COVID-19 Vaccination Record Card

Please keep this report card, which includes medical information about the vaccines you have received.

Last Name First Name Middle
Date of Birth Patient Number (Vaccine Registration Number)
NOT VACCINATED
Vaccine Product Name/ Manufacturer Lot Number Date Healthcare Professional or Clinical Site
Please bring this vaccination record to every vaccination or medical site. Check with your health care provider to make sure you are not missing any doses of routinely recommended vaccine.

For more Information about COVID-19 and COVID-19 vaccine, visit www.moh.gov.lr

You can report possible adverse reactions following COVID-19 vaccination to the infection Prevention and Control Unit at the Ministry of Health, Republic of Liberia or the National Public Health Institute of Liberia (NPHIL)