(19-‫اﻟﺘﻘﺮﻳﺮ اﻟﻄﺒﻲ ﻟﺘﻄﻌﻴﻢ ﻓﺎﻳﺮوس ﻛﻮروﻧﺎ )ﻛﻮﻓﻴﺪ‬

COVID-19 Vaccine Medical Report

Full Name AYMEN QASEM GHALEB NAJI ‫اﻳﻤﻦ ﻗﺎﺳﻢ ﻏﺎﻟﺐ ﻧﺎﺟﻲ‬ ‫اﻻﺳﻢ‬

ID Number 2503191385 2503191385 ‫ر ﻗ ﻢ ا ﻟ ﻬ ﻮﻳ ﺔ‬

Date of birth 01 Jan 1994 1994 ‫ ​ ﻳﻨﺎﻳﺮ‬01 ‫ﺗﺎرﻳﺦ اﳌﻴﻼد‬

Nationality Yemen ‫اﻟﻴ ﻤ ﻦ‬ ‫اﻟ ﺠﻨ ﺴﻴ ﺔ‬

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

Date 2021-06-17 2021 ‫ ​ ﻳﻮﻧﻴﻮ‬17 ‫اﻟﺘﺎرﻳﺦ‬

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

Vaccine Type Moderna ‫ﻣ ﻮ دﻳ ﺮﻧ ﺎ‬ ‫ﻧ ﻮ ع اﻟﺘ ﻄ ﻌﻴ ﻢ‬

Date 2021-12-05 2021 ‫ ​ دﻳﺴﻤﺒﺮ‬05 ‫اﻟﺘﺎرﻳﺦ‬

Batch Number 939917 939917 ‫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 VCC050122108331 ‫ﻫﺬا اﻟﺘﻘﺮ ﻳﺮ‬

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