Patient Name MonikaWegmueller Gender female Birthday 10.02.1967 Adress Leidensweg 10 CH - 9876 Specimendorf Contact home - tel:+41.32.685.12.34 Identifier urn:oid:2.999.1.2.3.4: 12345678; Author Practitioner AllzeitBereit (urn:oid:2.51.1.3: 7601888888884; ) Doktorgasse 2 CH - 8888 Musterhausen Organization Gruppenpraxis CH (urn:oid:2.51.1.3: 7601888888884; ) Doktorgasse 2 CH - 8888 Musterhausen ZH Date 01.06.2021 Immunization Administration ID Vaccination Date Vaccine Lot Route Target Doc Date Performer Identifier 7-1-Immunization 15.09.2017 Boostrix (637) 12-34244 20035000: Intramuscular use Diphtheria caused by Corynebacterium diphtheriae (disorder) Tetanus (disorder) Pertussis (disorder) 15.09.2017 Practitioner AllzeitBereit (urn:oid:2.51.1.3: 7601888888884; ) Doktorgasse 2 CH - 8888 Musterhausen Organization Gruppenpraxis CH (urn:oid:2.51.1.3: 7601888888884; ) Doktorgasse 2 CH - 8888 Musterhausen ZH urn:oid:2.999.1.2.3.4: 1829774; Comments
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