CV1 DO YES, SEEN 1 HAVE WHERE YES, NOT SEEN 2 CV3 NO CV3 (IF YES) May I see it please? Date of Immunization CV2 Copy dates for each vaccination from the card. Day Month Year Write ‘44’ in day column if card shows that vaccination was given but no date recorded. BCG POLIO 1 2 3 DPT/PENTA1 DPT/PENTA2 DPT/PENTA3 MMR) FEVER VITAMIN A THIS TABLE SHOULD BE ADAPTED TO BE IN LINE WITH NATIONAL VACCINATION CARDS
CV1 (IF YES) May I see it please? YES, SEEN 1 YES, NOT SEEN 2 NO CV3 CV3 CV2 Copy dates for each vaccination from the card. Write ‘44’ in day column if card shows that vaccination was given but no date recorded. Date of Immunization Day Month Year BCG 1 2 3 DPT/PENTA1 DPT/PENTA2 DPT/PENTA3 MMR) A THIS TABLE SHOULD BE ADAPTED TO BE IN LINE WITH NATIONAL VACCINATION CARDS HAVE POLIO VITAMIN DO WHERE FEVER