Certificate for COVID-19 Vaccination

Issued in India by Ministry of Health & Family Welfare, Govt. of India

Certificate ID 55212619457

Beneficiary Details
Beneficiary Name / लाभाथ का नाम Devendra Goswami

Age / उ 41

Gender / लग Male

ID Verified / पहचान प स ा पत PAN Card # AOEPG5704P

Unique Health ID (UHID)

Beneficiary Reference ID 34651854080398
Vaccination Status / टीकाकरण क त Fully Vaccinated (2 Doses) and a Precaution Dose

Vaccination Details
Vaccine Name / वै ीन का नाम COVISHIELD

Vaccine Type / टीका का कार COVID-19 vaccine, non-replicating viral vector

Manufacturer / उ पादक Serum Institute of India Pvt. Ltd.

Dose Number / खुराक क सं या 1/2 2/2 Precaution dose

Date of Dose / खुराक क तारीख 28 Jan 2021 05 Mar 2021 10 Jan 2022

Batch Number / बैच सं या 4120Z013 4120Z013 4121MC110

Vaccinated By / टीका लगाने वाले का नाम Jyotsana

Vaccination At / टीकाकरण का ान MLG Female Hospital 18 Plus, Aligarh,

Uttar Pradesh

“दवाई भी और कड़ाई भी।

Together, India will defeat
COVID-19”
- धानमं ी

In case of any adverse events, kindly contact the nearest Public Health Center/
Healthcare Worker/District Immunization Officer/State Helpline No. 1075

टीकाकरण प ात कसी तकूल घटना के होने पर नज़दीक ा क / ा कम / जला टीकाकरण

अ धकारी/रा ह लाइन 1075 पर स क कर

This certificate can be verified by scanning the QR code at

http://verify.cowin.gov.in