NHS COVID Pass - Vaccinated
Name
2D barcode expiry 9 January 2023
Rodolpho Pizysieznig
Please check against the bearer's identity. To protect your data privacy the 2D barcode
Date of birth expires on the stated expiry date. Please generate
22 July 1964 a new COVID-19 Pass to renew the barcode.
Pfizer/BioNTech COVID-19 vaccine [Booster]
Dose 3 of 3
Date of vaccination 17 December 2021
Vaccine product Comirnaty
Manufacturer Biontech Manufacturing GmbH
Vaccine SARS Cov-2 mRNA Vaccine
Batch number FK9712
Disease targeted COVID-19
Country of vaccination GB
Issuer NHS Digital
LORDSHIP LANE HEALTH CENTRE - COVID LOCAL
Administering Centre
VACCINATION SERVICE
This document is important. Keep it safe. It is a PDF copy of your vaccination records.
Find out about COVID-19 symptoms, testing, vaccination and self-isolation on the NHS website: [Link]/conditions/coronavirus-covid-19
Data Protection: The Department for Health and Social Care (DHSC) is the Data Controller and is responsible for processing your personal data for the purposes of the NHS COVID
Pass Programme. To find out more you can access the DHSC Privacy Notice at: [Link]/government/publications/dhsc-privacy-notice. The NHS COVID Pass Privacy Notice is
available within the guidance at: [Link]/guidance/demonstrating-your-covid-19-status
Page: 1 of 3
NHS COVID Pass - Vaccinated
Name
2D barcode expiry 9 January 2023
Rodolpho Pizysieznig
Please check against the bearer's identity. To protect your data privacy the 2D barcode
Date of birth expires on the stated expiry date. Please generate
22 July 1964 a new COVID-19 Pass to renew the barcode.
COVID-19 Vaccine AstraZeneca
Dose 2 of 2
Date of vaccination 15 June 2021
Vaccine product Vaxzevria
Manufacturer AstraZeneca AB
Vaccine SARS CoV-2 Antigen Vaccine
Batch number PV46673
Disease targeted COVID-19
Country of vaccination GB
Issuer NHS Digital
Administering Centre HORNSEY HEALTH CENTRE - COVID VACCINATION CENTRE
This document is important. Keep it safe. It is a PDF copy of your vaccination records.
Find out about COVID-19 symptoms, testing, vaccination and self-isolation on the NHS website: [Link]/conditions/coronavirus-covid-19
Data Protection: The Department for Health and Social Care (DHSC) is the Data Controller and is responsible for processing your personal data for the purposes of the NHS COVID
Pass Programme. To find out more you can access the DHSC Privacy Notice at: [Link]/government/publications/dhsc-privacy-notice. The NHS COVID Pass Privacy Notice is
available within the guidance at: [Link]/guidance/demonstrating-your-covid-19-status
Page: 2 of 3
NHS COVID Pass - Vaccinated
Name
2D barcode expiry 9 January 2023
Rodolpho Pizysieznig
Please check against the bearer's identity. To protect your data privacy the 2D barcode
Date of birth expires on the stated expiry date. Please generate
22 July 1964 a new COVID-19 Pass to renew the barcode.
COVID-19 Vaccine AstraZeneca
Dose 1 of 2
Date of vaccination 24 March 2021
Vaccine product Vaxzevria
Manufacturer AstraZeneca AB
Vaccine SARS CoV-2 Antigen Vaccine
Batch number PV46671
Disease targeted COVID-19
Country of vaccination GB
Issuer NHS Digital
Administering Centre HORNSEY HEALTH CENTRE - COVID VACCINATION CENTRE
This document is important. Keep it safe. It is a PDF copy of your vaccination records.
Find out about COVID-19 symptoms, testing, vaccination and self-isolation on the NHS website: [Link]/conditions/coronavirus-covid-19
Data Protection: The Department for Health and Social Care (DHSC) is the Data Controller and is responsible for processing your personal data for the purposes of the NHS COVID
Pass Programme. To find out more you can access the DHSC Privacy Notice at: [Link]/government/publications/dhsc-privacy-notice. The NHS COVID Pass Privacy Notice is
available within the guidance at: [Link]/guidance/demonstrating-your-covid-19-status
Page: 3 of 3
