(19-‫اﻟﺘﻘﺮﻳﺮ اﻟﻄﺒﻲ ﻟﺘﻄﻌﻴﻢ ﻓﺎﻳﺮوس ﻛﻮروﻧﺎ )ﻛﻮﻓﻴﺪ‬

COVID-19 Vaccine Medical Report

Full Name ABDULRAHMAN MOHAMMED AHMED ALI ‫ﻋ ﺒ ﺪا ﻟ ﺮ ﺣ ﻤ ﻦ ﻣ ﺤ ﻤ ﺪ ا ﺣ ﻤ ﺪ ﻋ ﲇ‬ ‫اﻻﺳﻢ‬

ID Number 2095879355 2095879355 ‫ر ﻗ ﻢ ا ﻟ ﻬ ﻮﻳ ﺔ‬

Date of birth 28 Mar 1993 1993 ‫ ​ ﻣﺎرس‬28 ‫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 2021-03-15 2021 ‫ ​ ﻣﺎرس‬15 ‫اﻟﺘﺎرﻳﺦ‬

Batch Number 4120Z018 4120Z018 ‫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 VCC15032159406 ‫ﻫﺬا اﻟﺘﻘﺮ ﻳﺮ‬

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