COVID-19 (SARS-COV-19)

CERTIFICATE OF VACCINATION

(MBPVC)

MBPVC RECORD

PATIENT:

MICHAEL ALAN BAIRD 09/25/1981

PP-2279815-C

VACCINE:

PFIZER-BIONTECH (BNT162B2)

FIRST ADMINISTRATION:

07/21/2021

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For MBPVC Official Use

FRONT OF CARD

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BACK OF CARD

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For vaccination confirmations and resources visit

www.mbpvc.org/vaccinationcertification