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COVID-19 VACCINATION CERTIFICATE

mation below. Ensure Enter your vaccination details. Only 5ll out the
ils on your doses given in the Philippines. Please leave
Full Name:
the 5elds for the other dose/s
VINCENT blank
JONES if you are
VIZCONDE KO

only partially vaccinated.

Date of Birth:
05-Apr-1995
Vaccination Details
Please tick if your vaccine brand is Johnson & Johnson
Issuer:
Philippine Department of SELECTION
CLEAR Health

Where did you have your 1st Dose Vaccination?

Issuance Date and Time:
Select City/Municipality13-Jan-2022 01:31
City of Las PM NC…
Piñas,

This is a secure QR code Date

and canofbe 1st Dose
verified *: (MM-DD-YYYY)
by using the
scan functionality at https://vaxcert.doh.gov.ph/ Certificate ID: 367566002

06 18 2021
5x.
Date of Vaccine/ Brand, Country of
Dose Number
Where did you have your 2nd Dose Vaccination?
Vaccination Prophylaxis Manufacturer
Lot Number
Vaccination

COVID-19 vaccine, CoronaVac,

1 18-Jun-2021 C20405092 Philippines
Select City/Municipality
inactivated virus SinovacCity of Las Piñas, NC…
COVID-19 vaccine, CoronaVac,
2 Date of 2nd Dose : (MM-DD-YYYY)
18-Jul-2021
inactivated virus * Sinovac
J202106034 Philippines

07 18 2021
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