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MAKLUMAT PENERIMA VAKSIN / VACCINEE DETAILS

Nama / Name
AHMAD HUSSAINI BIN AZIZAN
Warganegara / Nationality
Malaysian

MALAYSIA No. Kad Pengenalan / Identity No. No. Pasport / Passport No.
911218025073 _

SIJIL DIGITAL Tarikh Lahir / Date of Birth


18-Dec-1991
VAKSINASI COVID-19
DIGITAL CERTIFICATE for COVID-19 Kementerian Berkuasa / Authority Ministry
VACCINATION KEMENTERIAN KESIHATAN (MINISTRY OF HEALTH)
Negara Pengeluar / Issuing Country
MALAYSIA
Tarikh Dikeluarkan / Date Issued
12-Feb-2022
Page 1 of 2

MAKLUMAT VAKSINASI / VACCINATION DETAILS

Dose 1 of 2 Tarikh Divaksin / Date of Vaccination


27-Jul-2021
Pusat Pemberian Vaksin / Vaccination Center
AMS OSRAM IN-HOUSE VACCINATION CENTRE
Nama Produk / Product name
CoronaVac
Nama Umum / Common Name
Sinovac
Pengeluar / Manufacturer Jenis Vaksin / Vaccine Type
Sinovac Biotech covid-19 vaccines
No. Lot / Batch No.
202106050P

Dose 2 of 2 Tarikh Divaksin / Date of Vaccination


22-Aug-2021
Pusat Pemberian Vaksin / Vaccination Center
AMS OSRAM IN-HOUSE VACCINATION CENTRE
Nama Produk / Product name
CoronaVac
Nama Umum / Common Name
Sinovac
Pengeluar / Manufacturer Jenis Vaksin / Vaccine Type
Sinovac Biotech covid-19 vaccines
No. Lot / Batch No.
202107107I
MAKLUMAT PENERIMA VAKSIN / VACCINEE DETAILS
Nama / Name
AHMAD HUSSAINI BIN AZIZAN
Warganegara / Nationality
Malaysian

MALAYSIA No. Kad Pengenalan / Identity No. No. Pasport / Passport No.
911218025073 _

SIJIL DIGITAL Tarikh Lahir / Date of Birth


18-Dec-1991
VAKSINASI COVID-19
DIGITAL CERTIFICATE for COVID-19 Kementerian Berkuasa / Authority Ministry
VACCINATION KEMENTERIAN KESIHATAN (MINISTRY OF HEALTH)
Negara Pengeluar / Issuing Country
MALAYSIA
Tarikh Dikeluarkan / Date Issued
12-Feb-2022
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MAKLUMAT VAKSINASI / VACCINATION DETAILS

Booster Dose Tarikh Divaksin / Date of Vaccination


07-Jan-2022
Pusat Pemberian Vaksin / Vaccination Center
PPV Offsite Tapak Pesta Sungai Nibong
Nama Produk / Product name
Comirnaty
Nama Umum / Common Name
Pfizer
Pengeluar / Manufacturer Jenis Vaksin / Vaccine Type
Biontech Manufacturing GmbH SARS-CoV-2 mRNA vaccine
No. Lot / Batch No.
FP8233

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