Certificate for COVID-19 Vaccination

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

Certificate ID 26919742518

Beneficiary Details
Beneficiary Name / ଲାଭାଥୀ ର ନାମ Smurti Akash Jena

Age / ବୟସ 18

Gender / ଲ Male

ID Verified / ଆଇଡି ସତ ାପିତ େହାଇଛି Aadhaar # XXXXXXXX3122

Unique Health ID (UHID)

Beneficiary Reference ID 52273458749950
Vaccination Status / ଟୀକାକରଣ ସିତି Partially Vaccinated (1 Dose)

Vaccination Details
Vaccine Name / ଟିକା ନାମ COVISHIELD

Vaccine Type / ଟିକା ପକାର COVID-19 vaccine, non-replicating viral vector

Manufacturer / ନିମାତା Serum Institute of India Pvt. Ltd.

Dose Number / େଖାରାକ ନମର 1/2

Date of Dose / ଟୀକାକରଣ ତାରୀଖ 11 Jan 2022

Batch Number / େବଚ ନମର 4121AA071M

Next Due Date / ପରବ ୀ ଟୀକାକରଣ ତାରିଖ Between 05 Apr 2022 and 03 May 2022

Vaccinated By / ଟିକା େଦଉଥବା ବ କି ନାମ Truptimayee Sahoo

Vaccination At / ଟୀକାକରଣ ସାନ Karilopatana PHC-1, Kendrapara, Odisha

“ଔଷଧ ମ ଏବଂ କେଠାରତା ମ

Together, India will defeat
COVID-19”
- ପଧାନମନୀ ନେର େମାଦି

In case of any adverse events, kindly contact the nearest Public Health Center/
Healthcare Worker/District Immunization Officer/State Helpline No. 1075
େକୗଣସି ପକାର ପତିକୂଳ ଘଟଣା ଘଟିେଲ ଦୟାକରି ନିକଟସ ଜନସାସ େକ / ସାସ େସବା କମୀ / ଜିଲା
ଟୀକାକରଣ ଅଫସର / ରାଜ େହଲଲାଇନ ନମର 1075 ସହିତ େଯାଗାେଯାଗ କର

This certificate can be verified by scanning the QR code at

http://verify.cowin.gov.in