(19-‫اﻟﺘﻘﺮﻳﺮ اﻟﻄﺒﻲ ﻟﺘﻄﻌﻴﻢ ﻓﺎﻳﺮوس ﻛﻮروﻧﺎ )ﻛﻮﻓﻴﺪ‬

COVID-19 Vaccine Medical Report

Full Name NAZAR KOVVAL PUHIYA PURAYIL ‫ﻧﻈﺮ ﻛﻮﻓﺎل ﺑﻮﻫﻲ ﺑﻮراﺋﻴﻞ‬ ‫اﻻﺳﻢ‬

ID Number 2103727984 2103727984 ‫ر ﻗ ﻢ ا ﻟ ﻬ ﻮﻳ ﺔ‬

Date of birth 01 Jan 1971 1971 ‫ ​ ﻳﻨﺎﻳﺮ‬01 ‫ﺗﺎرﻳﺦ اﳌﻴﻼد‬

Nationality India ‫اﻟ ﻬﻨ ﺪ‬ ‫اﻟ ﺠﻨ ﺴﻴ ﺔ‬

Vaccine Type Oxford-AstraZeneca ‫أﺳﺘﺮاز ﻳﻨﻴﻜﺎ‬-‫أﻛﺴﻔﻮرد‬ ‫ﻧ ﻮ ع اﻟﺘ ﻄ ﻌﻴ ﻢ‬

Date 2021-04-22 2021 ‫ ​ أﺑﺮ ﻳﻞ‬22 ‫اﻟﺘﺎرﻳﺦ‬

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

Vaccine Type Oxford-AstraZeneca ‫أﺳﺘﺮاز ﻳﻨﻴﻜﺎ‬-‫أﻛﺴﻔﻮرد‬ ‫ﻧ ﻮ ع اﻟﺘ ﻄ ﻌﻴ ﻢ‬

Date 2021-07-15 2021 ‫ ​ ﻳﻮﻟﻴﻮ‬15 ‫اﻟﺘﺎرﻳﺦ‬

Batch Number OutsideKingdom OutsideKingdom ‫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 2022-01-09 2022 ‫ ​ ﻳﻨﺎﻳﺮ‬09 ‫اﻟﺘﺎرﻳﺦ‬

Batch Number FM3496 FM3496 ‫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 VCC09012272753 ‫ﻫﺬا اﻟﺘﻘﺮ ﻳﺮ‬

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

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