INTERNATIONAL COVID-19 VACCINATION CERTIFICATE

SERTIFIKAT VAKSINASI COVID-19 INTERNASIONAL

Number / Nomor :
346664500

DETAILS / RINCIAN

Full Name
I Gede Maha Putra
Nama
Lengkap

   National Identity Number
5171012712940003
NIK

Passport Number
C9696109
No.
Passport

Date of Birth 1994-12-27

For further details, please visit Tanggal
Lahir
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

29-Jan-2021 First / Pertama Indonesia CoronaVac 1 202009009

12-Feb-2021 Second / Kedua Indonesia CoronaVac 2 202011047

13-Aug-2021 Third / Ketiga Indonesia Moderna 3 009D21A

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