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Vacc Card

This document is a vaccination card that tracks influenza and pneumonia vaccines received by a patient over multiple years. It includes fields for the patient's name and address and charts for recording the administration date, vaccine lot number, administering person's name and signature for influenza and pneumonia vaccines in 2021, 2022, and 2023.

Uploaded by

Yana Pot
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
22 views

Vacc Card

This document is a vaccination card that tracks influenza and pneumonia vaccines received by a patient over multiple years. It includes fields for the patient's name and address and charts for recording the administration date, vaccine lot number, administering person's name and signature for influenza and pneumonia vaccines in 2021, 2022, and 2023.

Uploaded by

Yana Pot
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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VACCINATION CARD

Name:
Address:
VACCINES
2021 2022 2023
Administration
date
Influenza Lot No.
Administered by:
(Name and
Signature)
Administration
date
Lot No.
Pneumonia Administered by:
(Name and
Signature)

VACCINATION CARD
Name:
Address:
VACCINES
2021 2022 2023
Administration
date
Influenza Lot No.
Administered by:
(Name and
Signature)
Administration
date
Lot No.
Pneumonia Administered by:
(Name and
Signature)

VACCINATION CARD
Name:
Address:
VACCINES
2021 2022 2023
Administration
date
Influenza Lot No.
Administered by:
(Name and
Signature)
Administration
date
Lot No.
Pneumonia Administered by:
(Name and
Signature)

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