COVID-19 Vaccination Card

Please keep this record card, which includes medical information Card ID no.
about the vaccines you have received.
881772

CONDE JOHN RAY GENOLOS

Last Name First Name M.I. Suffix

137604015 SUN VALLEY, 137604 CITY OF

Address PARAÑAQUE, 1376 NCR FOURTH Contact No. +639215768500
DISTRICT, NationalCapitalRegion

Date of Birth 01/13/1998 Sex m Philhealth No. N/A Category C

Dosage Seq. Date Vaccine Manufacturer Batch No. Lot No.

1st Dose Schedule 08/14/2021 Moderna 059D21A

Vaccinator Name: JAIRUS KARL GONZALES

2nd Dose Schedule

Vaccinator Name:

Health Facility Name: NPF Drive Through Contact No.: +6300000000