Certificate of Health Insurance - Individuals

‫ ﻟﻸﻓﺮﺍﺩ‬- ‫ﺷﻬﺎﺩﺓ ﺍﻟﺘﺄﻣﻴﻦ ﺍﻟﺼﺤﻲ‬

EMERGING GLOBAL TECHNOLOGIES L.L.C DXB

Name of employer/sponsor BRANCH ‫ ﺍﻟﻜﻔﻴﻞ‬/ ‫ﺍﺳﻢ ﺻﺎﺣﺐ ﺍﻟﻌﻤﻞ‬

Effective date of insurance policy 21/05/2023 ‫ﺍﻟﺘﺎﺭﻳﺦ ﺍﻟﻔﻌﻠﻰ ﻟﺒﻮﻟﻴﺼﺔ ﺍﻟﺘﺄﻣﻴﻦ‬

Enrolment date for this insured member 21/05/2023 ‫ﺗﺎﺭﻳﺦ ﻗﻴﺪ ﺍﻟﻌﻀﻮ ﺍﻟﻤﺆﻣﻦ ﻋﻠﻴﻪ‬
Insured member's full name ‫ﺍﻹﺳﻢ ﺍﻟﻜﺎﻣﻞ ﻟﻠﻤﺆﻣﻦ ﻋﻠﻴﻪ‬
TASEER MOHAMMAD
Insured member's UID number ‫ﺍﻟﺮﻗﻢ ﺍﻟﻤﻮﺣﺪ ﻟﻠﻤﺆﻣﻦ ﻋﻠﻴﻪ‬
784199284710912
Expiry date of insurance policy ‫ﺗﺎﺭﻳﺦ ﺍﻧﺘﻬﺎﺀ ﺑﻮﻟﻴﺼﺔ ﺍﻟﺘﺄﻣﻴﻦ‬
20/05/2024

Number of persons holding a visa under ‫ﻋﺪﺩ ﺍﻷﺷﺨﺎﺹ ﺍﻟﺬﻳﻦ ﻳﺤﻤﻠﻮﻥ ﺗﺄﺷﻴﺮﺓ ﺻﺎﺣﺐ‬
this employer/sponsor ‫ ﺍﻟﻜﻔﻴﻞ‬/ ‫ﺍﻟﻌﻤﻞ‬
(complete as applicable) NA (‫)ﺗﻤﻸ ﺣﺴﺐ ﺍﻟﺤﺎﻟﺔ‬
Lower salary band employees ‫ﺷﻌﺒﺔ ﺍﻟﻤﻮﻇﻔﻴﻦ ﻣﻨﺨﻔﻀﻲ ﺍﻟﺮﻭﺍﺗﺐ‬
NA
Other employees ‫ﺑﺎﻗﻲ ﺷﻌﺐ ﺍﻟﻤﻮﻇﻔﻴﻦ‬
NA
Total employees ‫ﺍﻟﻌﺪﺩ ﺍﻹﺟﻤﺎﻟﻰ ﻟﻠﻤﻮﻇﻔﻴﻦ‬
NA
Spouses insured (if any) (‫ﺃﺯﻭﺍﺝ ﺍﻟﻤﺆﻣﻦ )ﺇﻥ ﻭﺟﺪ‬
NA
Dependents insured (if any) (‫ﺃﺑﻨﺎﺀ ﺍﻟﻤﺆﻣﻦ )ﺇﻥ ﻭﺟﺪ‬
NA

Number of insured members under the ‫ﻋﺪﺩ ﺍﻷﻋﻀﺎﺀ ﺍﻟﻤﺆﻣﻦ ﻋﻠﻴﻬﻢ ﻓﻰ ﻭﺛﻴﻘﺔ ﺍﻟﺘﺄﻣﻴﻦ‬
subject insurance policy NA ‫ﺍﻟﻤﺬﻛﻮﺭﺓ‬

This certificate confirms that the above named insured member has ‫ﻫﺬﻩ ﺍﻟﺸﻬﺎﺩﺓ ﺗﺆﻛﺪ ﺃﻥ ﺍﻟﻌﻀﻮ ﺍﻟﻤﺆﻣﻦ ﺃﻋﻼﻩ ﺗﻮﻓﺮ ﻟﻪ ﺍﻟﺘﺄﻣﻴﻦ ﺍﻟﺼﺤﻰ‬
been provided with health insurance, that meets or exceeds the ‫ﺍﻟﺬﻱ ﻳﻠﺒﻲ ﺃﻭ ﻳﺘﺠﺎﻭﺯ ﺍﻟﻤﺴﺘﻮﻯ ﺍﻷﺩﻧﻰ ﻣﻦ ﻣﻨﺎﻓﻊ ﺍﻟﺘﻐﻄﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻛﻤﺎ ﻫﻮ ﻣﻨﺼﻮﺹ‬
minimum benefit levels as stipulated by Dubai Health Authority. ‫ﻋﻠﻴﻪ ﻣﻦ ﻗﺒﻞ ﻫﻴﺌﺔ ﺍﻟﺼﺤﺔ ﻓﻰ ﺩﺑﻲ‬
(This certificate is valid for 30 days from its issue date) (‫ ﻳﻮﻣﺎ ﻣﻦ ﺗﺎﺭﻳﺦ ﺍﻹﺻﺪﺍﺭ‬30 ‫)ﻫﺬﻩ ﺍﻟﺸﻬﺎﺩﺓ ﺻﺎﻟﺤﺔ ﻟﻤﺪﺓ‬

Date of this certificate ‫ﺗﺎﺭﻳﺦ ﻫﺬﻩ ﺍﻟﺸﻬﺎﺩﺓ‬

6/6/2023

Note: This is an electronically generated document, an authorised

‫ ﻟﻘﺪ ﺗﻢ ﺗﺤﺮﻳﺮ ﻫﺬﺍ ﺍﻟﻤﺴﺘﻨﺪ ﺇﻟﻜﺘﺮﻭﻧﻴﺎ ﻭﻻ ﻳﺤﺘﺎﺝ ﺇﻟﻰ ﺗﻮﻗﻴﻊ ﻣﻌﺘﻤﺪ ﺃﻭ‬:‫ﻣﻼﺣﻈﺔ‬
signature/stamp is not required.
.‫ﺧﺘﻢ‬

MEMBER CONFIDENTIAL
National Health Insurance Company – Daman (PJSC) (P.O. Box 128888, Abu Dhabi, U.A.E. Tel No. +97126149555 Fax No. +97126149550)
Doc Ctrl No.: F/1835 Version No.: 1 Revision No.: 3 Date of Issue: 27.11.2019 Page No(s).: 1 of 1