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Ministry of Health

Covid 19 National Vaccination Certificate

Name
Date of birth
VICTOR HUGO MARQUES
20.Jun.1997
RODRIGUES Gender
Mother's Name Masculino
MARIA MARLENE MARQUES RODRIGUES Nationality
ID Brasileiro
015.904.461-86

Doses administered

Date Vaccine* Manufacturer Dose Lot Number CNES**

22.Dec.2021 COVID-19 PFIZER - COMIRNATY PFIZER Dose Adicional FM3884 0010790
COVID-19 ASTRAZENECA ASTRAZENECA
15.Jul.2021 2/2 215VCD134Z 0010790
/FIOCRUZ - COVISHIELD /FIOCRUZ
COVID-19 ASTRAZENECA ASTRAZENECA
22.Apr.2021 1/2 213VCD007W 9578277
/FIOCRUZ - COVISHIELD /FIOCRUZ

* The name of the vaccine is presented from the information of the Prophylaxis Name, Manufacturer/License
Holder - Trade name of the product.
** CNES indicates the Identification Number, at the National Registry of Health Establishments (CNES), of the
one where the vaccine was administered.
CNES 9578277: POLICLINICA LAGO SUL - BRASILIA/DF
CNES 0010790: UBS 1 SAO SEBASTIAO - BRASILIA/DF

Date of the issue : 02.Feb.2022, at 07:58 PM

This certificate is issued free of charge by Conecte SUS

and the information was provided by the National
Health Data Network - DATASUS/Ministry of Health.

Its authenticity can be confirmed through the Conecte

SUS application QR Code reader or on the Valida
Certidao page on the Internet, at validacertidao.saude.
gov.br, entering the code:

K16M.SS1L.PQOZ.RG0F

Remarks: This certificate is valid throughout Brazil. It is not mandatory to hold one. It cannot be used for
discriminatory purposes.
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Ministry of Health

Remarks: This certificate is valid throughout Brazil. It is not mandatory to hold one. It cannot be used for
discriminatory purposes.