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    Adobe Scan Jun 24, 2021

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    Camila Fernandez Sandoval
    This document provides a COVID-19 vaccination record card to track the vaccines received. It includes fields for personal information, vaccine details including type and date, and reminders to return for additional doses and bring the card to future medical appointments.

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    Download as PDF, TXT or read online from Scribd

    Adobe Scan Jun 24, 2021

    Uploaded by

    Camila Fernandez Sandoval
    50 views2 pages
    This document provides a COVID-19 vaccination record card to track the vaccines received. It includes fields for personal information, vaccine details including type and date, and reminders to return for additional doses and bring the card to future medical appointments.

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    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    This document provides a COVID-19 vaccination record card to track the vaccines received. It includes fields for personal information, vaccine details including type and date, and reminders to return for additional doses and bring the card to future medical appointments.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    50 views2 pages

    Adobe Scan Jun 24, 2021

    Uploaded by

    Camila Fernandez Sandoval
    This document provides a COVID-19 vaccination record card to track the vaccines received. It includes fields for personal information, vaccine details including type and date, and reminders to return for additional doses and bring the card to future medical appointments.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    COVID-19 Vaccinati on Record Card _..

    -,--~
    Please keep this record card, which includes medical information { __
    about the vaccines you have received. ',,,,,,,., fl"--
    Por favor, guarde esta tarjeta de registro, que incluye informaci6n
    medica sabre las vacunas que ha recibido.

    F-eyr-av:dez ~
    Last Name ·
    O\,Q\ Cam,la
    First Name Ml

    4-Jlo-2r:JJs
    Date of birth Patient number (medical record or /IS record number)

    Product Name/Manufacturer Healthcare Professional


    Vaccine Date
    or Clinic Sit e
    l>_

    1st Dose
    COVID-19

    2nd Dose
    COVID-19

    Other _ /_ _ / _
    mm dd yy

    Other _ !_ !_
    mm dd yy
    Reminder! Return for a second dose!
    iRecordatorio! iRegrese para la segunda dosis!
    Vaccine Date/ Fecha

    COVID-19 vaccine
    I ~ / " \ ,'
    Vacuna contra el COVID-19
    :lyy l .
    Other _ _! _ _ _.!_ _
    Otra mm dd yy

    Bring this vaccination record to every Lleve este registro de vacunaci6n a cada
    vaccination or medical visit. Check with your cita medica o de vacunaci6n. Consulte con
    health care provider to make sure you are not su proveedor de atenci6n medica para
    missing any doses of routinely recommended asegurarse de que no le falte ninguna dosis
    vaccines. de las vacunas recomendadas.
    For more information about COVID-19 Para obtener mas informaci6n sobre el
    and COVID-19 vaccine, visit cdc.gov/ COVID-19 y la vacuna contra el COVID-19,
    coronavirus/2019-ncov/index.html. visite espanol.cdc.gov/coronavirus/2019-
    You can report possible adverse reactions ncov/index.html.
    following COVID-19 vaccination to the Puede notificar las posibles reacciones
    Vaccine Adverse Event Reporting System adversas despues de la vacunaci6n contra
    (VAERS) at vaers.hhs.gov. el COVID-19 al Sistema de Notificaci6n de
    Reacciones Adversas a las Vacunas (VAERS)
    en vaers.hhs.gov.
    09/03/20 MLS-319813_r

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