※繁体中文和简体中文都不能使用.Simplified/Traditional Kanjis may not be used.

Please fill the date of the vaccination

Target groups: Medical personnel, People aged 60 years or older, Workers at senior citizen facilities and People with an underlying illness

PLEASE CHOOSE PDF UNLESS THE STAFF INSTRUCT DIFFERENTLY.

Please print on A4 paper (Not Legal) with 100% (1x) magnification.