(19-‫اﻟﺘﻘﺮﻳﺮ اﻟﻄﺒﻲ ﻟﺘﻄﻌﻴﻢ ﻓﺎﻳﺮوس ﻛﻮروﻧﺎ )ﻛﻮﻓﻴﺪ‬

COVID-19 Vaccine Medical Report

Full Name ABDULRAHMAN AHMED I AMAQAH ‫ﻋ ﺒ ﺪا ﻟ ﺮ ﺣ ﻤ ﻦ أ ﺣ ﻤ ﺪ ﺑ ﻦ اﺑ ﺮ ا ﻫ ﻴ ﻢ ﻋ ﻤ ﺎ ﻗ ﻪ‬ ‫اﻻﺳﻢ‬

ID Number 1133798239 1133798239 ‫ر ﻗ ﻢ ا ﻟ ﻬ ﻮﻳ ﺔ‬

Date of birth 31 Oct 2005 2005 ‫ ​ أﻛﺘﻮﺑﺮ‬31 ‫ﺗﺎرﻳﺦ اﳌﻴﻼد‬

Nationality Saudi Arabia ‫ا ﻟ ﺴ ﻌ ﻮ دﻳ ﺔ‬ ‫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 2021-08-01 2021 ‫ ​ أﻏﺴﻄﺲ‬01 ‫اﻟﺘﺎرﻳﺦ‬

Batch Number FF2153 FF2153 ‫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 2021-08-27 2021 ‫ ​ أﻏﺴﻄﺲ‬27 ‫اﻟﺘﺎرﻳﺦ‬

Batch Number FF5106 FF5106 ‫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 VCC010821203496 ‫ﻫﺬا اﻟﺘﻘﺮ ﻳﺮ‬

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