REPUBLIC OF KENYA a MINISTRY OF HEALTH International Certificate of Vaccination or Prophylaxis International Health Regulations (2005) Certificats International de Vaccination Ou de Prophylaxie Réglement Sanitaire International (2005) PORT HEALTH SERVICES Issues to/ Delivre a Passport number or travel document number Numero du passeport ou du document de voyage ALdIDZE HOINTERNATIONAL CERTIFICATE OF VACCINATION OR PROPHYLAXIS ChetoP MEY MiQel Requirements for validity This is to certi ach tt my Gre he date of bet nationality KE! national identification oc enes whose signature follows has on the date indicated been vacinat against: (name of disease or condition) in accordance with the International Health Regulations. ~ a, Signature and professigng status of suy clinician Ss Signature etttre ‘oy clinicien oe (Os 3 2 Vaccine or prophylaxis Vaccin ou agent prophylactique CERTIFICATS INTERNATIONAL DE VACCINATION DE PROPHYLAXIS Conditions de validité Nous certifiond que [nom] né(e) le ... et de nationalité document d’identification national, le cas échéant don't la signature suit .............. a été vacciné(e) ou a recu des agents prophylactiques a la date indiquée contre: (nom de la maladie ou de I'affection) conformément au Réglement sanitaire international. Manufacturer and Certificate valid Official stamp of the batch no. of vaccine or from: administering centre prophylaxis until: Certificat valable a Fabricant du vacci partir du: de agent propt jusqu’au: Cachet officiel du ‘centre habilite “Voir les conditions de validite la page 3.EE OTHER VACCINATIONS/AUTRES VACCINATIONS OTHER VACCINATIONS/AUTRES VACCINATIONS Manufacturer, brand name Next booster (date): Official Stamp and signature and batch no. of vaccine Cachet official et signature Prochain rappel Maladie visée Fabricant du vaccin, marque, et] (date): numéro du lot : Disease targeiedDisease targeted Next booster (date): Official Stamp and signature Cachet official et signature Maladie visée Fabricant du vacahmar Prochain rappel numér (date) 3 n regu lot 1SCEE INFORMATION FOR PHYSICIANS The dates for vaccination on each certificate are to be recorded in the following sequence: day. month, year - the month in letters. Example: January |,.2001 is written | January 2001. If vaccination is contraindicated on medical grounds, the physician should provide the uaveller with a written opinion, which health authorities should take into account. Vaccination certificate requirements of countries are published ~ by ‘WHO in Imernationa/ travel and health which also contains a list of approved yellow vaccine producers (annex |) Information on the designated yellow fever vaccinating VVcentres, is available from local or national health offices. The physician should always consider that his/her patient may have a travel-associated illness. RENSEIGNEMENTS DESTINES AUX MEDECINS La date de la vaccination doit etre portee sur Jes certificats dans |' ordre ‘Suivant: jour, mois, an nee le mois etant indique en lettres. Exemple: fer janvier 2001. Sila vaccination est contre - indiquee pour raison medicale, le medecin doit fourir au voyageur une attestation indiquat son opinion, don't Vauthorite sanitaire aux frontieres doll tenir compte. Les exigences des pays en matiere de vaccination sont publices par "OMS dans la brochure Voyages intemationaux et sante qui renfrerme egalement une liste des producteurs agrees du vaccin antiamail (annexe). Jes renseignemens sur Jes centers habilities a pratiquer al vaccmalloncontre la fievre jaune sont disponiblcs aupres des autorites Sanitaires locales ou nationales. Le medecin doit toujours tenir compte du fait que son patientpeut etre atteint d'une maladie lice a un voyage.