| Context | |
| IssueDate | |
| Issuer | |
| Type | |
| NonTrans |
| Type | |
| ID | |
| Ref ID | |
| Name | |
| Gender | |
| Age | |
| Nationality |
| Address 1 | |
| Address 2 | |
| District | |
| City | |
| State | |
| Zip | |
| Country |
| ID | |
| Type | |
| Manuf | |
| Product | |
| Batch# | |
| Date | |
| EffectStart | |
| EffectEnd | |
| Dose | |
| Doses | |
| Verifier |
| Name | |
| Address 1 | |
| Address 2 | |
| District | |
| City | |
| State | |
| Zip | |
| Country |