This document is a Covid-19 vaccination certificate issued by the Ministry of Health & Family Welfare of India for Penipa Goutam. It provides details of Mr. Goutam including his name, date of birth, gender, and passport number. It shows he received two doses of the COVISHIELD vaccine, manufactured by Serum Institute of India, with the first dose on July 1, 2021 and the second dose on October 19, 2021. The certificate encourages reporting any adverse events and can be verified by scanning the QR code provided.
This document is a Covid-19 vaccination certificate issued by the Ministry of Health & Family Welfare of India for Penipa Goutam. It provides details of Mr. Goutam including his name, date of birth, gender, and passport number. It shows he received two doses of the COVISHIELD vaccine, manufactured by Serum Institute of India, with the first dose on July 1, 2021 and the second dose on October 19, 2021. The certificate encourages reporting any adverse events and can be verified by scanning the QR code provided.
This document is a Covid-19 vaccination certificate issued by the Ministry of Health & Family Welfare of India for Penipa Goutam. It provides details of Mr. Goutam including his name, date of birth, gender, and passport number. It shows he received two doses of the COVISHIELD vaccine, manufactured by Serum Institute of India, with the first dose on July 1, 2021 and the second dose on October 19, 2021. The certificate encourages reporting any adverse events and can be verified by scanning the QR code provided.
Issued in India by Ministry of Health & Family Welfare, Govt of India
Certificate ID 45143619316
Beneficiary Details
Beneficiary Name Penipa Goutam
Date of Birth (YYYY-MM-DD) 1994-07-24 Gender Male Passport Number U2702994 Vaccination Status (# of doses) Fully Vaccinated (2 Doses) Beneficiary Reference ID 84379461629610
Vaccination Details
Vaccine Name COVISHIELD
Vaccine Type COVID-19 vaccine, non-replicating viral vector
Manufacturer Serum Institute of India Pvt. Ltd. Dose # 1st 2nd Date of Dose (YYYY-MM-DD) 2021-07-01 2021-10-19 Dose Batch # 4121MC016 4121P233
“Together, India will defeat
COVID-19” - Prime Minister Narendra Modi
In case of any adverse events, kindly contact the nearest health centre This certificate is compliant with WHO-DDCC:VS data dictionary
This certificate can be verified by scanning the QR code at