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Kusum 20230911 ReportCard

This document is a vaccination certificate for Kusum, a female born on December 2nd, 2020. It lists the vaccinations she has received to date, including BCG, OPV, Hep B, Penta, RVV, PCV, and fIPV vaccines at birth and various intervals up to 9 months. Her next scheduled vaccinations are MR-1 on August 14th, 2023 and Vit A-1 on an unspecified date. The certificate provides spaces to record additional routine and booster vaccines up to age 5-6 years. It encourages contacting health authorities if any adverse events occur from vaccination.

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nilesh.patidar87
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192 views1 page

Kusum 20230911 ReportCard

This document is a vaccination certificate for Kusum, a female born on December 2nd, 2020. It lists the vaccinations she has received to date, including BCG, OPV, Hep B, Penta, RVV, PCV, and fIPV vaccines at birth and various intervals up to 9 months. Her next scheduled vaccinations are MR-1 on August 14th, 2023 and Vit A-1 on an unspecified date. The certificate provides spaces to record additional routine and booster vaccines up to age 5-6 years. It encourages contacting health authorities if any adverse events occur from vaccination.

Uploaded by

nilesh.patidar87
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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E - VACCINATION CERTIFICATE

Ref ID: 19360951131741


Date of Birth: 02-DEC-2020
Name: Kusum
Gender: F emale
ABHA ID: N/ A ABHA Address: N/ A
Guardian Name: Lalita Guardian ref ID: 20323853351740
Vaccination Date: 11-Sep-2023 Vaccinated At: SHC C HENPUR A DEM,
NEEMUC H, MADHYA PR ADESH
Vaccinated By: Durga Patidar

BIRTH 1 ½ MONTHS 2 ½ MONTHS 3 ½ MONTHS 9 MONTHS


Date of Birth Next Vaccination Date Next Vaccination Date Next Vaccination Date Next Vaccination Date
02/12/2020 / / / / / / 29/08/2021

DATE OF VACCINATION DATE OF VACCINATION DATE OF VACCINATION DATE OF VACCINATION DATE OF VACCINATION
(dd/mm/yyyy): (dd/mm/yyyy): (dd/mm/yyyy): (dd/mm/yyyy): (dd/mm/yyyy):

OPV-0 02/12/2020 OPV-1 23/02/2021 OPV-2 23/03/2021 OPV-3 28/05/2021 MR-1 14/08/2023

Hep B -
Birth 02/12/2020 Penta -1 23/02/2021 Penta-2 23/03/2021 Penta-3 28/05/2021 Vit A-1 / /
Dose

PCV-
BCG 02/12/2021 RVV-1 23/02/2021 RVV-2 23/03/2021 RVV-3 28/05/2021 Booster / /

PCV-1 23/02/2021 PCV-2 28/05/2021 fIPV-3 / /

fIPV-1 23/02/2021 fIPV-2 28/05/2021

16-24 MONTHS 5-6 YEARS VITAMIN A


Next Vaccination Date Next Vaccination Date
06/04/2024 01/12/2025 CHILD AGE DATE GIVEN (dd/mm/yyyy) CHILD AGE DATE GIVEN (dd/mm/yyyy)

DATE OF VACCINATION
(dd/mm/yyyy):
DATE OF VACCINATION
(dd/mm/yyyy): Vit A-3 2.0 Years / / Vit A-7 4.0 Years / /
DPT DPT
Booster-
1
14/08/2023 Booster-
2
/ / Vit A-4 2.5 Years / / Vit A-8 4.5 Years / /
SIA / OTHERS
MR-2 11/09/2023
Vit A-5 3.0 Years / / Vit A-9 5.0 Years / /
VACCINE DATE GIVEN
NAME (dd/mm/yyyy)
Vit A-6 3.5 Years / /
OPV -
14/08/2023
Booster

"Let no child suffer from any vaccine


Vit A-2 / / preventable diseases"
- Shri Narendra Modi,
In case of any adverse events, kindly contact the nearest Health Prime Minister
Center/ Healthcare Worker/ District immunization Officer

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