Certificate for COVID-19 Vaccination

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

Certificate ID 30481121315

Beneficiary Details
Beneficiary Name / लाभाथ च नांव Urvesh Pandurang Vernekar

Age / पराय 22

Gender / लग Male

ID Verified / तपा श ी आयडी Aadhaar # XXXXXXXX4072

Unique Health ID (UHID)

Beneficiary Reference ID 10151736886055
Vaccination Status / वासीनाची ती Fully Vaccinated (2 Doses)

Vaccination Details
Vaccine Name / वासीनाच नांव COVISHIELD

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

Manufacturer / कारखानदार Serum Institute of India Pvt. Ltd.

Dose Number / डोसाचो आं कडो 1/2 2/2

Date of Dose / डोसाची तारीश 10 Aug 2021 19 Nov 2021

Batch Number / वगणाचो आं कडो 4121MC018 4121MC038

Vaccinated By / वासीन केलां PRINCY PETKAR

Vaccination At / वासीन द ो नामो PHC Candolim 2, North Goa, Goa

“वखद बी आ ण श बी
Together, India will defeat
COVID-19”
- धान मं ी नर मोदी

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

खंयचोय तकूल प रणाम जाणवलो जा ार, उपकार क न लागसर ा भौशीक भलायक क / भलायक
जतनाय कमचारी/ डि इ ुनायझेशन ऑफ सर/रा हॅ लायन . १०७५ / चेर संपक करचो

This certificate can be verified by scanning the QR code at

http://verify.cowin.gov.in