Sichuan cademy of Medical Sciences▪Sichuan Provincial Hospital

Medical Prevention and Vaccination Certificate

XXX, Male, born on XXX, ID No. is XXXXXXXXXXXXX. Home address: No. X,

XXX Road, XXX District, XXX City.

Mr. XXX has taken vaccinations in our hospital as follows: Chicken pox, Diphtheria,

Measles, Rubella.

Hereby certify,

Sichuan Academy of Medical Sciencesª¡Sichuan Provincial Hospital

Hospital Address:                                                       

  Signature of the doctor: XXX

 Contact number: XXX@163.com

Sichuan Academy of Medical Sciences ª¡ Sichuan Provincial Hospital

No. 32 West Second Section, First Ring Road, Chengdu City (610072)