canada immunization record samples immunizatio …

COVID-19 Vaccine

PrinceEdwardIsland.ca/PEIVaxPass

CANADA Immunization Record Samples

For more information visit: gov.bc.ca/VaccineCard

PAG E 2 I M M U N IZ AT I O N R ECO R D SA M PL E S | C A N A DA

Paper Record

Electronic Record

Paper Record

Online Record

Wallet-Size CardPaper Record

į Nova Scotia

į Ontario

į Northwest Territories į Nunavut

Paper Record

For more information visit: gov.bc.ca/VaccineCard

PAG E 3 I M M U N IZ AT I O N R ECO R D SA M PL E S | C A N A DA

COVID-19 VACCINATION RECORDCOVID-19 VACCINATION RECORD

Province of Saskatchewan, CANADAProvince of Saskatchewan, CANADA

Patient

Full Name : FamilyName, GivenName

Date of Birth : 12-May-2000

Age : 21yrs

Date : 27-Aug-2021 09:03 AM

Vaccinations

VaccinationVaccination

DateDateVaccineVaccine LocationLocation SourceSource Lot #Lot #

26-Jun-2021COVID-19 Pfizer-BioNTech mRNA BNT162b2

- COVID-19 mRNARegina - Evraz Hall C (Drive-Thru)

Government of

Saskatchewan3002542

24-Jul-2021COVID-19 Pfizer-BioNTech mRNA BNT162b2

- COVID-19 mRNARegina - Evraz Hall C (Drive-Thru)

Government of

Saskatchewan3003746

PLE ASE N O TE :PLE ASE N O TE :

This document contains COVID-19 immunizations as recorded in the Saskatchewan immunization registry.

It reflects only vaccine information entered into the registry at the time the report was printed, and may not represent all vaccines received by the individual.

PERSONAL HEALTH INFORMATION IS CONFIDENTIAL

Page 1 / 1

Wallet-Size Card

Electronic Record

Paper Record

Electronic Record

Paper Record

į Prince Edward Island

į Quebec

į Saskatchewan

Electronic Record

For more information visit: gov.bc.ca/VaccineCard

PAG E 1 I M M U N IZ AT I O N R ECO R D SA M PL E S | C A N A DA

IMMUNIZATION RECORD SAMPLESCanada

Paper Record

Paper Record

Paper Record

Online Record

Wallet-Size Card

į Alberta

į Manitoba

į New Brunswick į Newfoundland and Labrador

Electronic Record

For more information visit: gov.bc.ca/VaccineCard

PAG E 1 I M M U N IZ AT I O N R ECO R D SA M PL E S | C A N A DA

IMMUNIZATION RECORD SAMPLESCanada

Paper Record

Paper Record

Paper Record

Online Record

Wallet-Size Card

į Alberta

į Manitoba

į New Brunswick į Newfoundland and Labrador

Electronic Record

For more information visit: gov.bc.ca/VaccineCard

PAG E 3 I M M U N IZ AT I O N R ECO R D SA M PL E S | C A N A DA

COVID-19 VACCINATION RECORDCOVID-19 VACCINATION RECORD

Province of Saskatchewan, CANADAProvince of Saskatchewan, CANADA

Patient

Full Name : FamilyName, GivenName

Date of Birth : 12-May-2000

Age : 21yrs

Date : 27-Aug-2021 09:03 AM

Vaccinations

VaccinationVaccination

DateDateVaccineVaccine LocationLocation SourceSource Lot #Lot #

26-Jun-2021COVID-19 Pfizer-BioNTech mRNA BNT162b2

- COVID-19 mRNARegina - Evraz Hall C (Drive-Thru)

Government of

Saskatchewan3002542

24-Jul-2021COVID-19 Pfizer-BioNTech mRNA BNT162b2

- COVID-19 mRNARegina - Evraz Hall C (Drive-Thru)

Government of

Saskatchewan3003746

PLE ASE N O TE :PLE ASE N O TE :

This document contains COVID-19 immunizations as recorded in the Saskatchewan immunization registry.

It reflects only vaccine information entered into the registry at the time the report was printed, and may not represent all vaccines received by the individual.

PERSONAL HEALTH INFORMATION IS CONFIDENTIAL

Page 1 / 1

Wallet-Size Card

Electronic Record

Paper Record

Electronic Record

Paper Record

į Prince Edward Island

į Quebec

į Saskatchewan

Electronic Record

Paper or Electronic Record

Paper Wallet Size Record

SAMPLE

SAMPLE

COVID-19 Vaccine

PrinceEdwardIsland.ca/PEIVaxPass

CANADA Immunization Record Samples

For more information visit: gov.bc.ca/VaccineCard

PAG E 1 I M M U N IZ AT I O N R ECO R D SA M PL E S | C A N A DA

IMMUNIZATION RECORD SAMPLESCanada

Paper Record

Paper Record

Paper Record

Online Record

Wallet-Size Card

į Alberta

į Manitoba

į New Brunswick į Newfoundland and Labrador

Electronic Record

For more information visit: gov.bc.ca/VaccineCard

PAG E 1 I M M U N IZ AT I O N R ECO R D SA M PL E S | C A N A DA

IMMUNIZATION RECORD SAMPLESCanada

Paper Record

Paper Record

Paper Record

Online Record

Wallet-Size Card

į Alberta

į Manitoba

į New Brunswick į Newfoundland and Labrador

Electronic Record

Electronic Record

For more information visit: gov.bc.ca/VaccineCard

PAG E 2 I M M U N IZ AT I O N R ECO R D SA M PL E S | C A N A DA

Paper Record

Electronic Record

Paper Record

Online Record

Wallet-Size CardPaper Record

į Nova Scotia

į Ontario

į Northwest Territories į Nunavut

Paper Record

SAMPLE

COVID-19 Vaccine

PrinceEdwardIsland.ca/PEIVaxPass

CANADA Immunization Record Samples

For more information visit: gov.bc.ca/VaccineCard

PAG E 2 I M M U N IZ AT I O N R ECO R D SA M PL E S | C A N A DA

Paper Record

Electronic Record

Paper Record

Online Record

Wallet-Size CardPaper Record

į Nova Scotia

į Ontario

į Northwest Territories į Nunavut

Paper Record

For more information visit: gov.bc.ca/VaccineCard

PAG E 3 I M M U N IZ AT I O N R ECO R D SA M PL E S | C A N A DA

COVID-19 VACCINATION RECORDCOVID-19 VACCINATION RECORD

Province of Saskatchewan, CANADAProvince of Saskatchewan, CANADA

Patient

Full Name : FamilyName, GivenName

Date of Birth : 12-May-2000

Age : 21yrs

Date : 27-Aug-2021 09:03 AM

Vaccinations

VaccinationVaccination

DateDateVaccineVaccine LocationLocation SourceSource Lot #Lot #

26-Jun-2021COVID-19 Pfizer-BioNTech mRNA BNT162b2

- COVID-19 mRNARegina - Evraz Hall C (Drive-Thru)

Government of

Saskatchewan3002542

24-Jul-2021COVID-19 Pfizer-BioNTech mRNA BNT162b2

- COVID-19 mRNARegina - Evraz Hall C (Drive-Thru)

Government of

Saskatchewan3003746

PLE ASE N O TE :PLE ASE N O TE :

This document contains COVID-19 immunizations as recorded in the Saskatchewan immunization registry.

It reflects only vaccine information entered into the registry at the time the report was printed, and may not represent all vaccines received by the individual.

PERSONAL HEALTH INFORMATION IS CONFIDENTIAL

Page 1 / 1

Wallet-Size Card

Electronic Record

Paper Record

Electronic Record

Paper Record

į Prince Edward Island

į Quebec

į Saskatchewan

Electronic Record

COVID-19 Vaccine

PrinceEdwardIsland.ca/PEIVaxPass

CANADA Immunization Record Samples

For more information visit: gov.bc.ca/VaccineCard

PAG E 4 I M M U N IZ AT I O N R ECO R D SA M PL E S | C A N A DA

COVID-19Proofofvaccination/PreuvedevaccinationcontrelaCOVID-19

Name/Nom:CHARLIE,ZULUDateofbirth/Datedenaissance:05OCT/OCT1999

SMARTHealthCardsQRCodeCodeQRdelacarteSantéSMART

Vaccinationsadministered/Vaccinsreçus:2

Date:25JAN/JAN2021Product/Produit:ModernamRNA-1273Lot:3000489

Date:06MAY/MAI2021Product/Produit:ModernamRNA-1273Lot:3001176

IssuingProvince/TerritoryProvince/Territoirededélivrance

CountryofissuancePaysd’émission

Thisdocumentcontainsconfidentialinformationthatisintendedonlyforusebythenamedindividualorasauthorizedbylaw.Anyunauthorized

disclosure,copying,ordistributionofthecontentsisstrictlyprohibited.Issuedon2021/08/31.Ifthisdocumentisfolded,ensuretheQRcodeisnot

creased.

Cedocumentcontientdesrenseignementsconfidentielsquisontdestinésuniquementàl’usagedelapersonnenomméeouàl’usageautorisépar

laloi.Toutedivulgation,copieoudistributionnonautoriséedesoncontenueststrictementinterdite.Délivréle2021/08/31.Sicedocumentestplié,

assurez-vousquelecodeQRnel’estpas.

Electronic Record

Wallet-Size Card

į Yukon

Temporary Identification Card NDI Canadian Forces Identification Card NDI

į Canadian Department of National Defence

For more information visit: gov.bc.ca/VaccineCard

PAG E 4 I M M U N IZ AT I O N R ECO R D SA M PL E S | C A N A DA

COVID-19Proofofvaccination/PreuvedevaccinationcontrelaCOVID-19

Name/Nom:CHARLIE,ZULUDateofbirth/Datedenaissance:05OCT/OCT1999

SMARTHealthCardsQRCodeCodeQRdelacarteSantéSMART

Vaccinationsadministered/Vaccinsreçus:2

Date:25JAN/JAN2021Product/Produit:ModernamRNA-1273Lot:3000489

Date:06MAY/MAI2021Product/Produit:ModernamRNA-1273Lot:3001176

IssuingProvince/TerritoryProvince/Territoirededélivrance

CountryofissuancePaysd’émission

Thisdocumentcontainsconfidentialinformationthatisintendedonlyforusebythenamedindividualorasauthorizedbylaw.Anyunauthorized

disclosure,copying,ordistributionofthecontentsisstrictlyprohibited.Issuedon2021/08/31.Ifthisdocumentisfolded,ensuretheQRcodeisnot

creased.

Cedocumentcontientdesrenseignementsconfidentielsquisontdestinésuniquementàl’usagedelapersonnenomméeouàl’usageautorisépar

laloi.Toutedivulgation,copieoudistributionnonautoriséedesoncontenueststrictementinterdite.Délivréle2021/08/31.Sicedocumentestplié,

assurez-vousquelecodeQRnel’estpas.

Electronic Record

Wallet-Size Card

į Yukon

Temporary Identification Card NDI Canadian Forces Identification Card NDI

į Canadian Department of National Defence

For more information visit: gov.bc.ca/VaccineCard

PAG E 3 I M M U N IZ AT I O N R ECO R D SA M PL E S | C A N A DA

COVID-19 VACCINATION RECORDCOVID-19 VACCINATION RECORD

Province of Saskatchewan, CANADAProvince of Saskatchewan, CANADA

Patient

Full Name : FamilyName, GivenName

Date of Birth : 12-May-2000

Age : 21yrs

Date : 27-Aug-2021 09:03 AM

Vaccinations

VaccinationVaccination

DateDateVaccineVaccine LocationLocation SourceSource Lot #Lot #

26-Jun-2021COVID-19 Pfizer-BioNTech mRNA BNT162b2

- COVID-19 mRNARegina - Evraz Hall C (Drive-Thru)

Government of

Saskatchewan3002542

24-Jul-2021COVID-19 Pfizer-BioNTech mRNA BNT162b2

- COVID-19 mRNARegina - Evraz Hall C (Drive-Thru)

Government of

Saskatchewan3003746

PLE ASE N O TE :PLE ASE N O TE :

This document contains COVID-19 immunizations as recorded in the Saskatchewan immunization registry.

It reflects only vaccine information entered into the registry at the time the report was printed, and may not represent all vaccines received by the individual.

PERSONAL HEALTH INFORMATION IS CONFIDENTIAL

Page 1 / 1

Wallet-Size Card

Electronic Record

Paper Record

Electronic Record

Paper Record

į Prince Edward Island

į Quebec

į Saskatchewan

Electronic Record