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Confirm your information
The health pass will be added to your Blua Health account in maximum 2 days after Blua Health account created with successful payment.
Blua Health membership no.

Surname in English

Given name in English

Type of identification document

Identification document no.

Date of birth

Place of residence

Email address

Confirm your email address

Mobile no.

Sales referral code

Sales person name


Your contact details of Blua Health Pass will not override the contact details that the Service Provider has on record.

Confirmation

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Personal Information Collection Statement

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