COVID-19 Vaccination

Certificate
Sijil Vaksinasi COVID-19

Basic Information / Maklumat Asas

Medical Record No./BruHims No. : BN00010661

Name/Nama : Norsukryzal Hj Abd Wahab, ( Hj )

IC No./No. Kad Pengenalan : 00280736

Passport no./No. pasport : -

Age/Umur : 41

Gender/Jantina : Male

Date of Birth/Tarikh Lahir : 31 Mar 1980

Telephone No./No. Telefon : 8113153

Vaccine / Vaksin
Dose Batch Brand Country Date of Vaccination
/Dos /Kumpulan /Jenama /Negara /Tarikh Vaksinasi

1st 202012270 Sinopharm BBIBP-CorV Brunei 07 Apr 2021 09:28

2nd 202012270 Sinopharm BBIBP-CorV Brunei 05 May 2021 11:13

3rd 3004736 Moderna Spikevax Brunei 10 Oct 2021 09:36

Note/Nota: The vaccinators should keep the "Vaccination Certificate" properly for inspection (Pemberi vaksinasi hendaklah menyimpan "Sijil Vaksinasi"
dengan baik untuk membuat pemeriksaan).

MINISTRY OF
HEALTH