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Certificate for COVID-19 Vaccination

Issued in India by Ministry of Health & Family Welfare, Govt. of India


Certificate ID 87209996243

Beneficiary Details
Beneficiary Name / ଲାଭାଥୀ ର ନାମ Simadhari Jogarao

Age / ବୟସ 24

Gender / ଲ Male

ID Verified / ଆଇଡି ସତ ାପିତ େହାଇଛି Passport # V1357400

Unique Health ID (UHID)


Beneficiary Reference ID 86884530746620

Vaccination Status / ଟୀକାକରଣ ସିତି Fully Vaccinated (2 Doses) and a Precaution Dose

Vaccination Details
Vaccinated By / ଟିକା େଦଉଥବା ବ କି ନାମ Sasmita Rauto

Vaccination At / ଟୀକାକରଣ ସାନ Bagasala PHC, Gajapati, Odisha

Dose Number Date of Dose Vaccine Name Batch Number Vaccine Type Manufacturer
େଖାରାକ ନମର ଟୀକାକରଣ ତାରୀଖ ଟିକା ନାମ େବଚ ନମର ଟିକା ପକାର ନିମାତା

COVID-19 vaccine, Serum Institute of India Pvt.


1/2 19 Jul 2021 COVISHIELD 4121MC025 non-replicating viral vector Ltd.

COVID-19 vaccine, Serum Institute of India Pvt.


2/2 12 Oct 2021 COVISHIELD 4121MF003 non-replicating viral vector Ltd.

COVID-19 vaccine, Serum Institute of India Pvt.


Precaution dose 13 Oct 2022 COVISHIELD 4122Z028 non-replicating viral vector Ltd.

“ଔଷଧ ମ ଏବଂ କେଠାରତା ମ


Together, India will defeat
COVID-19”
- ପଧାନମନୀ ନେର େମାଦି

In case of any adverse events, kindly contact the nearest Public Health Center/
Healthcare Worker/District Immunization Officer/State Helpline No. 1075
େକୗଣସି ପକାର ପତିକୂଳ ଘଟଣା ଘଟିେଲ ଦୟାକରି ନିକଟସ ଜନସାସ େକ / ସାସ େସବା କମୀ / ଜିଲା
ଟୀକାକରଣ ଅଫସର / ରାଜ େହଲଲାଇନ ନମର 1075 ସହିତ େଯାଗାେଯାଗ କର

This certificate can be verified by scanning the QR code at


http://verify.cowin.gov.in

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