Public Health Center

ଲ ଭ ଥ ର ନ ମ

ଲ

ବୟସ

ଆଇଡି ସତ ପିତ ହ ଇଛି

ଟିକ ନ ମ

ପ ଥମ ଡ ଜର ତ ରିଖ

ଟିକ ଦଉଥ ବ ବ କି ନ ମ

ପରବ ଟ କ କରଣ ତ ରିଖ

Beneficiary Details

Vaccination Details

Beneficiary Name /

Gender /

Age /

ID Verified /

Unique Health ID (UHID)

Beneficiary Reference ID

Vaccine Name /

Date of 1st Dose /

Vaccinated by /

Next due date /

Vaccination at / ଟ କ କରଣ ସ ନ

Provisional Certificate for COVID-19 Vaccination - 1st Dose This certificate can be verified by scanning the QR code at http://verify.cowin.gov.in

Together, India will defeat

COVID-19”

In case of any adverse events, kindly contact the nearest Public Health Center/ Healthcare Worker/District Immunization Officer/State Helpline No. 1075

“ଔଷଧ ମ ଏବ କ ଠ ରତ ମ

କ ଣସି ପ କ ର ପ ତିକୂଳ ଘଟଣ ଘଟି ଲ ଦୟ କରି ନିକଟସ ଜନସ ସ କ / ସ ସ ସବ କମ / ଜିଲ ଟ କ କରଣ ଅଫ ସର / ର ଜ ହଲ ଲ ଇନ ନମ ର 1075 ସହିତ ଯ ଗ ଯ ଗ କର

- ପ ଧ ନମନ ନ ର ମ ଦି

Parveen Bibi

20

Female

Aadhaar # XXXXXXXX4618

942***********

COVISHIELD

27 Aug 2021 (Batch no. 4121Z169)

Between 19 Nov 2021 and 17 Dec 2021

Sukanti Jena

Dharmasala CHC, Jajpur, Odisha

Contact this candidate