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COVID-19

Vaccination Card
Please keep this record card, which includes medical information ID No. PV-SV2V62
about the vaccines you have received.

BOLANDO MARICEL L

Last Name First Name M.I. Suffix


Address N/A, SAPSAP, PASTRANA, LEYTE... Contact No. 09173059331

Date of Birth 02/14/1987 Sex Female Philhealth No. 132008264817 Category A4

Date
Dosage Seq. (mm/dd/yy) Vaccine Manufacturer Batch No. Lot No.

07/23/21 ASTRAZENECA 210052


1st Dose
Vaccinator Name: JACKIE LOU A DIZON, RN Signature

2nd Dose
(Schedule : / / ) Vaccinator Name: Signature

Health Facility Name: MUNICIPALITY OF LIMASAWA RHU Contact No: 09972063979

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