Noc For Tetanus Vaccine

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NOC FOR TETANUS VACCINE

[Father’s Name]……………………………………………………………………..
[Address]…………………………………………………………………………..
[City, State, PIN]……………………………………………………………………
[Email Address]…………………………………………………………………….
[Phone Number]…………………………………………………………………..
[Date]……………………………………………………………………………

To Whom It May Concern,


I, [Name]………………………………………(Fathers name) hereby give my consent for the
administration of the tetanus vaccine to my ward …………………………………...(student
name) of class ………………...at KV BHEL JAGDISHPUR AMETHI. I understand that this
vaccine is being provided to prevent tetanus infection and I have received information about
the benefits and possible side effects of this vaccination.
I confirm that I have been informed about:
The purpose of the tetanus vaccine.
The potential side effects, which may include but are not limited to soreness at the injection
site, mild fever, and headache.

Student's Name: […………………………………………….]


Date of Birth: [………………………………………………..]
Date: […………………………………………………]
Fathers name [………………………………………..……….]
Signature: [……………………………………………]

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