INTERNATIONAL COVID-19 VACCINATION CERTIFICATE

SERTIFIKAT VAKSINASI COVID-19 INTERNASIONAL

Number / Nomor :
764993418

DETAILS / RINCIAN

Full Name
TEDDY PRAWIRO
Nama
Lengkap

National Identity Number

3523162406910001

  
NIK

Passport Number
X1264817
No.
Passport

Date of Birth 1991-06-24

Tanggal
Lahir
For further details, please visit
https://verify.kemkes.go.id

VACCINATION DETAILS / RINCIAN VAKSINASI

Date of vaccination
Dose Number
Country of Vaccination
Vaccine Manufacturer
Type
Batch ID

Tanggal Vaksinasi Dosis ke Negara /Tempat Vaksinasi Jenis Vaksin Type Batch ID

13-Apr-2021 First / Pertama Indonesia CoronaVac 1/2 24001521

30-Apr-2021 Second / Kedua Indonesia CoronaVac 2/2 24001521

21-Aug-2021 Third / Ketiga Indonesia Moderna Additional 021D21A

Vaccination is to protect ourselves and our families, neighbors and

protect Indonesian people and people worldwide.

Vaksinasi
melindungi diri kita, keluarga kita, tetangga dan melindungi rakyat
Indonesia dan manusia di seluruh dunia.

World Health Organization Digital Documentation for COVID-19

Certificates Format