19 -‫ﺷﻬﺎدة ﺗﻄﻌﻴﻢ ﻟﻘﺎح ﻛﻮﻓﻴﺪ‬

Immunization certificate for covid 19 vaccine

Beneficiary Details ‫ﺗﻔﺎﺻﻴﻞ اﻟﻤﺴﺘﻔﻴﺪ‬

Name SYAMSUNDAR GUJJU ‫اﻻﺳﻢ‬

Age / DoB 24 Years / 12-03-1997 ‫ ﺗﺎرﻳﺦ اﻟﻤﻴﻼد‬/‫اﻟﻌﻤﺮ‬

Gender Male ‫اﻟﺠﻨﺲ‬

Nationality INDIA ‫اﻟﺠﻨﺴﻴﺔ‬

Civil No 117188796 ‫اﻟﺮﻗﻢ اﻟﻤﺪﻧﻲ‬

Passport No ‫رﻗﻢ اﻟﺠﻮاز‬

Vaccination Details ‫ﺗﻔﺎﺻﻴﻞ اﻟﺘﻄﻌﻴﻢ‬

Dose Date of Dose Vaccine Name Batch No Vaccination At

‫اﻟﺠﺮﻋﺔ‬ ‫ﺗﺎرﻳﺦ اﻟﺠﺮﻋﺔ‬ ‫اﻟﻠﻘﺎح‬ ‫رﻗﻢ اﻟﺪﻓﻌﺔ‬ ‫ﻣﻜﺎن اﻟﺘﻄﻌﻴﻢ‬

FirstDose 18-06-2021 Sinovac B202104033 Badr Al Samaa Polyclinic Duqm

SecondDose 06-08-2021 Sinovac B202104033 Badr Al Samaa Polyclinic Duqm

Remarks:

‫ ﻳﺮﺟﻰ اﻟﺘﺄﻛﺪ ﻣﻦ أن اﻟﺮاﺑﻂ ﻫﻮ‬.‫ ﻗﻢ ﺑﻤﺴﺢ رﻣﺰ اﻻﺳﺘﺠﺎﺑﺔ اﻟﺴﺮﻳﻌﺔ اﻟﻤﻮﺿﺢ ﻫﻨﺎ‬، ‫ﻟﻠﺘﺤﻘﻖ ﻣﻦ ﺻﺤﺔ اﻟﺸﻬﺎدة‬
covid19.moh.gov.om

‫اﻟﺘﺎرﻳﺦ‬
To check the authenticity of the certificate, scan the QR code
Date 26/Nov/2021
shown here
Please ensure the URL is covid19.moh.gov.om