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Provisional Certificate For COVID-19 Vaccination - 1 Dose: Beneficiary Details

This document is a provisional certificate for Rajdeep Purkayastha indicating that he received the first dose of the COVISHIELD vaccine. He is 27 years old and was vaccinated on August 12, 2021 at Aditya Diagnostic And Hospital in Tinsukia, Assam. He is due for his second dose between November 4 and December 2, 2021. The certificate provides contact information for reporting any adverse events from the vaccine.

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Raj Deep
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34 views1 page

Provisional Certificate For COVID-19 Vaccination - 1 Dose: Beneficiary Details

This document is a provisional certificate for Rajdeep Purkayastha indicating that he received the first dose of the COVISHIELD vaccine. He is 27 years old and was vaccinated on August 12, 2021 at Aditya Diagnostic And Hospital in Tinsukia, Assam. He is due for his second dose between November 4 and December 2, 2021. The certificate provides contact information for reporting any adverse events from the vaccine.

Uploaded by

Raj Deep
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Provisional Certificate for COVID-19 Vaccination - 1st Dose

Beneficiary Details

Beneficiary Name / িহতািধকাৰীৰ নাম Rajdeep Purkayastha

Age / বয়স 27

Gender / িলংগ Male

ID Verified / পিৰচয় প সত ািপত Aadhaar # XXXXXXXX7657

Unique Health ID (UHID)


Beneficiary Reference ID 68676171219130

Vaccination Details

Vaccine Name / ভি নৰ নাম COVISHIELD

Date of 1st Dose / থম পািলৰ তািৰখ 12 Aug 2021 (Batch no. 4121Z110)

Next due date / পৰৱতী িনয়ত তািৰখ Between 04 Nov 2021 and 02 Dec 2021

Vaccinated by / কাকৰণ কিৰেছ Karabi Buragohain

Vaccination at / কাকৰণৰ ান Aditya Diagnostic And Hospital,

Tinsukia, Assam

“ঔষধৰ লগেত কেঠাৰতাও


Together, India will defeat
COVID-19”
- ধান ম ী নেৰ মাডী

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

িযেকােনা িতকল ঘটনাৰ ত, অনু হ কিৰ িনকটৱতী ৰাজ ৱা া ক / া কমী/িজলা


কাকৰণ িবষয়া/ ৰািজ ক হ লাই ন ৰ 1075 ত যাগােযাগ কৰক।

This certificate can be verified by scanning the QR code at


http://verify.cowin.gov.in

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