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INTERNATIONAL COVID-19 VACCINATION CERTIFICATE

SERTIFIKAT VAKSINASI COVID-19 INTERNASIONAL


Number / Nomor :
692617241

DETAILS / RINCIAN

Full Name
Agnes Sionny Sabaruddin
Nama
Lengkap


   National Identity Number
3171025203470003
NIK

Passport Number
X1944330
No.
Passport

Date of Birth 1947-03-12


Tanggal
Lahir
For further details, please visit
https://verify.kemkes.go.id

VACCINATION DETAILS / RINCIAN VAKSINASI

Date of vaccination
Dose Number
Country of Vaccination
Vaccine Manufacturer
Type
Batch ID

Tanggal Vaksinasi Dosis ke Negara /Tempat Vaksinasi Jenis Vaksin Type Batch ID

11-Feb-2021 First / Pertama Indonesia CoronaVac 1 202011047

12-Mar-2021 Second / Kedua Indonesia CoronaVac 2 24000121

13-Aug-2021 Third / Ketiga Indonesia Moderna 3 009D21A

23-Dec-2022 Fourth / Keempat Indonesia COVID-19 Vaccine Pfizer 4 FX2761

Vaccination is to protect ourselves and our families, neighbors and


protect Indonesian people and people worldwide.

Vaksinasi
melindungi diri kita, keluarga kita, tetangga dan melindungi rakyat
Indonesia dan manusia di seluruh dunia.

World Health Organization Digital Documentation for COVID-19


Certificates Format

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