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(19-‫اﻟﺘﻘﺮﻳﺮ اﻟﻄﺒﻲ ﻟﺘﻄﻌﻴﻢ ﻓﺎﻳﺮوس ﻛﻮروﻧﺎ )ﻛﻮﻓﻴﺪ‬

COVID-19 Vaccine Medical Report

Full Name ---- ‫اﺑ ﺮ ا ﻫ ﻴ ﻢ ﻓ ﻬ ﺪ ﺑ ﻦ ﺻ ﺎ ﻟ ﺢ ا ﻟ ﺸ ﻬ ﻴ ﻞ‬ ‫اﻻﺳﻢ‬

ID Number 1121525537 1121525537 ‫ر ﻗ ﻢ ا ﻟ ﻬ ﻮﻳ ﺔ‬

Date of birth 09 Aug 2003 2003 ‫ ​ أﻏﺴﻄﺲ‬09 ‫ﺗﺎرﻳﺦ اﳌﻴﻼد‬

Nationality Saudi Arabia ‫ا ﻟ ﺴ ﻌ ﻮ دﻳ ﺔ‬ ‫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 2021-08-23 2021 ‫ ​ أﻏﺴﻄﺲ‬23 ‫اﻟﺘﺎرﻳﺦ‬

Batch Number FF5106 FF5106 ‫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 2021-09-14 2021 ‫ ​ ﺳﺒﺘﻤﺒﺮ‬14 ‫اﻟﺘﺎرﻳﺦ‬

Batch Number FG3526 FG3526 ‫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 VCC230821116310 ‫ﻫﺬا اﻟﺘﻘﺮ ﻳﺮ‬

https://VaccineCertificate.sehhaty.sa https://VaccineCertificate.sehhaty.sa

www.moh.gov.sa | 937 | SaudiMOH | MOHPortal | SaudiMOH | Saudi_MOH

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