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    ( (19 19 - ﻛ ﻮ ﻓ ﻴ ﺪ ﻛ ﻮ ﻓ ﻴ ﺪ) ) ﻛ ﻮ ر و ﻧﺎ ﻛ ﻮ ر و ﻧﺎ ﻓ ﺎﻳ ﺮ و س ﻓ ﺎﻳ ﺮ و س ﻟﺘ ﻄ ﻌ ﻴ ﻢ ﻟﺘ ﻄ ﻌ ﻴ ﻢ اﻟ ﻄ ﺒ ﻲ اﻟ ﻄ ﺒ ﻲ اﻟ ﺘ ﻘ ﺮﻳ ﺮ اﻟ ﺘ ﻘ ﺮﻳ ﺮ COVID-19 Vaccine Medical Report

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    ( (19 19 - ﻛ ﻮ ﻓ ﻴ ﺪ ﻛ ﻮ ﻓ ﻴ ﺪ) ) ﻛ ﻮ ر و ﻧﺎ ﻛ ﻮ ر و ﻧﺎ ﻓ ﺎﻳ ﺮ و س ﻓ ﺎﻳ ﺮ و س ﻟﺘ ﻄ ﻌ ﻴ ﻢ ﻟﺘ ﻄ ﻌ ﻴ ﻢ اﻟ ﻄ ﺒ ﻲ اﻟ ﻄ ﺒ ﻲ اﻟ ﺘ ﻘ ﺮﻳ ﺮ اﻟ ﺘ ﻘ ﺮﻳ ﺮ COVID-19 Vaccine Medical Report

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    ( (19 19 - ﻛ ﻮ ﻓ ﻴ ﺪ ﻛ ﻮ ﻓ ﻴ ﺪ) ) ﻛ ﻮ ر و ﻧﺎ ﻛ ﻮ ر و ﻧﺎ ﻓ ﺎﻳ ﺮ و س ﻓ ﺎﻳ ﺮ و س ﻟﺘ ﻄ ﻌ ﻴ ﻢ ﻟﺘ ﻄ ﻌ ﻴ ﻢ اﻟ ﻄ ﺒ ﻲ اﻟ ﻄ ﺒ ﻲ اﻟ ﺘ ﻘ ﺮﻳ ﺮ اﻟ ﺘ ﻘ ﺮﻳ ﺮ COVID-19 Vaccine Medical Report

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    (19-‫اﻟﺘﻘﺮﻳﺮ اﻟﻄﺒﻲ ﻟﺘﻄﻌﻴﻢ ﻓﺎﻳﺮوس ﻛﻮروﻧﺎ )ﻛﻮﻓﻴﺪ‬

    COVID-19 Vaccine Medical Report

    Full Name ---- ‫ﺳ ﻤ ﺮ ﻣ ﺸ ﻌ ﻞ ﺑ ﻦ ﻣﺎ ﻃ ﺮ اﳌﺎ ﻟ ﲃ‬ ‫اﻻﺳﻢ‬

    ID Number 1105516171 1105516171 ‫ر ﻗ ﻢ ا ﻟ ﻬ ﻮﻳ ﺔ‬

    Date of birth 11 Oct 1999 1999 ‫ ​ أﻛﺘﻮﺑﺮ‬11 ‫ﺗﺎرﻳﺦ اﳌﻴﻼد‬

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

    Vaccine Type AstraZeneca (VAXZEVRIA®, COVISHIELD™) ‫أﺳﺘﺮاز ﻳﻨﻴﻜﺎ‬ ‫ﻧ ﻮ ع اﻟﺘ ﻄ ﻌﻴ ﻢ‬

    Date 2021-09-04 2021 ‫ ​ ﺳﺒﺘﻤﺒﺮ‬04 ‫اﻟﺘﺎرﻳﺦ‬

    Batch Number 130521 130521 ‫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 2021-10-04 2021 ‫ ​ أﻛﺘﻮﺑﺮ‬04 ‫اﻟﺘﺎرﻳﺦ‬

    Batch Number FG3525 FG3525 ‫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 VCC04102130374 ‫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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