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1、NO 2-88365 Children Planned Immunity Vaccination Certificate Issued by Issued Date Gen eral Con diti on Name Wang Zhijia n Sex Male Date of Birth March 2th,1998 Chin ese Zodiac Address Group10,No.11 Health Committee,Yua nli n, Tiedong District,Anshan City, Liaoning Provin ce, China Father s Name Wan

2、g Jinsong Worki ng Unit Refractory Co.,Ltd Mother s Name Yu Jie Worki ng Unit Anshan Bran ch,Chi na Con structio n Ba nk Pedo-phore In stitutio n Serious Disease I Allergic History I Tran sfer-i n Unit Tran sfer-out Unit Tran sfer-i n Date Tran sfer-out Date Nursery and Kin dergarte n Resp on sible

3、Pers on Surren der Value In sura nee Termi nate Date Resp on sible Pers on WU CHUNQING 、 In sura nee Amount 150,000 Beg inning and Ending In sura nee Time April 7th, 1998 to March,2th,2000 Number 1 2 3 Vaccine (HBV 2 dose Apr.2 nd,2008 Liu 3rd dose :Sep.2nd,2008 Wu Mar.2nd,2005 Apr.19 th,2002 Other

4、Immuni zati on Record Vacc ine Name Vacci ne Date Vacci ne Pers on Japanese en cephalitis vaccine (JEV Primary Vacci nati on 1st dose May 4th,1999 Wu 2“ dose May 11th,1999 Wu Repeat Vacci nati on 1st May 9th ,2000 Wu 2“ 3rd 4th Epidemic cerebrosp inal menin gitis polysaccharide vacci ne Primary Vacc

5、i nati on 1st dose Nov.16th,1999 Wu 2“ dose Nov.28th ,2000 Wu Repeat Vacci nati on 1st Oct.31th,2003 Ren Guo 2nd DT Aug.19th,2005 Liu Li HepatitisB 1st dose Mar.2nd,2008 WU Other Immuni zati on Record Vacci ne Name Vacc ine Date Vacc ine Pers on BGG Primary Vacc in ati on Mar.2nd,1998 WU Repeat Vacc

6、 in ati on 1st dose 亠nd 2 dose Live Poliomyelittis vacc in e,Oral (OPV) Primary Vacc in ati on 1st May 4th,1998 WU 2nd Jun.4 th,1998 WU 3rd Jul.4 th,1998 WU Stren gthe n Mar.21th,2000 WU Apr.11 th ,2002 WU DPT Primary 1st dose Jun.4 th,1998 WU 2nd dose Jul.4 th,1998 WU 3rd dose Aug.9th,1998 WU Stren

7、 gthe n Mar.29th,2000 WU Measles vaccine( MV Primary Vacci nati on Nov.3th,1998 WU Repeat Vacc in ati on May 15th,2001 WU Jul4th,2003 WU (注:专业文档是经验性极强的领域,无法思考和涵盖全面,素 材和资料部分来自网络,供参考。可复制、编制,期待你的好评 Immuno logical Exam in atio n Determ in atio nof An tibodies与关注) Record Test Item Test Value Test Date Test Unit Rubella 17/4 Liu Accordi ngly In fectious Diseases Record Date

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