‫ﺗ ﻘ ﺮ ﻳ ﺮ إ ﺟﺎز ة ﻣ ﺮ ﺿ ﻴ ﺔ‬

‫‪Sick Leave Report‬‬

‫‪GSL22092806429‬‬

‫‪KHAMIS MUSHAIT GENERAL HOSPITAL states that patient‬‬

‫ﻳ ﻔ ﻴــ ﺪ ﻣ ﺴ ﺘ ﺸــ ﻔ ﻰ ﺧ ﻤ ﻴ ﺲ ﻣ ﺸــ ﻴ ﻂ ا ﻟ ﻌـ ﺎ م ﺑــــــ ﺄ ن ا ﻟ ﻤ ﺮ ﻳ ﺾ ﻧـ ﺎ ﻳ ﻒ ﻣ ﺴـ ﻔ ﺮ ﺳـ ﻌ ﺪ‬
‫‪NAIF MESFER SAAD ALQAHTANI Holder of ID Number‬‬
‫اﻟﻘﺤﻄﺎﻧﻲ ﺻﺎﺣﺐ اﻟﻬﻮﻳﺔ رﻗﻢ ‪ 1106724055‬ﻗﺪ ﻣﻨﺢ إﺟﺎزة ﻣﺮﺿﻴﺔ ل ‪ 2‬ﻣﻦ‬
‫‪1106724055 has been given a sick leave for 2 of days from‬‬
‫اﻷﻳﺎم ﻣﻦ ﺗﺎرﻳﺦ ‪ 28-02-1444‬إﻟﻰ ﺗﺎرﻳﺦ ‪ 29-02-1444‬ﺣﺴﺐ اﻟﺘﺎﻟﻲ‪:‬‬
‫‪2022-09-24 to 2022-09-25.‬‬

‫‪Patient’s Information‬‬ ‫ﺑ ﻴﺎ ﻧﺎ ت ا ﻟ ﻤ ﺮ ﻳ ﺾ‬

‫‪Medical Record Number: 1436008467‬‬ ‫رﻗﻢ اﻟﺴﺠﻞ اﻟﻄﺒﻲ ‪1436008467 :‬‬

‫‪National ID Number : 1106724055‬‬ ‫رﻗﻢ اﻟﻬﻮﻳﺔ اﻟﻮﻃﻨﻴﺔ ‪ /‬اﻹﻗﺎﻣﺔ ‪1106724055 :‬‬

‫‪Full Name : NAIF MESFER SAAD ALQAHTANI‬‬ ‫ا ﻻ ﺳ ﻢ اﻟ ﻜﺎ ﻣ ﻞ ‪ :‬ﻧﺎﻳ ﻒ ﻣ ﺴ ﻔ ﺮ ﺳ ﻌ ﺪ اﻟ ﻘ ﺤ ﻄﺎﻧ ﻲ‬

‫‪Sick Leave Issue Date : 2022-09-28‬‬ ‫ﺗﺎرﻳﺦ إﺻﺪار اﻹﺟﺎزة اﻟﻤﺮﺿﻴﺔ ‪02-03-1444 :‬‬

‫‪Gender :Male‬‬ ‫اﻟ ﺠﻨ ﺲ ‪ :‬ذ ﻛ ﺮ‬

‫‪Date of Birth : 2000-01-17‬‬ ‫ﺗﺎرﻳﺦ اﻟﻤﻴﻼد ‪1420-10-10 :‬‬

‫‪Nationality : Saudi Arabia‬‬ ‫اﻟ ﺠ ﻨ ﺴ ﻴ ﺔ ‪ :‬اﻟ ﺴ ﻌ ﻮ دﻳ ﺔ‬

‫‪Employer :‬‬ ‫ﺟ ﻬ ﺔ اﻟ ﻌ ﻤ ﻞ ‪:‬‬

‫‪Occupation :‬‬ ‫اﻟ ﻤ ﻬﻨ ﺔ ‪:‬‬

‫‪Visit Date : 2022-09-24‬‬ ‫ﺗﺎرﻳﺦ اﻟﺪﺧﻮل ‪28-02-1444 :‬‬

‫‪Discharge Date : 2022-09-24‬‬ ‫ﺗﺎرﻳﺦ اﻟﺨﺮوج ‪28-02-1444 :‬‬

‫‪Revisit Date :‬‬ ‫ﺗﺎرﻳ ﺦ ا ﻟ ﻤ ﺮ ا ﺟ ﻌ ﺔ ‪:‬‬

‫‪Recommendation‬‬ ‫ا ﻟ ﺘ ﻮ ﺻ ﻴﺎ ت‬

‫‪Sick Leave for 2 days‬‬ ‫ﺗ ﻢ ﻣ ﻨ ﺤ ﻪ إ ﺟﺎز ة ﻣ ﺮ ﺿ ﻴ ﺔ ﻟ ﻤ ﺪ ة ‪ 2‬أﻳﺎ م‬

‫‪From : 2022-09-24‬‬ ‫ﻣﻦ ﺗﺎرﻳﺦ ‪28-02-1444 :‬‬

‫‪To : 2022-09-25‬‬ ‫ﺣﺘﻰ ﺗﺎرﻳﺦ ‪29-02-1444 :‬‬

‫‪Consultation Date :‬‬ ‫ﻣ ﺮ ا ﺟ ﻌ ﺔ ا ﻟ ﻄ ﺒ ﻴ ﺐ ا ﻟ ﻤ ﻌﺎ ﻟ ﺞ ﻗ ﺒ ﻞ اﻧ ﺘ ﻬﺎ ء إ ﺟﺎزﺗ ﻪ ‪:‬‬

‫‪Attending Physician Information‬‬ ‫ﺑ ﻴﺎ ﻧﺎ ت ا ﻟ ﻄﺒ ﻴ ﺐ ا ﻟ ﻤ ﻌﺎ ﻟ ﺞ‬

‫‪Name : SELVAKUMAR JEGANATHAN - PARAMASIVAM‬‬ ‫ا ﻻ ﺳ ﻢ ‪ :‬ﺳ ﻴ ﻠ ﻔﺎ ﻛ ﻮ ﻣﺎر ﺟ ﻴ ﻐﺎﻧﺎﺗﺎ ن ‪ -‬ﺑﺎر ا ﻣﺎ ﺳ ﻴ ﻔﺎ م‬

‫‪Position : Registrar‬‬ ‫ا ﻟ ﻤ ﺴ ﻤ ﻰ ا ﻟ ﻮ ﻇ ﻴ ﻔ ﻲ ‪ :‬ﻧﺎﺋ ﺐ‬

‫‪Alternate Physician Information‬‬ ‫ﺑ ﻴﺎ ﻧﺎ ت ا ﻟ ﻄﺒ ﻴ ﺐ ا ﻟ ﻤﻨﺎ و ب‬

‫‪Name :‬‬ ‫اﻻﺳﻢ ‪:‬‬

‫‪Position :‬‬ ‫اﻟ ﻤ ﺴ ﻤ ﻰ اﻟ ﻮ ﻇ ﻴ ﻔ ﻲ ‪:‬‬

‫ﻟ ﻠ ﺘ ﺤ ﻘ ﻖ ﻣ ﻦ ﺻ ﺤ ﺔ ا ﻟ ﺘ ﻘ ﺮﻳ ﺮ ﻳ ﺮ ﺟ ﻰ زﻳﺎر ة ﻣ ﻨ ﺼ ﺔ ﺻ ﺤ ﺔ ﻋ ﻠ ﻰ‬
‫اﻟ ﺮاﺑ ﻂ‬
‫‪https://www.seha.sa/Home/SickLeave‬‬
‫و إ د ﺧﺎ ل اﻟ ﺮ ﻗ ﻢ اﻟ ﻤ ﺮ ﺟ ﻌ ﻲ ﻟ ﻠ ﺘ ﻘ ﺮﻳ ﺮ‬