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‫ﺗﺴﺠﻴﻞ ﺍﻟﻘﺪﻭﻡ‬

Arrival Registration

Name DIPENDRA SHARMA ‫ﺍﻻﺳﻢ‬

Passport Number 06482247 ‫ﺭﻗﻢ ﺍﻟﺠﻮﺍﺯ‬

Birthdate 1992-08-21 ‫ﺗﺎﺭﻳﺦ ﺍﻟﻤﻴﻼﺩ‬

Visa Number 6074188538 ‫ﺭﻗﻢ ﺍﻟﺘﺄﺷﻴﺮﺓ‬

Nationality Nepal ‫ﻧﻴﺒﺎﻝ‬ ‫ﺍﻟﺠﻨﺴﻴﺔ‬

Registration Number GDP2243123868 ‫ﺭﻗﻢ ﺍﻟﺘﺴﺠﻴﻞ‬

Registration Date 2021-09-22 ‫ﺗﺎﺭﻳﺦ ﺍﻟﺘﺴﺠﻴﻞ‬

Vaccine Country Nepal ‫ﻧﻴﺒﺎﻝ‬ ‫ﺩﻭﻟﺔ ﺍﻟﺘﺤﺼﻴﻦ‬

‫ﺟﺮﻋﺔ ﻭﺍﺣﺪﺓ ﻣﻦ ﻟﻘﺎﺡ ﺟﺎﻧﺴﻴﻦ‬


Vaccine Type ‫ﻧﻮﻉ ﺍﻟﺘﺤﺼﻴﻦ‬
One dose of Janssen Vaccine

Dose Date 2021-08-03 ‫ﺗﺎﺭﻳﺦ ﺍﻟﺠﺮﻋﺔ‬

‫ ﺃﻗﺮ ﺑﺼﺤﺔ ﺍﻟﻤﻌﻠﻮﻣﺎﺕ ﺍﻟﻤﺪﺧﻠﺔ ﻭﺃﻧﻪ ﺳﻴﺘﻢ ﺍﻟﺘﺤﻘﻖ ﻣﻦ ﺻﺤﺔ ﺍﻟﻤﻌﻠﻮﻣﺎﺕ ﻋﻨﺪ ﺍﺻﺪﺍﺭ ﻛﺮﺕ ﺻﻌﻮﺩ ﺍﻟﻄﺎﺋﺮﺓ ﻭﻓﻲ ﻣﻨﺎﻓﺬ ﺍﻟﺪﺧﻮﻝ ﻭﻋﺪﻡ ﺍﻻﻟﺘﺰﺍﻡ ﺑﻬﺬﻩ ﺍﻻﺷﺘﺮﺍﻃﺎﺕ ﺗﺠﻌﻠﻨﻲ ﻋﺮﺿﻪ‬-
.‫ﻟﻤﻨﻊ ﺍﻟﺪﺧﻮﻝ ﺍﻟﻰ ﺍﻟﻤﻤﻠﻜﺔ ﺍﻟﻌﺮﺑﻴﺔ ﺍﻟﺴﻌﻮﺩﻳﺔ ﻭﺍﻟﺘﺒﻌﺎﺕ ﺍﻟﻘﺎﻧﻮﻧﻴﺔ‬

.(‫ ﻳﺸﺘﺮﻁ ﺣﻤﻞ ﺷﻬﺎﺩﺓ ﻭﺭﻗﻴﺔ ﻣﻌﺘﻤﺪﺓ ﻹﺛﺒﺎﺕ ﺃﺧﺬ ﺍﻟﻠﻘﺎﺡ ﻣﺼﺪﻗﺔ ﻣﻦ ﺍﻟﺠﻬﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺮﺳﻤﻴﺔ ﻓﻲ ﺑﻼﺩ ﺍﻟﻤﺴﺎﻓﺮﻳﻦ ﺍﻟﻘﺎﺩﻣﻴﻦ )ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺍﻭ ﺟﻬﺔ ﺻﺤﻴﺔ ﻣﺨﻮﻟﺔ‬-

- I acknowledge that the entered information is correct and that the information will be verified when the boarding pass is issued and at the ports
of entry, and the failure to comply with these requirements makes me open to preventing entry to the Kingdom of Saudi Arabia and the legal

- It is required to carry an approved paper certificate to prove the vaccination, certified by the official health authorities in the countries of arriving
travelers (the Ministry of Health or an authorized health authority).

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