Provisional Certificate for COVID-19 Vaccination - 1st Dose

Beneficiary Details

Beneficiary Name / பலனா ெபய Ayyammal

Age / வய 48

Gender / பா ன Female

ID Verified / அைடயாள சா Aadhaar # XXXXXXXX3469

Unique Health ID (UHID)

Beneficiary Reference ID 31580217372727

Vaccination Details

Vaccine Name / த ெபய COVISHIELD

Date of 1st Dose / த ேடா ேத 28 Jul 2021 (Batch no. 4121MC037)

Next due date / அ த ைவ ேத Between 20 Oct 2021 and 17 Nov 2021

Vaccinated by / த ைய வழ யவ Raja

Vaccination at / த வழ க ப ட இட TP Mills UPHC Workplace, Sivakasi,

Tamil Nadu

“ம ம
மன ட
Together, India will defeat
COVID-19”
- ரதம ம நேர ர ேமா

In case of any adverse events, kindly contact the nearest Public Health Center/
Healthcare Worker/District Immunization Officer/State Helpline No. 1075
ஏேத எ மைற ைள க ஏ ப டா , தய ெச அ காைம ள ெபா
காதார ைமய / ஆேரா ய பராம ப யாள / மாவ ட த அ வல /
மா ல உத எ . 1075ஐ ெதாட ெகா ள .

This certificate can be verified by scanning the QR code at

http://verify.cowin.gov.in