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  • eZC Onsult: Dosage Seq. Date (Mm/dd/yyyy) Vaccine Brand Name of Vaccinator Batch No. Lot No

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    angel
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    This document summarizes Angelica Adaza Ebio's COVID-19 vaccination record. It lists her name, date of birth, address, and contact information. It records that she received her first dose of the Moderna vaccine on September 6, 2021 from Jennifer Celestino and her second dose on October 4, 2021 from Richard Baquiran. Both doses were administered at the NPF Drive Through facility. The document can be validated through the patient's eZConsult app.

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    This document summarizes Angelica Adaza Ebio's COVID-19 vaccination record. It lists her name, date of birth, address, and contact information. It records that she received her first dose of the Moderna vaccine on September 6, 2021 from Jennifer Celestino and her second dose on October 4, 2021 from Richard Baquiran. Both doses were administered at the NPF Drive Through facility. The document can be validated through the patient's eZConsult app.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    20 views2 pages

    eZC Onsult: Dosage Seq. Date (Mm/dd/yyyy) Vaccine Brand Name of Vaccinator Batch No. Lot No

    Uploaded by

    angel
    This document summarizes Angelica Adaza Ebio's COVID-19 vaccination record. It lists her name, date of birth, address, and contact information. It records that she received her first dose of the Moderna vaccine on September 6, 2021 from Jennifer Celestino and her second dose on October 4, 2021 from Richard Baquiran. Both doses were administered at the NPF Drive Through facility. The document can be validated through the patient's eZConsult app.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 2

    COVID-19 Vaccination Card

    *Please keep this record card, which includes medical information about the vaccines you have received.
    *Pakitago ang record card na ito, kung saan mababasa ang impormasyong mrdikal tungkol sa bakunang iyong natanggap.

    Last Name: Ebio First Name: Angelica Middle Name: Adaza Suffix: UN-
    KNOWN

    Address: 137604001 BACLARAN , 137604 CITY OF PARAÑAQUE , 1376 NCR FOURTH DIS- Contact No.: 9556500608
    TRICT , NationalCapitalRegion

    Date of Birth: 06/24/2000 Sex: F Philhealth No.: N/A Category: C

    Dosage Seq. Date Vaccine Name of Vaccinator Batch Lot No.


    (mm/dd/yyyy) Brand No.
    1st Dose 09/06/2021 Moderna

    u l t
    Jennifer P. Celestino

    s
    939894

    n
    2nd Dose 10/04/2021 Moderna Richard Baquiran 083F21B

    1st Booster

    C o -

    eZ
    2nd Booster -

    Health Facility Name(1st Dose): NPF Drive Through Facility Contact No.:
    Health Facility Name(2nd Dose): NPF Drive Through Facility Contact No.:
    Health Facility Name(1st Booster): - Facility Contact No.:
    Health Facility Name(2nd Booster): - Facility Contact No.:
    *To certify the authenticity of this document, please request the patient to show his or her eZConsult app to validate the information.

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