(19-‫اﻟﺘﻘﺮﻳﺮ اﻟﻄﺒﻲ ﻟﺘﻄﻌﻴﻢ ﻓﺎﻳﺮوس ﻛﻮروﻧﺎ )ﻛﻮﻓﻴﺪ‬

COVID-19 Vaccine Medical Report

Full Name MOHAMMAD RAFI MUKHTAR - AHMAD ‫ أ ﺣ ﻤ ﺪ‬- ‫ﻣ ﺤ ﻤ ﺪ را ﻓ ﻊ ﻣ ﺨ ﺘﺎر‬ ‫اﻻﺳﻢ‬

ID Number 2272822129 2272822129 ‫ر ﻗ ﻢ ا ﻟ ﻬ ﻮﻳ ﺔ‬

Date of birth 01 Feb 1973 1973 ‫ ​ ﻓﺒﺮاﻳﺮ‬01 ‫ﺗﺎرﻳﺦ اﳌﻴﻼد‬

Nationality India ‫اﻟ ﻬﻨ ﺪ‬ ‫اﻟ ﺠﻨ ﺴﻴ ﺔ‬

Vaccine Type ‫أﺳﺘﺮاز ﻳﻨﻴﻜﺎ‬-‫أﻛﺴﻔﻮرد‬ Oxford-AstraZeneca ‫ﻧ ﻮ ع اﻟﺘ ﻄ ﻌﻴ ﻢ‬

First Dose Date 2021-04-01 2021 ‫ ​ أﺑﺮ ﻳﻞ‬01 ‫ﺗﺎرﻳﺦ اﻟﺠﺮﻋﺔ اﻷوﱃ‬

Batch Number 4120Z018 4120Z018 ‫ر ﻗ ﻢ اﻟﺘ ﺸ ﻐﻴ ﻠ ﺔ‬

Vaccine Type ‫ﺑ ﻴ ﻮﻧ ﺘ ﻚ‬- ‫ﻓ ﺎﻳ ﺰ ر‬ Pfizer-BioNTech ‫ﻧ ﻮ ع اﻟﺘ ﻄ ﻌﻴ ﻢ‬

First Dose Date 2021-07-04 2021 ‫ ​ ﻳﻮﻟﻴﻮ‬04 ‫ﺗﺎرﻳﺦ اﻟﺠﺮﻋﺔ اﻷوﱃ‬

Batch Number FC9000 FC9000 ‫ر ﻗ ﻢ اﻟﺘ ﺸ ﻐﻴ ﻠ ﺔ‬

‫ اﳌﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‬،‫ﺗﻢ إﺻﺪار ﻫﺬا اﻟﺘﻘﺮ ﻳﺮ ﻣﻦ ﻗﺒﻞ وزارة اﻟﺼﺤﺔ‬

‫ﻫﺬا اﻟﺘﻘﺮ ﻳﺮ ﻟﻺﺳﺘﺨﺪام اﻟﻄﺒﻲ ﺧﺎرج اﳌﻤﻠﻜﺔ ﰲ اﻟﺪول اﻟﱵ ﻟﻢ ﺗﺮﺗﺒﻂ إﻟﻜﺘﺮوﻧﻴﺎ ﻣﻊ اﻷﻧﻈﻤﺔ اﻟﺤﻜﻮﻣﻴﺔ ﰲ اﳌﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‬

This Report has been issued by the Ministry of Health, Kingdom of Saudi Arabia

This report is intended to be used for medical purposes outside the Kingdom of Saudi Arabia, in the countries that are not integrated with
the Kingdom's government systems.

Kindly scan the QR code to vaildate Report No. ‫رﻗﻢ اﻟﺘﻘﺮ ﻳﺮ‬ ‫ﻳﺮﺟﻰ ﻣﺴﺢ اﻟﺒﺎرﻛﻮد ﻟﻠﺘﺤﻘﻖ ﻣﻦ ﺻﺤﺔ‬

this report VCC04072147442 ‫ﻫﺬا اﻟﺘﻘﺮ ﻳﺮ‬

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