TNTERNATIONAL CERTIFICATE OF VACCINATION OR REVACCINATION AGAINST YEI,LOW FEVER

CERTIFICAT INTERNATIONAL DE VACCINATION OU DE REVACCINATION CONTRE LA FIEVRf, JALINE

MEDUNARODNO UVJERf,NJE O VAKCINIRANJU ILI REVAKCIN.IRANJU ZUTE CROZNICE
This is ro ceflifyrhal
Je soussigndrer cerrifie que
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has on the date indicated been vaccinated or revaccinated against yellow fever.
a 6t6 vaccin6(e) ou revaccin6(e) contre la fidvre jaune d la date indiquee.
bio(la) vakciniran(a) ili revakciniran(a) protiy Zute groznice oznadenog datuma.
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Signature and professional Origin and batch

status of vaccinator no. of vaccine
Official sramp of raccinaring centre
Signature et qualite Origine du vaccin Cacher officiel du ccnlre de \accinatiotr
professionnelle du vacinateur empJoy6 et nu-
m6ro du lot Sluibeni pedat centra
Potpis i strudno zvanje za vakciniranje
osobe koja vrii vakciniranje Porijeklo vakcine
i broj serije

I t'|AY [011

This certificate is valid only if the vaccine used has been approved by the World Heaith Organization and if the vaccinaring I

centre has been designated by the health administration for the territory in which that centre is situated. u
The vaiidity of this ceftificate shall extend for a period of ten years, beginning ten days after that date of vaccination or, in l
the event of a revaccination within such period of ten years! from the date of that revaccination.
Any armendment of this certificate, or erasure! or failure to complete ony part of it, may render it invalid.
Ce certificat n'est valable que si le vaccin employ6 a 6t6 approuv6 par l'Organisation mondiale de la Sanr6 et sj le centre de
vaccination a 6t6 habilite par l'administration sanitajre du territoire dans lequel ce centre est situ6.
La valjdit6 de ce certificat couvre une p6riode de <iix ans commencant dix jours apris la date de la vaccination ou. dans le cas
d'une revaccination au cours de cette periode de dix ans, 1e jour de cette revaccination.
Toute correction ou rature sur le ceItificat ou l'omission d'une quelconque des mentions qu'ii comporte peut affecter sa validi-
16.
Ovo uvjerenje vaZi samo ako je upotrebljenu rakcinu odobrila SvjeLska zdravstvena orga.izacija i ako je centar za vakcinira-
nje dobio ovlaitenje od zdravstlene uprave podruija na kojem se centar nirlazi.
Vaznost ovog uvjerenja obuhvaia razdoblje od deset godina. koje podinje deset dana poslije daluma vakcjniranja ili u sludaju
revakciniranja u toku ovog razdoblja od 10 godina, <ianom ovog vakciniranja.
Svako ispravljanje ili brisanje na uvjerenju ili izostavljanje bilo kog podatka koji ono sadr2i mo2e da utjeae na n.jegovu \alia-
nost.