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INTERNATIONAL CERTIFICATE
OF VACCINATION OR PROPHYLAXIS

Ministry of Health & Family Welfare · Republic of India
CERT NO.
VC-2026-000000
OFFICIAL RECORD
CITY IMMUNISATION CENTRE
✎ OFFICIAL
VACCINATED
PARTICULARS OF HOLDER
Rohan Vijay Deshmukh Date of Birth14 March 1994 SexMale NationalityIndian Passport / National IDZ-4821990
RECORD OF VACCINATION
Vaccine / ProphylaxisDoseDateBatch / Lot No.Manufacturer
Certificate Validity: Valid for the lifetime of the holder
Issuing Centre: City Immunisation Centre
VC-2026-000000
Dr. A. Nair
Signature of Health Practitioner
Dr. A. Nair
Date of Issue:
26 August 2026
⚠️ This tool creates sample / novelty vaccination record documents for personal record keeping, school camps or commemorative use only. It is not an official government document and must not be used for travel or legal purposes.