Vaccine Card - 20240322 - 075554 - 0000

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covid@9ceir@doh.gov.ph.

COVID- 19 Vaccination Card


Last Name First Name Suffix

Please keep this record card, which includes medical information


about the vaccine you have received.
Dosage Seq. Dose Vaccine Manufacturer Batch No.
ID no. -Lot No.

(632) 8561 - 7800 loc. 1936


Last Name First Name M.I Suffix
1st Dose
Address Contact No.

Date of Birth Philhealth No. Categeory

2nd Dose
Dosage Seq. Date Vaccine Manufacturer Batch No. Lot
LotNo.
No.

doh.gov.ph
1st Dose
Vaccinator Name Signature

DOHgovph
2nd Dose
Vaccinator Name Signature

Official DOHGov
Health Facility Name Contact No.

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