E - VACCINATION CERTIFICATE

Ref ID: 35718499037994 Date of Birth: 02-AUG-2023

Name: Vishu Gender: Male

ABHA ID: N/ A ABHA Address: N/ A

Guardian Name: Sureshchand Guardian ref ID: 34679659576402

Vaccination Date: 06-Apr-2024 Vaccinated At: Basay ach SUB C ENTR ,

MUZAF F AR NAGAR , UTTAR
Vaccinated By: Poonam PR ADESH

BIRTH 1 ½ MONTHS 2 ½ MONTHS 3 ½ MONTHS 9 MONTHS

Date of Birth Next Vaccination Date Next Vaccination Date Next Vaccination Date Next Vaccination Date
02/08/2023 / / / / / / 01/06/2024

DATE OF VACCINATION DATE OF VACCINATION DATE OF VACCINATION DATE OF VACCINATION DATE OF VACCINATION
(dd/mm/yyyy): (dd/mm/yyyy): (dd/mm/yyyy): (dd/mm/yyyy): (dd/mm/yyyy):

OPV-0 09/08/2023 OPV-1 07/10/2023 OPV-2 02/12/2023 OPV-3 06/04/2024 MR-1 / /

Hep B -
Birth / / Penta -1 07/10/2023 Penta-2 02/12/2023 Penta-3 06/04/2024 Vit A-1 / /
Dose

BCG 09/08/2023 RVV-1 07/10/2023 RVV-2 02/12/2023 RVV-3 06/04/2024 JE-1 / /

PCV-
PCV-1 07/10/2023 PCV-2 06/04/2024 Booster / /

fIPV-1 07/10/2023 fIPV-2 06/04/2024 fIPV-3 / /

16-24 MONTHS 5-6 YEARS VITAMIN A

Next Vaccination Date Next Vaccination Date
/ / / / CHILD AGE DATE GIVEN (dd/mm/yyyy) CHILD AGE DATE GIVEN (dd/mm/yyyy)

DATE OF VACCINATION
(dd/mm/yyyy):
DATE OF VACCINATION
(dd/mm/yyyy): Vit A-3 2.0 Years / / Vit A-7 4.0 Years / /
DPT DPT
Booster-
1
/ / Booster-
2
/ / Vit A-4 2.5 Years / / Vit A-8 4.5 Years / /
SIA / OTHERS
Vit A-5 3.0 Years / / Vit A-9 5.0 Years / /
MR-2 / / VACCINE DATE GIVEN
NAME (dd/mm/yyyy)
Vit A-6 3.5 Years / /
OPV -
Booster / /

Vit A-2 / /

JE-2 / /
In case of any adverse events, kindly contact the nearest Health
Center/ Healthcare Worker/ District immunization Officer