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PATIENT NAME :

NRIC/PASSPORT :
MEDICATION : I/M HEP B VACCINE (FULL DOSE) 0,1,2,6

DATE DOSE LOT. NO. SIGN STAFF SIGN WITNESS


2dose@40mcg

2dose@40mcg

2dose@40mcg

2dose@40mcg

PATIENT NAME :
NRIC/PASSPORT :
MEDICATION : I/M HEP B VACCINE (FULL DOSE) 0,1,2,6

DATE DOSE LOT. NO. SIGN STAFF SIGN WITNESS


2dose@40mcg

2dose@40mcg

2dose@40mcg

2dose@40mcg

PATIENT NAME :
NRIC/PASSPORT :
MEDICATION : I/M HEP B VACCINE (FULL DOSE) 0,1,2,6

DATE DOSE LOT. NO. SIGN STAFF SIGN WITNESS


2dose@40mcg

2dose@40mcg

2dose@40mcg

2dose@40mcg
PATIENT NAME :
NRIC/PASSPORT :
MEDICATION : I/M HEP B VACCINE (BOOSTER DOSE)

DATE DOSE LOT. NO. SIGN STAFF SIGN WITNESS


2 DOSE/2ML

PATIENT NAME :
NRIC/PASSPORT :
MEDICATION : I/M HEP B VACCINE (BOOSTER DOSE)

DATE DOSE LOT. NO. SIGN STAFF SIGN WITNESS


2 DOSE/2ML

PATIENT NAME :
NRIC/PASSPORT :
MEDICATION : I/M HEP B VACCINE (BOOSTER DOSE)

DATE DOSE LOT. NO. SIGN STAFF SIGN WITNESS


2 DOSE/2ML

PATIENT NAME :
NRIC/PASSPORT :
MEDICATION : I/M HEP B VACCINE (BOOSTER DOSE)

DATE DOSE LOT. NO. SIGN STAFF SIGN WITNESS


2 DOSE/2ML
IMMUNISATION HEPATITIS B VACCINE

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