Certificate of immunization against the novel coronavirus infection COVID-19 or medical

contraindications to vaccination and (or) recovery from a disease caused by the novel
coronavirus infection COVID-19

Abdulaev Andrei
Date of birth 6H[
19.02.1994 0DOH
Personal identity document ,QWHUQDWLRQDOLGHQWLW\GRFXPHQW
4515 052290 
Personal insurance policy number 3ROLF\RIREOLJDWRU\PHGLFDOLQVXUDQFH

161-122-501 02 

№ 1000 0380 1484 7949

Information about immunization against the novel coronavirus

infection COVID-19
Vaccination record Information about the medicinal product (name, Name of the medical institution
number manufacturer, batch and date of vactination)

630000028792446 Gam-COVID-Vac (“Sputnik V”), combined heterologous GBUZ SO "TGP N 2"

recombinant adenovirus (rAd)-based vaccine for
prophylaxis of coronavirus infectious diseases caused by g. Toliatti, ul. Banykina, d. 8, kor.
SARS-CoV-2 14

The Federal Government Budgetary Institution “National

Research Center for Epidemiology and Microbiology
named after Honorary Academician N.F. Gamaleya” of
the Ministry of Health of the Russian Federation, series
I-220521
July 6, 2022

Gam-COVID-Vac (“Sputnik V”), combined heterologous GBUZ SO "TGP N 2"

recombinant adenovirus (rAd)-based vaccine for
prophylaxis of coronavirus infectious diseases caused by g. Toliatti, ul. Gorkogo, d. 61
SARS-CoV-2
The Federal Government Budgetary Institution “National
Research Center for Epidemiology and Microbiology
named after Honorary Academician N.F. Gamaleya” of
the Ministry of Health of the Russian Federation, series
II-770621
July 29, 2022
Information about recovery from a disease caused by the novel
coronavirus infection COVID-19 (if any)

There is no data