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INTERNATIONAL COVID-19 VACCINATION CERTIFICATE

SERTIFIKAT VAKSINASI COVID-19 INTERNASIONAL


Number / Nomor :
300811619

DETAILS / RINCIAN

Full Name
SAMSIADI
Nama
Lengkap


   National Identity Number
6403055209770003
NIK

Passport Number
SAMSIADI
No.
Passport

Date of Birth 1977-09-12


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 24001921

11-May-2021 Second / Kedua Indonesia CoronaVac 2/2 24002221

22-Jan-2022 Third / Ketiga Indonesia COVID-19 Vaccine Pfizer Additional 330408D

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

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