E - VACCINATION CERTIFICATE

Ref ID: 19360951131741

Date of Birth: 02-DEC-2020
Name: Kusum
Gender: F emale
ABHA ID: N/ A ABHA Address: N/ A
Guardian Name: Lalita Guardian ref ID: 20323853351740
Vaccination Date: 11-Sep-2023 Vaccinated At: SHC C HENPUR A DEM,
NEEMUC H, MADHYA PR ADESH
Vaccinated By: Durga Patidar

BIRTH 1 ½ MONTHS 2 ½ MONTHS 3 ½ MONTHS 9 MONTHS

Date of Birth Next Vaccination Date Next Vaccination Date Next Vaccination Date Next Vaccination Date
02/12/2020 / / / / / / 29/08/2021

DATE OF VACCINATION DATE OF VACCINATION DATE OF VACCINATION DATE OF VACCINATION DATE OF VACCINATION
(dd/mm/yyyy): (dd/mm/yyyy): (dd/mm/yyyy): (dd/mm/yyyy): (dd/mm/yyyy):

OPV-0 02/12/2020 OPV-1 23/02/2021 OPV-2 23/03/2021 OPV-3 28/05/2021 MR-1 14/08/2023

Hep B -
Birth 02/12/2020 Penta -1 23/02/2021 Penta-2 23/03/2021 Penta-3 28/05/2021 Vit A-1 / /
Dose

PCV-
BCG 02/12/2021 RVV-1 23/02/2021 RVV-2 23/03/2021 RVV-3 28/05/2021 Booster / /

PCV-1 23/02/2021 PCV-2 28/05/2021 fIPV-3 / /

fIPV-1 23/02/2021 fIPV-2 28/05/2021

16-24 MONTHS 5-6 YEARS VITAMIN A

Next Vaccination Date Next Vaccination Date
06/04/2024 01/12/2025 CHILD AGE DATE GIVEN (dd/mm/yyyy) CHILD AGE DATE GIVEN (dd/mm/yyyy)

DATE OF VACCINATION
(dd/mm/yyyy):
DATE OF VACCINATION
(dd/mm/yyyy): Vit A-3 2.0 Years / / Vit A-7 4.0 Years / /
DPT DPT
Booster-
1
14/08/2023 Booster-
2
/ / Vit A-4 2.5 Years / / Vit A-8 4.5 Years / /
SIA / OTHERS
MR-2 11/09/2023
Vit A-5 3.0 Years / / Vit A-9 5.0 Years / /
VACCINE DATE GIVEN
NAME (dd/mm/yyyy)
Vit A-6 3.5 Years / /
OPV -
14/08/2023
Booster

"Let no child suffer from any vaccine

Vit A-2 / / preventable diseases"
- Shri Narendra Modi,
In case of any adverse events, kindly contact the nearest Health Prime Minister
Center/ Healthcare Worker/ District immunization Officer