Facistol-Mata, Rachelle | Ivax Medical Solutions

Patient Vaccination Record

Vhea Sarah Carascal ( Vaccinator)

Ivax Card Gold

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Rachelle Ann

Facistol-Mata

Patient ID: 215

Vaccination Logs

Vaccine Name: Varicella

Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
1	02/06/2024	Valerix	Imus	No adverse reactions. Given on the left thigh.
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Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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Vaccine Name:

Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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Vaccine Name:

Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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Vaccine Name:

Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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Vaccine Name:

Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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Vaccine Name:

Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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Vaccine Name:

Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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Vaccine Name:

Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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Vaccine Name:

Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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Vaccine Name:

Dose Number	Vaccination Date (dd/mm/yyyy)	Brand / Manufacturer / Lot No	Vaccinator / Vaccination Site	Remarks
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