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KINGDOM OF CAMBODIA

NATION- RELIGION -KING

MINISTRY OF HEALTH Phnom Penh, Date: 21 March, 2022

No: 211387 DGH

Medical Certificate for General Passenger

The Ministry of Health, Kingdom of


Cambodia, certifies that
Sex: Male
Mr. 0JHA AMIT KUMAR
Date of Birth: 29 May 1988
Passport No: L1678201

Nationality: INDIAN

Health
The National Institute of Public
Has been examined and tested by
on the genome
detection of 2019 novel
Laboratory and have found Negative with
and Oropharyngeal specimen
coronavirus (SARS-CoV-2) in Nasopharyngeal

reference number: n CoVC-19 211387

after the issued date.


This certificate is valid for 72 hours

Sertified by:
A sy of Health

D
segnasa KKimcheng
rector General for Health

TUOL KORK DISTRICT, PHNOM PENH.


PHONEIFAX: (856-23) 885 970
HEALTH No. 80, SAMDECH PENN
NOUTH Blvd. (289), SANGKAT BOEUNGKAK 2,
MINISTRY OF

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