COVID-19 TEST FORM TEST REQUEST FOR LEAVING COUNTRY Full Name ID or Passport Birth Date Select birth date Day: Select...12345678910111213141516171819202122232425262728293031 Month: Select...JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Year: Select...20222020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900 Age Select test type PCR or Antigen Select...NAAT (PCR)Quick Test (Antigen) Address Test Reason Nacionality Phone Number Email Address Test language PDF file: Select...EnglishSpanish Departure date and hour Select departure date and hour Day: Select...12345678910111213141516171819202122232425262728293031 Month: Select...JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Year: Select...20222020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900 Hour: Select...01:0002:0003:0004:0005:0006:0007:0008:0009:0010:0011:0012:00 Time: Select...AMPM
