(19-‫اﻟﺘﻘﺮﻳﺮ اﻟﻄﺒﻲ ﻟﺘﻄﻌﻴﻢ ﻓﺎﻳﺮوس ﻛﻮروﻧﺎ )ﻛﻮﻓﻴﺪ‬

COVID-19 Vaccine Medical Report

Full Name TANKA BAHADUR MAGAR KRISHNA ‫ﺗ ﺎﻧ ﻜ ﺎ ﺑ ﻬ ﺎ د و ر ﻣ ﺎ ﻏ ﺎ ر ﺑ ﻬ ﺎ د و ر‬ ‫اﻻﺳﻢ‬

ID Number 2301453235 2301453235 ‫ر ﻗ ﻢ ا ﻟ ﻬ ﻮﻳ ﺔ‬

Passport Number 08892476 08892476 ‫ر ﻗ ﻢ ا ﻟ ﺠ ﻮاز‬

Date of birth 26 Aug 1976 1976 ‫ ​ أﻏﺴﻄﺲ‬26 ‫ﺗﺎرﻳﺦ اﳌﻴﻼد‬

Nationality Nepal ‫ﻧ ﻴ ﺒﺎ ل‬ ‫اﻟ ﺠﻨ ﺴﻴ ﺔ‬

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

Date 2021-04-23 2021 ‫ ​ أﺑﺮ ﻳﻞ‬23 ‫اﻟﺘﺎرﻳﺦ‬

Batch Number EX2294 EX2294 ‫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

Date 2021-07-12 2021 ‫ ​ ﻳﻮﻟﻴﻮ‬12 ‫اﻟﺘﺎرﻳﺦ‬

Batch Number 28115BA 28115BA ‫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 VCC25042180015 ‫ﻫﺬا اﻟﺘﻘﺮ ﻳﺮ‬

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