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Amir

This document is a vaccination record for Amir Khater, born 10/12/2014. It lists all vaccinations he has received to date, including Hep B, DTaP, HIB, PCV13, rotavirus, MMR, varicella, meningococcal, hepatitis A, influenza and COVID-19. His next appointment is scheduled for today to receive seasonal flu and COVID-19 vaccines. The record notes it is important to keep the immunization information up to date and accurate.

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suziekhater
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51 views1 page

Amir

This document is a vaccination record for Amir Khater, born 10/12/2014. It lists all vaccinations he has received to date, including Hep B, DTaP, HIB, PCV13, rotavirus, MMR, varicella, meningococcal, hepatitis A, influenza and COVID-19. His next appointment is scheduled for today to receive seasonal flu and COVID-19 vaccines. The record notes it is important to keep the immunization information up to date and accurate.

Uploaded by

suziekhater
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Vaccination Record - Confidential Information

Healthy Happy Children Medical Services, 1300 Main Ave, Ste 2C, Clifton, NJ
Return Address: 973-340-6666
Ariolis Grullon, MD
1300 Main Avenue, Suite 2C Date printed: 10/12/2022
Clifton, NJ 070112266
Your Next Appointment:

THOM KHATER
334 HOLLYWOOD AVE
Fairfield, NJ 07004
Patient: 342 : AMIR KHATER SEX: M D.O.B.: 10/12/2014
Age on date printed: 8 yrs. 0 mos.
Message..... It is important that your child's immunization record is up to date and accurate. Please
notify us of any corrections or updates immediately. Thank you.
Vaccination Forecast: ......... Recommended Range...... Earliest
..........................................................................................
..........
Flu - Seasonal ..... Today -
COVID19 ............ Today -
-
Allergies... No active medication allergies or reactions; No documented food/non-medication allergies

IMMUNIZATIONS
Hep B HIB D-T-P Group Polio
HepB 10/13/2014 DTaP-HIB-IPV 12/30/2014 DTaP-HIB-IPV 12/30/2014 DTaP-HIB-IPV 12/30/2014
HepB 12/30/2014 DTaP-HIB-IPV 02/18/2015 DTaP-HIB-IPV 02/18/2015 DTaP-HIB-IPV 02/18/2015
HepB 05/04/2015 DTaP-HIB-IPV 05/04/2015 DTaP-HIB-IPV 05/04/2015 DTaP-HIB-IPV 05/04/2015
HIB-PRP-T 01/13/2016 DTaP 01/13/2016 DTaP-IPV 11/14/2018
DTaP-IPV 11/14/2018
Pneumococcal Rotavirus MMR Varicella
PCV13 12/30/2014 RotaVirus 12/30/2014 MMR 11/11/2015 VAR 11/11/2015
PCV13 02/18/2015 RotaVirus 02/18/2015 MMRV 11/14/2018 MMRV 11/14/2018
PCV13 05/04/2015 RotaVirus 05/04/2015
PCV13 03/21/2016 Influenza
Meningococcal ACWY
FLU-IIV3 6-35m pf 11/11/2015
Hep A Other Vaccines FLU-IIV3 6-35m pf 03/21/2016
HepA 2dose 03/21/2016 FLU-IIV3 6-35m pf 12/02/2016
HepA 2dose 09/21/2016 FLU-IIV4 6m+ pf 12/03/2018
MenB
Covid19
Td Group

MenCY
HPV

*Only 4 most recent Flu listed

10/12/2022 03:39 PM Ariolis Grullon, MD


Copyright Office Practicum New Jersey 25MA0918110

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