'ltnt~0rsot 'i>C1Jss

The Department of Disaster Oooe,rnimeinit of

Management, Relief & Rehabilitation ~ a.,f\Jurush.itru

Sayyed Faizan Zeeshan Rizvi

Male20

Tra,u-eit 8a,tegory

Ln•Rt.lo"II 'Id

~7688908227390
».w I 1>ot• » oH ll » ott

08-07-2021 16-09-2021

You may scan t he QRcode

CtJt
to verify t his pass on '\J3t00'l~~Afrf;3)
DMRR Blockchain. SO'U'Ree e<>'W'l~ 'VC'R'lTlCV

Thia ta not n 'llt\010 'Id

Thia Blookcholn aocurod dooumont la Issued by Oep11rtment ol Olsattor Mnniaoemont. RoMol and RohnbWltatlon. Scan tho ORoodo and Vorltv 1h11 docurnonl.
to 11u1honuc010 111 volidoty U RL· htlt>S I/block dm,r mohnonlono QOV IIV\IRl•l)l)l5?od•4d5 10bd71C3817153358d89231o63"2dll0018833od 1b08779c3d37cm10125:lb1
 I.....
Mlnlatry of Health & Family Welfare
Government of India

Certificate for COVID-19 Vaccination

Issued In India by Ministry of Health & Family Welfare, Govt. of India
Cer1Hlcate1D •284123903

Beneficja,:y Details
Beneficiary Name I Mll!Teffa mr SAYYED FAIZAN ZEESHAN RIZVI
Age / <l?J ·2D

Gender I fwr Male

ID Verified / 3fla561 4:4 PAN Card II FDAPR21DDR

Unique Health ID (UHID)

Beneficiary Reference ID 11775813105900

Vaccination Status I <"1-tflc'5M ™ Fully Vaccinated (2 Doan)

Vaccination Details
Vaccine Name I ~ mi COVISHIELD

Vaccine Type I ~ Wl>R COVID-19 vaccine, non-repllcatlng viral vector

Manufacturer I ~ Serum Institute of lndla Pvt. Ltd.

Dose Number / m~ 1/2 2/2

Date of Dose I ~ ~ 2021-09-15 2021-12-01

Batch Number / ifq ~ 4121MC080 412.241

Vaccinated By / <liill1,1~ t"l-tflc'5M PRIYANKAPAWAR

Vaccination At / t"l-tflc'5M lil ~ MALVANI 2 UPHC, Mumbai, Maharashtra

+
+
litlN~3MUl'~Ra~
Together, India will defeat
COVID-19"
. lfflJNR •. ""'11Wt

In cese of any adverse events. kindly contact the nearest Public Health Center/
Healthcare Worker/ District Immunization Officer/St11to Helpline No. 1075

~ ~ ll'ftvTrq llTl?f' llTll'll"mf'l"ll~~ 31TTI1lf~ ~

~ ~ ~ ~ TI';ilQ ~wll'lcr; to1t<, ~ ~ l!TUT.

COWIN
+
Winning Over COVID + This certificate can be verified by scanning the QR co de at
 Name: Sayyed Faizan Zeeshan Rizvi Age/Gender: 28/04/2003 , Male
0000 00213 1702

Referred By: N.A Client Name: N.A

Collection Date: 09-02-2021 17:39:50 Report Release Date: 10-02-2021 02:49:57

Sr.No Investigation Observed Value Reference Range

1 SARS-CoV-2 RT-PCR Not Detected

Swab, Method: RT PCR

2 CT Value for ORF1ab Gene --

Swab, Method: RT PCR

Target Selected :ORF1ab and N gene (SARS-CoV-2 specific)

Equipment :BIORAD CFX96 Real Time System.
ICMR Registration No :RPPLCMM

Interpretation :
1. SARS-CoV-2 NEGATIVE: The 2019 novel corona virus (SARS-CoV-2) target nucleic acids are not detected.
2. SARS-CoV-2 POSITIVE: The 2019 novel corona virus (SARS-CoV-2) target nucleic acids are detected.
3. SARS-CoV-2 PRESUMPTIVE POSITIVE: The 2019 novel corona virus (SARS-CoV-2) target nucleic acids may be
present. Sample should be retested. For samples with a repeated presumptive positive result, additional confirmatory
testing may be contacted with fresh sample.

Clinical Indications :
Clinical Indications:COVID-19 is an infectious disease caused by the virus strain "severe acute respiratory syndrome
coronavirus 2" (SARS-CoV-2), Common signs of infection include respiratory symptoms, fever, cough, shortness of
breath and breathing difficulties. In more severe cases, infection can causes pneumonia, severe acute respiratory syndrome
and kidney failure.

Limitations :
1. Presence of PCR inhibitors may interfere with PCR amplification.
2. Negative result does not rule out the possibility of infection. Presence of inhibitors, mutations & insufficient organism
RNA can influence the result.
3. Performance of the SARS-CoV-2 has only been established in nasopharyngeal swab specimen.
4. A false negative result may occur if a specimen is in improperly collected, transported or handle. False negative result
may also occur if the RNA virus in adequately present in the specimen

Disclaimer :
1. The intention of the test is for use in conjunction with clinical presentation and other laboratory markers.
2. Improper sample collection, handling, storage and transportation may results in false negative results.
3. Sensitivity of this test depends on the quality of the sample submitted for the testing.
Note :
Note: All the positive cases will be notified to ICMR for further surveillance.

* The analyte is not in the lab scope.

CRM No :2131702
Sample Received Time: 09-02-2021 17:42:24 Authorized Signatory Authorized Signatory
Report Release Date: 10-02-2021 02:49:57 Dr Anju Dhar Dr. Mahesh Hampe
Patient Name: RASIK BOGATI MD (Microbiologist) MD (Biochemistry) Page 1 of 1
Patient ID: 2131702