1.0 KiB
1.0 KiB
type, category, person, date, provider, source
| type | category | person | date | provider | source |
|---|---|---|---|---|---|
| vaccination-record | covid-19 | Erica Jiang | 2021-04-10 | LAFD USC | erica-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).