42 lines
1.2 KiB
Markdown
42 lines
1.2 KiB
Markdown
---
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type: vaccination-record
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category: covid-19
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person: Yanxin Lu
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date: 2021-04-15
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provider: Forum
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source: lu-covid-vaccine.pdf
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---
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# COVID-19 Vaccination Record Card
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| Field | Value |
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|---|---|
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| **Last Name** | Lu |
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| **First Name** | Yanxin |
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| **MI** | |
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| **Date of Birth** | 10/17/1989 |
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| **Patient Number** | |
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## Vaccination Details
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| | 1st Dose COVID-19 | 2nd Dose COVID-19 |
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|---|---|---|
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| **Product Name/Manufacturer** | Pfizer | Pfizer |
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| **Lot Number** | EW0161 | EW0173 |
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| **Expiration** | 07/31/2021 | 08/31/2021 |
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| **Date** | 04/15/2021 | 05/06/2021 |
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| **Healthcare Professional / Clinic Site** | Forum | Forum |
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## Reminder (Back of Card)
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| Field | Value |
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|---|---|
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| **Vaccine** | Pfizer |
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| **Return Date (2nd Dose)** | 05/06/21 |
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## Notes
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- Two physical cards are present in the PDF (pages 1-2 and pages 3-4). Both belong to the same person and contain consistent information.
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- Card 1 (page 1) shows the 1st dose entry; the back (page 2) shows the 2nd dose reminder date of 05/06/21 and a Pfizer vaccine sticker.
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- Card 2 (page 3) shows both 1st and 2nd dose entries filled in; the back (page 4) shows a Pfizer vaccine sticker with blank reminder date fields.
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