(19-‫اﻟﺘﻘﺮﻳﺮ اﻟﻄﺒﻲ ﻟﺘﻄﻌﻴﻢ ﻓﺎﻳﺮوس ﻛﻮروﻧﺎ )ﻛﻮﻓﻴﺪ‬

COVID-19 Vaccine Medical Report

Full Name OSAMA ISMAIL ABD ALFATAH ALNATUR ‫ا ﺳﺎ ﻣ ﺔ ا ﺳ ﻤﺎ ﻋ ﻴ ﻞ ﻋ ﺒ ﺪا ﻟ ﻔ ﺘﺎ ح ﺣ ﻤﺎ د ا ﻟ ﻨﺎ ﻃ ﻮر‬ ‫اﻻﺳﻢ‬

ID Number 2028811517 2028811517 ‫ر ﻗ ﻢ ا ﻟ ﻬ ﻮﻳ ﺔ‬

Date of birth 28 Feb 1982 1982 ‫ ​ ﻓﺒﺮاﻳﺮ‬28 ‫ﺗﺎرﻳﺦ اﳌﻴﻼد‬

Nationality ‫ﻓﻠﺴﻄﻴﲏ ﺑﻮﺛﻴﻘﺔ ﻣﺼﺮ ﻳﺔ‬ ‫ﻓﻠﺴﻄﻴﲏ ﺑﻮﺛﻴﻘﺔ ﻣﺼﺮ ﻳﺔ‬ ‫اﻟ ﺠﻨ ﺴﻴ ﺔ‬

Vaccine Type Pfizer-BionTech (COMIRNATY®) ‫ﺑ ﻴ ﻮﻧ ﺘ ﻚ‬- ‫ﻓ ﺎﻳ ﺰ ر‬ ‫ﻧ ﻮ ع اﻟﺘ ﻄ ﻌﻴ ﻢ‬

Date 2021-06-05 2021 ‫ ​ ﻳﻮﻧﻴﻮ‬05 ‫اﻟﺘﺎرﻳﺦ‬

Batch Number EY5456 EY5456 ‫ر ﻗ ﻢ اﻟﺘ ﺸ ﻐﻴ ﻠ ﺔ‬

Vaccine Type Pfizer-BionTech (COMIRNATY®) ‫ﺑ ﻴ ﻮﻧ ﺘ ﻚ‬- ‫ﻓ ﺎﻳ ﺰ ر‬ ‫ﻧ ﻮ ع اﻟﺘ ﻄ ﻌﻴ ﻢ‬

Date 2021-08-18 2021 ‫ ​ أﻏﺴﻄﺲ‬18 ‫اﻟﺘﺎرﻳﺦ‬

Batch Number FD5613 FD5613 ‫ر ﻗ ﻢ اﻟﺘ ﺸ ﻐﻴ ﻠ ﺔ‬

Vaccine Type Pfizer-BionTech (COMIRNATY®) ‫ﺑ ﻴ ﻮﻧ ﺘ ﻚ‬- ‫ﻓ ﺎﻳ ﺰ ر‬ ‫ﻧ ﻮ ع اﻟﺘ ﻄ ﻌﻴ ﻢ‬

Date 2022-01-03 2022 ‫ ​ ﻳﻨﺎﻳﺮ‬03 ‫اﻟﺘﺎرﻳﺦ‬

Batch Number FK8892 FK8892 ‫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 VCC05062165602 ‫ﻫﺬا اﻟﺘﻘﺮ ﻳﺮ‬

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