预 防 接 种 证 明 书 CERTIFICATE OF VACCINATION姓名： 性别： 出生日期： 年 月 日 国 籍：Name Gender Date of Birth Nationality已接种下列疫苗 The following vaccine had been immunized:疫 苗 Vaccine接种日期Date of given剂量 Dose 接种单位 Hospital卡介苗 Bacillus Calmette Guerin Vaccine0.1mlMaternity and Child Health Center Of Song Jiang District 松江区妇婴保健所乙型肝炎疫苗Hepatitis B Vaccine0.5ml0.5ml0.5mlSong Jiang Center Hospital松江区中心医院Yue Yang community health care岳阳社区卫生服务中心Yue Yang community health care脊髓灰质炎疫苗Oral Poliomyelitis Vaccine1 dosage1 dosage1 dosage1 dosage1 dosageYue Yang community health careYue Yang community health careYue Yang community health careYue Yang community health care白喉百日咳破伤风联合疫苗Diphtheria Pertussis Tetanus Vaccine0.5ml0.5ml0.5ml0.5mlYue Yang community health careYue Yang community health careYue Yang community health careYue Yang community health care麻疹疫苗Measles Vaccine0.5ml0.5mlYue Yang community health careYue Yang community health care乙型脑炎疫苗Encephalitis B Vaccine0.5ml0.5ml0.5mlYue Yang community health careYue Yang community health care麻疹腮腺炎风疹联合疫苗Measles Mumps Rubella Vaccine0.5ml0.5mlYue Yang community health careYue Yang community health careA 群流行性脑膜炎疫苗Meningococcus A Vaccine0.5ml0.5ml0.5mlYue Yang community health careYue Yang community health careYue Yang community health care水痘疫苗Varicella Zoster Vaccine0.5mlYue Yang community health care甲型肝炎疫苗Hepatitis A Vaccine0.5ml0.5mlYue Yang community health careYue Yang community health care精巧白喉破伤风两联疫苗Purified Diphtheria Tetanus Vaccine0.5ml0.5mlYue Yang community health care肺炎球菌结合疫苗Conjugate Pneumococcal Vaccination0.5ml流感疫苗Influenza Vaccine0.5ml日期 年 月 日 医生签名 Signature: 中国上海市松江区疾病防止控制中心Date Centers for Disease Control and Prevention Songjiang District,Shanghai, P.R.China
VIP
