Part 82, page 351

Transcript

The scan is the source; the transcript is machine-generated from it.

REMARKS CONCERNING VACCINATIONS—REMARQUES CONCERNANT LES VACCINATIONS

INTERNATIONAL CERTIFICATE OF VACCINATION OR REVACCINATION AGAINST SMALLPOX CERTIFICAT INTERNATIONAL DE VACCINATION OU DE REVACCINATION CONTRE LA VARIOLE

This is to certify that Je soussigné(e) certifie que Willard C. Twigg, Jr. sex: Male

whose signature follows date of birth: March 22, 1922 dont la signature suit né(e) le

has on the date indicated been vaccinated or revaccinated against smallpox a été vacciné(e) ou revacciné(e) contre la variole à la date indiquée

[TABLE HEADERS] Date | Indicate by "X" whether | Signature, professional status, and address of vaccinator | Approved stamp Caso | Indiquer par "X" s'il s'agit de | Signature, qualité professionnelle et adresse du vaccinateur | Cachet d'authentification

5-8-68 1a Primary vaccination performed [redacted] [redacted]

Primary vaccination effective 1b [redacted]

Oct 15, 1963 - Revaccination

July 11, 1959 Revaccination

July 26, 1961

7-26-61 THE V[redacted] after the date of a successful primary vaccination or in the event of a revacci[nation on] [the] date of that revaccination

The approved stamp mentioned above must be in a form prescribed by the health admin[istration] of the country in which the vaccination is performed. In the United States, the stamp is that of the local or State [health] department, of the area in which the [vaccinating] physician practices, the Department of Defense a designated yellow fever vaccination center, the seal of the Public Health Service, or the special "S+C" stamp approved by the [Surgeon General]

Any amendment of this certificate, or erasure, or failure to complete any part of it may render it invalid

LA VALIDITE DE CE CERTIFICAT contre [la] variole [est] [valable] de trois ans commençant huit jours après la date d'une primo-vaccination [réussie] ou de [la] date [de la] revaccination, le jour de cette revaccination

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DB Cooper-36265

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