预防接种证明书(出国填写,英文)

1、预防接种证明CERTIFICATEOF VACCINATION姓名？ ？ ？ 性别男出生日期2005年 1月12日 国籍中国Name ? ? Gender MaleDate of BirthJan .12th,2005Nationality P.R.China已接种下列疫苗 The follow ing vacci ne had bee n immuni zed:疫苗Vacc ine接种日期Date of give n剂量Dose接种单位Hospital卡介苗Bacillus Calmette Gueri n Vacci ne0.1mlMaternity and Child Health Ce

2、nter OfSong Jiang District松江区妇婴保健所乙型肝炎疫苗Hepatitis B Vacci ne0.5ml0.5ml0.5mlSong 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 Vacci ne1 dosage1 dosage1 dosage1 dosage1 dosageYue Yang community health care Yue Yang communi

3、ty health care Yue Yang community health care Yue Yang community health care白喉百日咳破伤风联合疫苗Diphtheria Pertussis Teta nus Vacci ne0.5ml0.5ml0.5ml0.5mlYue Yang community health care Yue Yang community health care Yue Yang community health care Yue Yang community health care麻疹疫苗Measles Vacci ne0.5ml0.5mlY

4、ue Yang community health careYue Yang community health care乙型脑炎疫苗En cephalitis B Vacc ine0.5ml0.5ml0.5mlYue Yang community health careYue Yang community health care麻疹腮腺炎风疹联合疫苗Measles Mumps Rubella Vacc ine0.5ml0.5mlYue Yang community health careYue Yang community health careA群流行性脑膜炎疫苗Menin gococcus

5、A Vacci ne0.5ml0.5ml0.5mlYue Yang community health careYue Yang community health careYue Yang community health care水痘疫苗Varicella Zoster Vacci ne0.5mlYue Yang community health care甲型肝炎疫苗Hepatitis A Vaccine0.5ml0.5mlYue Yang community health careYue Yang community health care精制白喉破伤风两联疫苗Purified Diphtheria Teta nus Vacc ine0.5ml0.5mlYue Yang community health care肺炎球菌结合疫苗Con jugate Pn eumococcal Vacc in ati on0.5ml流感疫苗In flue nza Vacci ne0.5ml日期 2016年3月21日医 生签名 Sig nature : 中国上海市松江区疾病预防控制中心Date Mar.21th