INTERNATIONAL COVID-19 VACCINATION CERTIFICATE

SERTIFIKAT VAKSINASI COVID-19 INTERNASIONAL

Number / Nomor :
313359323

DETAILS / RINCIAN

Full Name
LAY MEI TJIN
Nama
Lengkap

   National Identity Number
5303054505770001
NIK

Passport Number
C9089452
No.
Passport

Date of Birth 1977-05-05

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

08-May-2021 First / Pertama Indonesia AZD1222 1/2 CTMAV516

02-Aug-2021 Second / Kedua Indonesia AZD1222 2/2 D005A

17-Feb-2022 Third / Ketiga Indonesia COVID-19 Vaccine Pfizer Additional FM9090

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