Provisional Certificate for COVID-19 Vaccination - 1st Dose

Beneficiary Details

Beneficiary Name / ಫ ಾನುಭ ಯ ಸರು Tania Sarkar S

Age / ವಯಸು 24

Gender / ಂಗ Female

ID Verified / ಐ. . ಗುರುತು Aadhaar # XXXXXXXX8122

Unique Health ID (UHID)

Beneficiary Reference ID 16276182415110

Vaccination Details

Vaccine Name / ಲ ಸರು COVISHIELD

Date of 1st Dose / ದಲ ೂೕ ಾಂಕ 27 Jul 2021 (Batch no. 4121MC029)

Next due date / ಮುಂ ನ ಲ ೕಡುವ ಾಂಕ Between 19 Oct 2021 and 16 Nov 2021

Vaccinated by / ಲ ೕ ದವರು Ambika

Vaccination at / ಲ ಾ ದ ಸಳ Hoskote UPHC 18, Bangalore Rural,

Karnataka

“ಔಷ /ಲ ೕಕು,
ೂ ದೃಢ ೕಕು
Together, India will defeat
COVID-19”
- ಪ ಾನಮಂ ನ ೕಂದ ೕ

In case of any adverse events, kindly contact the nearest Public Health Center/
Healthcare Worker/District Immunization Officer/State Helpline No. 1075
ಾವ ೕ ಅಡಪ ಾಮ ಉಂ ಾದ ಸಂದಭ ದ , ದಯ ಟು ಸ ೕಪದ ಾವ ಜ ಕ ಆ ೂೕಗ
ೕಂದ /ಆ ೂೕಗ ಶುಷೂ ಾಯ ಕ / ಾ ಲ ಅ ಾ / ಾಜ ಸ ಾಯ ಾ ಸಂ. 1075
ಸಂಪ

This certificate can be verified by scanning the QR code at

http://verify.cowin.gov.in