Newborn Immunization Record Card

Newborn Information

Name:
Date of Birth:
Sex:
Mother's Name:
Father's Name:
Address:
Contact Number:

Immunization Record

Vaccine Date Given Batch No./Expiry Given By Remarks
BCG
Hepatitis B (Birth Dose)
OPV
DTaP
Hib
IPV
Pneumococcal
Rotavirus

Next Due Date

Vaccine/Dose:
Due Date:

Notes