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Certificate for COVID-19 Vaccination

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


Certificate ID 34789842894

Beneficiary Details
Beneficiary Name / लाभाथ का नाम Pankaj Singh

Age / उ 20

Gender / लग Male

ID Verified / पहचान प स ा पत PAN Card # NSLPS1334H

Unique Health ID (UHID)


Beneficiary Reference ID 66985097073390

Vaccination Status / टीकाकरण क त Fully Vaccinated (2 Doses) and a Precaution Dose

Vaccination Details
Vaccinated By / टीका लगाने वाले का नाम Rekha Devi
KPM WP Kanodia Dhara. CV 18, Kanpur Nagar, Uttar
Vaccination At / टीकाकरण का ान Pradesh

Dose Number Date of Dose Vaccine Name Batch Number Vaccine Type Manufacturer
खुराक क सं या खुराक क तारीख वै ीन का नाम बैच सं या टीका का कार उ पादक

COVID-19 vaccine, Serum Institute of India Pvt.


1/2 08 Oct 2021 COVISHIELD 4121MF010 non-replicating viral vector Ltd.

COVID-19 vaccine, Serum Institute of India Pvt.


2/2 02 Jan 2022 COVISHIELD 4121MC152 non-replicating viral vector Ltd.

COVID-19 vaccine, Serum Institute of India Pvt.


Precaution dose 21 Aug 2022 COVISHIELD 4122Z017M non-replicating viral vector Ltd.

“दवाई भी और कड़ाई भी।


Together, India will defeat
COVID-19”
- धानमं ी नर मोदी

In case of any adverse events, kindly contact the nearest Public Health Center/
Healthcare Worker/District Immunization Officer/State Helpline No. 1075
टीकाकरण प ात कसी तकूल घटना के होने पर नज़दीक ा क / ा कम / जला टीकाकरण
अ धकारी/रा ह लाइन 1075 पर स क कर

This certificate can be verified by scanning the QR code at


http://verify.cowin.gov.in

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