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(19-‫اﻟﺘﻘﺮﻳﺮ اﻟﻄﺒﻲ ﻟﺘﻄﻌﻴﻢ ﻓﺎﻳﺮوس ﻛﻮروﻧﺎ )ﻛﻮﻓﻴﺪ‬

COVID-19 Vaccine Medical Report

Full Name RAFEH MUDLAH FAHAD ALDOSARI ‫ر ﻓ ﻌ ﻪ ﻣ ﺪﻟ ﻪ ﻓ ﻬ ﺪ اﻟ ﺪ و ﺳﺮ ي‬ ‫اﻻﺳﻢ‬

ID Number 1090736784 1090736784 ‫ر ﻗ ﻢ ا ﻟ ﻬ ﻮﻳ ﺔ‬

Date of birth 21 May 1996 1996 ‫ ​ ﻣﺎﻳﻮ‬21 ‫ﺗﺎرﻳﺦ اﳌﻴﻼد‬

Nationality Saudi Arabia ‫ا ﻟ ﺴ ﻌ ﻮ دﻳ ﺔ‬ ‫اﻟ ﺠﻨ ﺴﻴ ﺔ‬

Vaccine Type Pfizer-BioNTech ‫ﺑ ﻴ ﻮﻧ ﺘ ﻚ‬- ‫ﻓ ﺎﻳ ﺰ ر‬ ‫ﻧ ﻮ ع اﻟﺘ ﻄ ﻌﻴ ﻢ‬

Date 2021-07-02 2021 ‫ ​ ﻳﻮﻟﻴﻮ‬02 ‫اﻟﺘﺎرﻳﺦ‬

Batch Number FC9000 FC9000 ‫ر ﻗ ﻢ اﻟﺘ ﺸ ﻐﻴ ﻠ ﺔ‬

Vaccine Type Pfizer-BioNTech ‫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 Moderna ‫ﻣ ﻮ دﻳ ﺮﻧ ﺎ‬ ‫ﻧ ﻮ ع اﻟﺘ ﻄ ﻌﻴ ﻢ‬

Date 2022-02-07 2022 ‫ ​ ﻓﺒﺮاﻳﺮ‬07 ‫اﻟﺘﺎرﻳﺦ‬

Batch Number 001K21A 001K21A ‫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 VCC02072121726 ‫ﻫﺬا اﻟﺘﻘﺮ ﻳﺮ‬

https://VaccineCertificate.sehhaty.sa https://VaccineCertificate.sehhaty.sa

www.moh.gov.sa | 937 | SaudiMOH | MOHPortal | SaudiMOH | Saudi_MOH

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