Certificate for COVID-19 Vaccination

Issued in India by Ministry of Health & Family Welfare, Govt. of India

Certificate ID 40926580294

Beneficiary Details
Beneficiary Name / लाभाथ च नांव Palak Sanjay Nikam

Age / पराय 15

Gender / लग Female

ID Verified / तपा श ी आयडी Aadhaar # XXXXXXXX6828

Unique Health ID (UHID)

Beneficiary Reference ID 10151476055636
Vaccination Status / वासीनाची ती Partially Vaccinated (1 Dose)

Vaccination Details
Vaccine Name / वासीनाच नांव COVAXIN

Vaccine Type / वासीनाचे कार COVID-19 vaccine, inactivated virus

Manufacturer / कारखानदार Bharat Biotech, India

Dose Number / डोसाचो आं कडो 1/2

Date of Dose / डोसाची तारीश 2022-01-04

Batch Number / वगणाचो आं कडो 37M21045A

Next Due Date / फुडली दय तारीख Between 01 Feb 2022 and 15 Feb 2022

Vaccinated By / वासीन केलां ARUNA GAWAS

Vaccination At / वासीन द ो नामो PHC Candolim 15 To 18, North Goa, Goa

“वखद बी आ ण श बी
Together, India will defeat
COVID-19”
- धान मं ी नर मोदी

In case of any adverse events, kindly contact the nearest Public Health Center/
Healthcare Worker/District Immunization Officer/State Helpline No. 1075

खंयचोय तकूल प रणाम जाणवलो जा ार, उपकार क न लागसर ा भौशीक भलायक क / भलायक
जतनाय कमचारी/ डि इ ुनायझेशन ऑफ सर/रा हॅ लायन . १०७५ / चेर संपक करचो

This certificate can be verified by scanning the QR code at

http://verify.cowin.gov.in