Certificate for COVID-19 Vaccination

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

Certificate ID 23275056061

Beneficiary Details
Beneficiary Name / ಫ ಾನುಭ ಯ ಸರು Marianna Betadappa

Age / ವಯಸು 29

Gender / ಂಗ Male

ID Verified / ಐ. . ಗುರುತು Aadhaar # XXXXXXXX0316

Unique Health ID (UHID)

Beneficiary Reference ID 16282994666026
Vaccination Status / ಲ ೕ ಗ Fully Vaccinated (2 Doses)

Vaccination Details
Vaccinated By / ಲ ೕ ದವರು SHEELA

Vaccination At / ಲ ಾ ದ ಸಳ SC BUDAGUMPA, Koppal, Karnataka

Dose Number Date of Dose Vaccine Name Batch Number Vaccine Type Manufacturer
ೂೕ ಸಂ ೂೕ ಾಂಕ ಲ ಸರು ಾ ಸಂ ಾವ ೕ ಯ ಲ ತ ಾರಕರು

COVID-19 vaccine, Serum Institute of India Pvt.

1/2 23 Oct 2021 COVISHIELD 4121MC107 non-replicating viral vector Ltd.

COVID-19 vaccine, Serum Institute of India Pvt.

2/2 29 Jan 2022 COVISHIELD 4121AA070M non-replicating viral vector Ltd.

“ಔಷ /ಲ ೕಕು,
ೂ ದೃಢ ೕಕು
Together, India will defeat
COVID-19”
- ಪ ಾನಮಂ ನ ೕಂದ ೕ

In case of any adverse events, kindly contact the nearest Public Health Center/
Healthcare Worker/District Immunization Officer/State Helpline No. 1075
ಾವ ೕ ಅಡಪ ಾಮ ಉಂ ಾದ ಸಂದಭ ದ , ದಯ ಟು ಸ ೕಪದ ಾವ ಜ ಕ ಆ ೂೕಗ
ೕಂದ /ಆ ೂೕಗ ಶುಷೂ ಾಯ ಕ / ಾ ಲ ಅ ಾ / ಾಜ ಸ ಾಯ ಾ ಸಂ. 1075
ಸಂಪ

This certificate can be verified by scanning the QR code at

http://verify.cowin.gov.in