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Shot Record Card (Indiana)

This displays an Official Immunization Record card (9" x 4.5") for a specific patient. You must first search for the patient.

The facility phone number prints on the card. The Varicella message displays Varicella History: Parent report of disease regardless of patient ownership.

Run the Report

To create the card click the Reports > State Reports > Shot Record Card > 9" x 4.5" Card link. The Official Immunization Record for the patient displays in a separate browser tab and can be printed using the browser's print function or downloaded, depending on the browser and PDF plug-in. When printing the card, follow the instructions on the page.

Example Report

The following image is of an example shot record card:

Example Shot Record Card (Official Immunization Record card) for Indiana

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