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Republic of the Philippines

Bangsamoro Autonomous Region in Muslim Mindanao


Ministry of Health
Integrated Provincial Health Office
RURAL HEALTH UNIT
SULTAN KUDARAT
Brgy. Katuli, Sultan Kudarat Maguindanao

VACCINE CERTIFICATE

Name: UTAR, SURAIDA SANSON Age: 30 Sex: & FEMALE


MALE
Birthdate: 11/15/1992
Address: Purok 3 Banubo Sultan Kudarat
Maguindanao.
VACCINATION HUB:
SCHOOL
PROVINCIAL HOSPITAL
MALL
DISTRICT HOSPITAL
OTHERS, SPECIFY:
MUNICIPAL HOSPITAL
______________
RURAL HEALTH UNIT

This is to certify that Mr/Ms. UTAR, SURAIDA SANSON was given dose/s of PFIZER vaccine
with lot No.FH0160 Batch no.PAA174601 at Brgy. Banubo, Sultan Kudarat Maguindanao.

This certification has been issued upon the request of above-named person for
whatever legal purpose may serve him/her best.

Given this 2nd of March, 2023 at Brgy. Katuli Sultan Kudarat, Maguindanao.

confirmed by:

RAHMA M MOKHALID RM,BSM FARHAN E. MELING, RN

License No: 0171429


License no: 000000

RURAL HEALTH MIDWIFE


NDP

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