---
type: vaccination-record
category: covid-19
person: Erica Jiang
date: 2021-04-10
provider: LAFD USC
source: jiang_covid_vaccine.pdf
---

# COVID-19 Vaccination Record Card

| Field | Value |
|---|---|
| **Last Name** | Jiang |
| **First Name** | Erica |
| **MI** | |
| **Date of Birth** | 03/13/1993 |
| **Patient Number** | |

## Vaccination Details

| | 1st Dose COVID-19 | 2nd Dose COVID-19 |
|---|---|---|
| **Product Name/Manufacturer** | Pfizer | Pfizer |
| **Lot Number** | ER8329 | EW0171 |
| **Date** | 04/10/2021 | |
| **Healthcare Professional / Clinic Site** | LAFD USC | LAFO - USC |

## Reminder (Back of Card)

| Field | Value |
|---|---|
| **Vaccine** | COVID-19 vaccine |
| **Return Date (2nd Dose)** | 04/27/21 |

## Notes

- The 2nd dose date field on the front of the card is not clearly filled in. The back of the card indicates a return date of 04/27/21 for the 2nd dose.
- The 2nd dose clinic site appears to read "LAFO - USC" (handwriting is difficult to parse; may be the same site as the 1st dose, LAFD USC).