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    10905V

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    10905V

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    of 1

    Vaccination Record - Confidential Information

    Burlington Pediatrics, P.A., 530 West Webb Avenue, Burlington, NC 27217


    Return Address: 336-524-0304
    Warren K. Bonney, MD
    530 West Webb Avenue Date printed: 9/19/2023
    Burlington, NC 272173706

    Patient: 10905 : MARIONE ENOCH SEX: M D.O.B.: 7/8/2005


    Age on date printed: 18 yrs. 2 mos.
    Vaccination Forecast: ......... Recommended Range...... Earliest
    ..........................................................................................
    ..........
    Flu - Seasonal ..... Today -
    Meningococcal B .... Today -
    COVID19 ............ Today -
    Td/Tdap Booster .... 08/04/2032 - 08/31/2032 08/04/2027
    -
    Allergies... No active medication allergies or reactions; No documented food/non-medication allergies

    IMMUNIZATIONS
    Hep B HIB D-T-P Group Polio
    DTaP 06/11/2010
    HIB-OMP 02/26/2007 DTaP 02/26/2007 IPV 06/11/2010
    HepB 05/09/2006 HIB-OMP 01/12/2006 DTaP 01/12/2006 IPV 05/09/2006
    HepB. 08/09/2005 HIB-OMP 11/07/2005 DTaP 11/17/2005 IPV 11/17/2005
    HepB 07/08/2005 HIB-OMP 09/13/2005 DTaP+ 09/13/2005 IPV 09/13/2005
    Pneumococcal Rotavirus MMR Varicella
    MMR 06/11/2010
    PCV7 07/10/2006 MMR 07/10/2006 VAR 03/31/2009
    PCV7 01/12/2006 VAR 07/10/2006
    PCV7 11/17/2005 Influenza
    Meningococcal ACWY
    PCV7 09/13/2005
    Hep A MCV4O 08/04/2022
    Other Vaccines
    MCV4O 08/16/2017
    HepA 2dose 09/06/2007 FLU - 5yrs+ pf 09/25/2012
    HepA 2dose 02/26/2007 MenB
    Covid19
    Td Group
    Tdap 08/04/2022 MenB-4C_2Dose 08/04/2022
    Tdap 02/05/2015 COVID19 30 07/02/2021
    MenCY
    COVID19 30 06/10/2021
    HPV

    HPV9 03/01/2018
    HPV9 08/16/2017

    *Only 4 most recent Flu listed

    09/19/2023 02:07 PM Warren K. Bonney, MD


    Copyright Office Practicum North Carolina 9801600

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