International Certificate Vaccination Or Prophylaxis
L00-0973942
Klinik Utama Kirana Medika
L00-0973942
L00-0973942
SOPI SOPRIADI
19th September 1996
Male
INDONESIA
-
-
Typhoid
| Vaccine or Prophy | Date | Signature and profesional status of supervising clinican | Manufacture and batch no. of vaccine or prophylaxis | Certificate valid until | Official stamp of the administering centre | Disease targeted | Date | Manufacture, brand name and batch no. of vaccine | Next Booster (date) | Official stamp and signature |
|---|---|---|---|---|---|---|---|---|---|---|
| TIFOID | 6th September 2021 | Dr. Herlina Arfan | 20022019 | 6th September 2024 | Klinik Utama Kirana Medika | - | - | - | - | - |
| YELLOW FEVER | 12th April 2024 | dr. Rienny Esta M | 18042023 | Lifetime | Port Medical Center | - | - | - | - | - |
| CHOLERA | 24th April 2024 | dr. Regina Listyarini A | 12032023 | 24th April 2027 | Port Medical Center | - | - | - | - | - |