INTERNATIONAL COVID-19 VACCINATION CERTIFICATE

SERTIFIKAT VAKSINASI COVID-19 INTERNASIONAL

Number / Nomor :
206048302

DETAILS / RINCIAN

Full Name
SUPIYANTO
Nama
Lengkap

   National Identity Number
3175092606690005
NIK

Passport Number
S415042
No.
Passport

Date of Birth 1969-06-26

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

02-Mar-2021 First / Pertama Indonesia CoronaVac 1/2 24000721

18-Mar-2021 Second / Kedua Indonesia CoronaVac 2/2 24000721

31-Jan-2022 Third / Ketiga Indonesia COVID-19 Vaccine Pfizer Additional fm2957

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