Certificate for COVID-19 Vaccination

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

Certificate ID 67516899895

Beneficiary Details
Beneficiary Name / ଲାଭାଥୀ ର ନାମ Manas Kumar Das

Age / ବୟସ 25

Gender / ଲ Male

ID Verified / ଆଇଡି ସତ ାପିତ େହାଇଛି Aadhaar # XXXXXXXX5133

Unique Health ID (UHID)

Beneficiary Reference ID 79487092158220
Vaccination Status / ଟୀକାକରଣ ସିତି Fully Vaccinated (2 Doses)

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 2/2

Date of Dose / ଟୀକାକରଣ ତାରୀଖ 05 Jul 2021 20 Oct 2021

Batch Number / େବଚ ନମର 4121MC019 4121MC112

Vaccinated By / ଟିକା େଦଉଥବା ବ କି ନାମ Sanjukta Kumari Dash

Vaccination At / ଟୀକାକରଣ ସାନ Brajendra High School NGR18-44,

Nayagarh, 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