(19-‫اﻟﺘﻘﺮﻳﺮ اﻟﻄﺒﻲ ﻟﺘﻄﻌﻴﻢ ﻓﺎﻳﺮوس ﻛﻮروﻧﺎ )ﻛﻮﻓﻴﺪ‬

COVID-19 Vaccine Medical Report

Full Name KENN - BABIARTE ACANA ‫ ﺑﺎﺑﻴﺎرﺗﻲ أﻛﺎﻧﺎ‬- ‫ﻛﻴﻦ‬ ‫اﻻﺳﻢ‬

ID Number 2477449272 2477449272 ‫ر ﻗ ﻢ ا ﻟ ﻬ ﻮﻳ ﺔ‬

Date of birth 11 Aug 1993 1993 ‫ ​ أﻏﺴﻄﺲ‬11 ‫ﺗﺎرﻳﺦ اﳌﻴﻼد‬

Nationality Philippines ‫اﻟ ﻔﻴ ﻠﺒﻴ ﻦ‬ ‫اﻟ ﺠﻨ ﺴﻴ ﺔ‬

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

Date 2021-05-10 2021 ‫ ​ ﻣﺎﻳﻮ‬10 ‫اﻟﺘﺎرﻳﺦ‬

Batch Number EY5456 EY5456 ‫ر ﻗ ﻢ اﻟﺘ ﺸ ﻐﻴ ﻠ ﺔ‬

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

Date 2021-07-16 2021 ‫ ​ ﻳﻮﻟﻴﻮ‬16 ‫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 VCC100521123428 ‫ﻫﺬا اﻟﺘﻘﺮ ﻳﺮ‬

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