Provisional Certificate for COVID-19 Vaccination - 1st Dose

Beneficiary Details

Beneficiary Name / ଲାଭାଥୀ ର ନାମ Kaushik Kumar Mohanty

Age / ବୟସ 34

Gender / ଲ Male

ID Verified / ଆଇଡି ସତ ାପିତ େହାଇଛି Aadhaar # XXXXXXXX9510

Unique Health ID (UHID) 74-7270-6081-3432

Beneficiary Reference ID 31945105251410

Vaccination Details

Vaccine Name / ଟିକା ନାମ COVISHIELD

Date of Dose / ଟୀକାକରଣ ତାରୀଖ 28 Jun 2021 (Batch no. 4121Z109)

Next due date / ପରବ ୀ ଟୀକାକରଣ ତାରିଖ Between 20 Sep 2021 and 18 Oct 2021

Vaccinated by / ଟିକା େଦଉଥବା ବ କି ନାମ Amrita Kerketta

Vaccination at / ଟୀକାକରଣ ସାନ Koira Chc, Sundargarh, 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 is a secure QR code. For further details, please visit

https://verify.cowin.gov.in