Гид/сопровождающий путешествий

Описание

Medical certificate of immunization against the novel coronavirus infection COVID-19 or medical
contraindications to vaccination and (or) recovery from a disease caused by the novel coronavirus
infection COVID-19
10.11.1988 Female
Date of birth Sex


FEDENIUK SVETLANA
№ 1000 2484 8826 6125
Personal identity document
1509 780951
Personal insurance policy number
151-336-085 33
76 3991370
International identity document
Policy of obligatory medical insurance
3248110889000256
Information about immunization against the novel coronavirus
infection COVID-19
Vaccination record
number
Information about the medicinal product (name,
manufacturer, batch and date of vactination) Name of the medical institution
780000056965630 Gam-COVID-Vac (“Sputnik V”), combined heterologous
recombinant adenovirus (rAd)-based vaccine for
prophylaxis of coronavirus infectious diseases caused by
SARS-CoV-2
SPb GBUZ "Gorodskaia bolnitsa
N40"
g. Zelenogorsk, pr-kt. Krasnykh
Komandirov, d. d45 sA The Federal Government Budgetary Institution “National
Research Center for Epidemiology and Microbiology
named after Honorary Academician N.F. Gamaleya” of the
Ministry of Health of the Russian Federation, series I-
210521
October 21, 2021
Gam-COVID-Vac (“Sputnik V”), combined heterologous
recombinant adenovirus (rAd)-based vaccine for
prophylaxis of coronavirus infectious diseases caused by
SARS-CoV-2
SPb GBUZ "Gorodskaia bolnitsa
N40"
g. Zelenogorsk, pr-kt. Krasnykh
Komandirov, d. d45 sA The Federal Government Budgetary Institution “National
Research Center for Epidemiology and Microbiology
named after Honorary Academician N.F. Gamaleya” of the
Ministry of Health of the Russian Federation, series II-
500721
November 15, 2021

Information about recovery from a disease caused by the novel
coronavirus infection COVID-19 (if any)
There is no data
Information on medical contraindications to vaccination
There is no data