Certificate for COVID-19 Vaccination
Issued in India by Ministry of Health & Family Welfare, Govt. of India
                                                           Certificate ID   54788432604
Beneficiary Details
Beneficiary Name / लाभाथ का नाम                                           Shamim Ahmed Khan
Age / उ                                                                  47
Gender / लग                                                              Male
ID Verified / पहचान प स ा पत                                              Passport # N6569693
Unique Health ID (UHID)
Beneficiary Reference ID                                                  49677606252270
Vaccination Status / टीकाकरण क               त                           Fully Vaccinated (2 Doses)
Vaccination Details
Vaccine Name / वै        ीन का नाम                                       COVISHIELD
Vaccine Type / टीका का कार                                               COVID-19 vaccine, non-replicating viral vector
Manufacturer / उ पादक                                                    Serum Institute of India Pvt. Ltd.
Dose Number / खुराक क सं या                                              1/2                    2/2
Date of Dose / खुराक क तारीख                                             08 Dec 2021            03 Mar 2022
Batch Number / बैच सं या                                                 4121MF017              4121Z017M
Vaccinated By / टीका लगाने वाले का नाम                                   Rita Yadav
Vaccination At / टीकाकरण का            ान                                TARY PIPARA AGARWA, Kushinagar, Uttar
                                                                         Pradesh
                                “दवाई भी और कड़ाई भी।
                                Together, India will defeat
                                COVID-19”
                                - धानमं ी नर मोदी
In case of any adverse events, kindly contact the nearest Public Health Center/
Healthcare Worker/District Immunization Officer/State Helpline No. 1075
टीकाकरण प    ात कसी तकूल घटना के होने पर नज़दीक     ा    क / ा     कम / जला टीकाकरण
अ धकारी/रा   ह लाइन 1075 पर स क कर
                                                                                            This certificate can be verified by scanning the QR code at
                                                                                                                               http://verify.cowin.gov.in