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COVID-19 Vaccination Card: 1 Dose 2nd Dose Booster

This document is a COVID-19 vaccination card that records the medical information about the vaccines a person has received. It includes fields for the person's name, address, date of birth, sex, PhilHealth number, vaccine doses administered with dates, and information about the health facility where the vaccines were given such as the name, contact number and Department of Health contact details.

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jeankayzelrodelas
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1K views1 page

COVID-19 Vaccination Card: 1 Dose 2nd Dose Booster

This document is a COVID-19 vaccination card that records the medical information about the vaccines a person has received. It includes fields for the person's name, address, date of birth, sex, PhilHealth number, vaccine doses administered with dates, and information about the health facility where the vaccines were given such as the name, contact number and Department of Health contact details.

Uploaded by

jeankayzelrodelas
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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COVID-19 Vaccination Card ID No.

* Please keep this card, which includes medical information about the vaccines you have received.
* Pakitago ang record card na ito, kung saan mababasa ang impormasyong medikal tungkol sa
Last Name ______________________ First Name _________________________ Middle Name___________________ Suffix ________

Address ___________________________________________________________ Contact no.__________________________________

Date of Birth _________________ Sex ______ PhilHealth No. ___________________________________Category _________________

1st Dose
1st Dose

2nd Dose
2st Dose
Booster
Booster

Health Facility Name ________________________________________________ Facility Contact no. _________________

OfficialDOHgov @DOHgoph (632) 8561- 7800 Local 1936 [email protected]

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