Provisional Certificate for COVID-19 Vaccination - 1st Dose

Beneficiary Details

Beneficiary Name / பலனா ெபய Gilbert Rozareo F

Age / வய 19

Gender / பா ன Male

ID Verified / அைடயாள சா Aadhaar # XXXXXXXX6407

Unique Health ID (UHID) 40-8238-0674-8643

Beneficiary Reference ID 81816295233760

Vaccination Details

Vaccine Name / த ெபய COVISHIELD

Date of Dose / ேடா வழ க ப ட ேத 17 Jul 2021 (Batch no. 4121Z100)

Next due date / அ த ைவ ேத Between 09 Oct 2021 and 06 Nov 2021

Vaccinated by / த ைய வழ யவ Yamuna

Vaccination at / த வழ க ப ட இட AS Industrial WP, Coimbatore, Tamil

Nadu

“ம ம
மன ட
Together, India will defeat
COVID-19”
- ரதம ம நேர ர ேமா

In case of any adverse events, kindly contact the nearest Public Health Center/
Healthcare Worker/District Immunization Officer/State Helpline No. 1075
ஏேத எ மைற ைள க ஏ ப டா , தய ெச அ காைம ள ெபா
காதார ைமய / ஆேரா ய பராம ப யாள / மாவ ட த அ வல /
மா ல உத எ . 1075ஐ ெதாட ெகா ள .

This certificate can be verified by scanning the QR code at

http://verify.cowin.gov.in