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    CECEP

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    8 views1 page

    CECEP

    Uploaded by

    AI SRIYANTI
    CECEP

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    KARTU VAKSINASI COVID-19

    No. Tiket : UU-0020JXT No. NIK : 3206012205900002


    Nama Lengkap : CECEP SUGARA ANDI BRATA
    Tanggal Lahir : 1990-05-26
    No.HP : 082216172902
    Alamat : KP.CIANDUM 06/01, DESA.CIANDUM KEC. CIPATUJAH
    Lokasi Menerima : CIPATUJAH - 10222401

    Riwayat Pemberian Vaksin Covid-19

    Tanggal Nama No.Batch Lokasi Keterangan


    Vaksinasi Vaksin Menerima

    2021-03-29 CoronaVac 24001021 CIPATUJAH - Datang kembali di Vaksin tanggal 12 April 2021
    09:52:00 10222401

    2021-04-12 CoronaVac 24001021 CIPATUJAH - Selesai divaksin


    09:27:00 10222401

    2023-05-09 Zifivax A202108181 CIPATUJAH - SUDAH DI VAKSIN DENGAN NO. SERI PAA173696
    09:24:00 10222401 DAN TETAP PATUHI PROKES

    Catatan:
    Apabila terdapat gejala pasca dilakukan vaksinasi dapat menghubungi :
    Nama : AI SRIYANTI
    No Telp : 081323172902

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