COVID-19

Vaccination Card
Please keep this record card, which includes medical information ID No. PV-AXDHF9
about the vaccines you have received.

DELOS SANTOS FIDEL .

Last Name First Name M.I. Suffix

Address #31 GSIS AVE., VILLAGE, PROJECT 8, QUEZON CITY, ME... Contact No. 0977-699-2253

Date of Birth 05/03/1996 Sex Male Philhealth No. 05-02566556-0 Category A4

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

08/06/21 SINOVAC L202106047

1st Dose
Vaccinator Name: PCpl JAYSON P CATAMA Signature

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

Health Facility Name: MAGILAS HALL, PANGASINAN PPO Contact No: 09171022318