
Non-Quota Immigrant Visa with work permit
Permanent Residence with work permit
แรงงาน3สัญชาติ (พม่า ลาว กัมพูชา)
One Year Non-Immigrant Visa
Thai Elite Visa
Other
VISA Expired
Please Select
1
2
3
4
5
6
7
8
9
10
11
12
13
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18
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20
21
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23
24
25
26
27
28
29
30
31
Day
Please Select
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please Select
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
Year
Thai Address
Province
Phuket
District
Please Select
Mueang Phuket
Kathu
Thalang
Subdistrict
Please Select
Village No.
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