

This is a list of your immunization history, based on your medical claims.
| IMMUNIZATION: | |
| Name: | Influenza |
| Immunization Date: | 11/19/06 |
| Location: | Dr. Barry Albert's Office |
| Manufacturer: | |
| Expiration Date: | |
These are the immunizations self reported by you. If you have received an immunization that was not done by your doctor (e.g. flu shot at a local pharmacy) be sure to add it here.
| IMMUNIZATION: | |
| Name: | |
| Immunization Date: | |
| Location: | |
| Next Immunization Due | |
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