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INSTRUCTIONS TO PHYSICIANS 1. Information requested on each certificate must be com plete for the certificate to be valid; otherwlte, the person may be subject to surveillance of isolation when these certificates are required for international travel. 9. The space for primary voccination against smallpox is 40 be used only when o person receives his vaccination rihefirsttime. unsuccessful a new certificate ‘ fer a repeat primary vaccination. must be vevs * ny 4. The dates on each certificate are .o be + the day In arabic numerals, followed by the month in letters ond the year in orable numerals. Example: October 1, 1966, should be written 1/Oct./66. 4. Vaccinations may be performed by a nurse oF medical veciie A itynder 0 hysi wr airect sv The physicion's writen signature rnust appear on the certificate; signature stamp is not o ccoptable. —_ “ tee jtten with Deeratweds Tae to §, If vaccination is contraindicated tfve physicion should provide the person with o written opinion, which port health authorities way take Into account, 8. Officiat immunization requirem{ ynts for international trave! ond the tist of designated; yellow fever vaccine tion centers in the United States ore contained In the booklet “Immunization Infor ation for International Travel, PHS No. 364, on salgs at the Superintendent of Documents, U.S. Gover ament Printing Office, Washington, D.C., 20402. Changes in requirements may be obtained from f local ot Stote health “tment. armation cord .cerning certificates and im- eee me ate MOY mrprantimnes Prac. fe _- . a ee menhbla yes te tus iv \ . ag 10 due « td Meat ery in or foilure 9 Crmpiate ony part of it, + OF TF such petited of 10 pects, from tre? cond for 2 PA, of 10 years, beginn | wih ssshon a or foityre to $ 23 2 s § £333 ios ffh3 § ; 3 at 3 3\; . *¢:- § < Ey: $ % 3 £ 8 ek. $e 3 “ Ef. } dg: 3 Bel = SE ¢ a” | « a 2 bs ¢ z3 | Seetat Ee we PB, tos 3 3 re Se SS bet wwe BCE RP He VE RR