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Vaccination Certificate

This document is a COVID-19 vaccination certificate issued in India, confirming that Dilip Madhukar Kolambe, a 29-year-old male, is fully vaccinated with two doses of the COVISHIELD vaccine. The vaccinations were administered by L.B. Nikwade at Kadav PHC in Raigad, Maharashtra, with the first dose on September 9, 2021, and the second on December 3, 2021. The certificate includes a QR code for verification and contact information for reporting any adverse events.

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kolambekiran3
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54 views1 page

Vaccination Certificate

This document is a COVID-19 vaccination certificate issued in India, confirming that Dilip Madhukar Kolambe, a 29-year-old male, is fully vaccinated with two doses of the COVISHIELD vaccine. The vaccinations were administered by L.B. Nikwade at Kadav PHC in Raigad, Maharashtra, with the first dose on September 9, 2021, and the second on December 3, 2021. The certificate includes a QR code for verification and contact information for reporting any adverse events.

Uploaded by

kolambekiran3
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Certificate for COVID-19 Vaccination

Issued in India by Ministry of Health & Family Welfare, Govt. of India


Certificate ID 16772416747

Beneficiary Details
Beneficiary Name / लाभाथ चे नाव Dilip Madhukar Kolambe

Age / वय 29

Gender / लग Male

ID Verified / ओळखप Aadhaar # XXXXXXXX7587

Unique Health ID (UHID)


Beneficiary Reference ID 21393115563749

Vaccination Status / लसीकरण ती Fully Vaccinated (2 Doses)

Vaccination Details
Vaccinated By / यां ा ार लसीकरण [Link]

Vaccination At / लसीकरणाचे ळ Kadav PHC Karjat, Raigad, Maharashtra

Dose Number Date of Dose Vaccine Name Batch Number Vaccine Type Manufacturer
डोस मांक डोसची तारीख लसीचे नाव बॅच मांक लस कार उ पादक

COVID-19 vaccine,
1/2 09 Sep 2021 COVISHIELD 4121MC078 non-replicating viral vector Serum Institute of India

COVID-19 vaccine, Serum Institute of India Pvt.


2/2 03 Dec 2021 COVISHIELD 4121Z241 non-replicating viral vector Ltd.

औषध सु ा आ ण श सु ा
Together, India will defeat
COVID-19”
- पंत धान ी. नर मोदी

In case of any adverse events, kindly contact the nearest Public Health Center/
Healthcare Worker/District Immunization Officer/State Helpline No. 1075
कोणतेही तकूल प रणाम आढळू न आ यास कृपया जवळचे सावज नक आरो य क / आरो यसेवा
कमचारी/ ज हा लसीकरण अ धकारी/ रा य ह पलाइन मांक १०७५ वर संपक साधा.

This certificate can be verified by scanning the QR code at


[Link]

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