861 B
861 B
type, category, person, date, source
| type | category | person | date | source |
|---|---|---|---|---|
| medical-record | vaccination | Jiang Xuewei (Erica) | 2021-11-24 | jiang_vaccine_3rd_shot.jpg |
COVID-19 Vaccination Record Card — Jiang Erica (Xuewei)
| Field | Value |
|---|---|
| Last Name | Jiang |
| First Name | Erica (Xuewei) |
| MI | — |
| Date of Birth | 03/13/1993 |
| Patient Number | — |
Vaccination Records
| Dose | Vaccine | Product Name/Manufacturer | Lot Number | Date | Healthcare Professional or Clinic Site |
|---|---|---|---|---|---|
| 1st Dose COVID-19 | Pfizer | Pfizer | ER8729 | 4/6/21 | LAFD USC |
| 2nd Dose COVID-19 | Pfizer | Pfizer | EW 0171 | 4/27/21 | LAFD - USC |
| Other | Pfizer | Pfizer | FJ1620 | 11/24/21 | USC Pharmacy |
| Other | — | — | — | — | — |
Scanned by TapScanner.