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# CATEGORY COMORBIDITY UNIQUE_PERSON_ID PWD Indigenous Member Last_Name First_Name Middle_Name Suffix Contact_No. Guardian Name Current_Residence:_Region Current_Residence: Province Current_Residence: Municipality/City Current_Residence: Barangay Sex Birthdate_mm/dd/yyyy_ DEFERRAL REASON_FOR_DEFERRAL Date of Vaccination Manufacturer Name Batch Number Lot Number BAKUNA_CENTER_CBCR_ID Vaccinator Name 1st Dose 2nd Dose Adverse Event Adverse Event Condition
1st Dose 2nd Dose Adverse Event Adverse Event Condition