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LYCEUM

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LYCEUM VrzcaRRe
CERTIFICATE OF IMMU NIZATION r-,4 IHa fllJ,PF,IES
UNIVLRSI'IY L)r\i,No!rr. Cinlra

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This is to cerlify thot

NS tin rBofi L, {B t
d,

hos been voccinoled with the voccine(s) described below on the following dotes:

Dec. 4 . zulb
Hepotitis A

Hepotitis B 20 pg (Hepovox Gene TF) 1st dose 2nd dose 3rd dose
Dec.4.2015 Feb" 22, 2016 Feb" 21,2417

Dr Iin
Medicol Direcior QMR
Vizcorro Diognostic Center

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