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VACCINATION FOR CLASS XI
ISS/WEBCIR/044/15-16
08 November 2015

Dear Parents,

The Ministry of Health will conduct a vaccination programme in December 2015/January 2016. Please indicate in the table below whether your child needs vaccination.

 

Name of Child:  __________________________ Class & Sec: _____________ GR No:____________

 

Age Group

Senior School Level-11 (16-17 years)

OPV

1)       Whether the child has already taken the vaccination ( YES / NO )

2)       Whether the child needs the vaccination

( YES / NO)

Confirmation (Put  )

Give Vaccination (     )

Don’t give Vaccination

(     )

Age Group

Senior School Level-11 (16-17 years)

DT Child

1)       Whether the child has already taken the vaccination ( YES / NO )

2)       Whether the child needs the vaccination

( YES / NO)

Confirmation (Put  )

Give Vaccination (     )

Don’t give Vaccination

(     )

 

I hereby grant permission to MOH to give the above vaccination to my child, as per their programme.

 

Sign of the Parent: ______________                                                                  Date __________________

Name of the Parent: _________________________________     Telephone No: _________________

 

Please return this letter to the class Teacher with your consent and signature by 8.00am, on or before Tuesday 10th November  2015.

 

Thanks and Regards,

 

Sanchita Verma                                                                                                                            Dr. Vinu Kumar

Principal                                                                                                                                          Vice- Principal

   
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