Ministry of Health & Population glSulig dell dylig Preventive Sector eligi cla General Quarantine Department So sell pall aaLell 315 Eee Public health card G6) Seal OS oo oy ‘we care for your health Kindly fill the eer arena Full Name Daly al ‘AgelSex Elly Gal Nationality ia > Passport No. pat 519 ab] Country of Departure (gis pal agi Date of Arrival Weg G8 Flight No/ Seat No. BAL gy Anal gy [Airline Name Dlpaall Be paul Residence address in Egypt Tor neat 3 wecks Tat gy VV SE pans LLY gigas Phone Number in Egypt ys od CghaEl ay Mobile Phone ‘gas! 6 gitl 3, Email Address gS! sal ‘Ministry of Health & Population j a, Preyentive Sector iligll glbaill General Quarantine Department greall pall dalell dyl5,fl Public health card dole)! dowal! 5 Ups (piled ll USL eI alal (V) Radke gud Please mark (V) if you have any of the following symptoms High Fever more than (38)¢ ANA) Go SIE pall ays GP ELIT Vomiting cal Diarrhoea el ‘Unusual weakness oleh om Headache Rash Difficulty in breathing Tn the last (21) days did you have close contact with someone who had any Communicable illness? Yes(_) No( ) (Mention) (eG Lagy TY DS pels Jats lala Js CYC ) pai sane dye de oly dls Uae (oa pMl si) eal FS a Te 1 esleall 3g