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Passport 1st January 1970 |
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International Certificate of Vaccination (Prophylaxis)
Certificat Internatiional de Vaccination ou de Prophylaxie
In accordance with the International Health Regulations
compormement au Reglement sanitaire international
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Vaccine or Prophylaxis Vaccin ou agent prophylactique |
Manufacturer and Batch no. of vaccine or prophylaxis Fabircant du vaccin ou de l'agent prophylactique prophylactique et numero du lot |
Date Date |
Valid Until Valiable jusqu'au |
Administering Location & Supervising Clinician Lieu d'administration et Clinicien superviseur |
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| Disease targeted | Date | Manufacture and Batch No. of vaccine or prophylaxis | Next Booster | Official stamp and signature |
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