‫ﺗﻘﺮﻳﺮ إﺟﺎزة ﻣﺮﺿﻴﺔ‬

Sick Leave Report

GSL20070900023

di sp
s pe ennssaar
r yy hhud
udaaiip
p states that patient FFU UTTU
UNN SAU
SAUD ‫ﺘﻮنن‬
‫ﻳﺐ ﺑﺄن اﻟﻤﺮﻳﺾ ﻓﻓﺘﻮ‬ ‫ﻴﺔ ﺑﺑﻬﻬﺪﺪﻳﺐ‬
‫اﻻووﻟﻟﻴﺔ‬
‫ﺤﻴﻴﺔﺔ اﻻ‬‫ﺼﺤ‬‫اﻟﺼ‬
‫ﺮﻋ ﺎﺎﻳﻳﺔﺔ اﻟ‬
‫ﻛﺰ ااﻟﻟﺮﻋ‬
‫ﻳﻔﻴﺪ ﻣﻣﺮﺮﻛ ﺰ‬
RAT
R ATIIB B A AL R UWAI
UWA IL I Holder of ID Number 111 11113366667793
93 111 1111336666779933 ‫ﻲ ﺻﺎﺣﺐ اﻟﻬﻮﻳﺔ رﻗﻢ‬ ‫ﺐ ااﻟﻟﺮﺮووﻳﻳﻠﻠﻲ‬‫راﺗﺗﺐ‬‫ﺳﻌﻌﻮﻮدد را‬ ‫ﺳ‬
(t el : 11
1 1113
113666793)
6793) has been given a sick leave for 11 of ‫ ﻣﻦ اﻷﻳﺎم ﻣﻦ ﺗﺎرﻳﺦ‬11 ‫(( ﻗﺪ ﻣﻨﺢ إﺟﺎزة ﻣﺮﺿﻴﺔ ل‬tteel: l:1111111136
3666793 793))
days from 20 202 2 0-07-01
0 -07-01 to 22002200--0077--0011. :‫ ﺣﺴﺐ اﻟﺘﺎﻟﻲ‬1100--1111--11444411 ‫ إﻟﻰ ﺗﺎرﻳﺦ‬1100--11 11--1144 4411
Pa ttii eenntt’s
’s I nf
n fo r m a t i o n ‫ﺾ‬
‫ﺮﻳﺾ‬
‫ﻤﺮﻳ‬
‫ت ااﻟﻟﻤ‬
‫ﺑﻴ ﺎﺎﻧﻧﺎﺎت‬
‫ﺑﻴ‬
Medical Record Number: 1111366793 (tel:1111366793) 1111366793 : ‫( رﻗﻢ اﻟﺴﺠﻞ اﻟﻄﺒﻲ‬tel:1111366793)

National ID Number : 1111366793 (tel:1111366793) 1111366793 : ‫ اﻹﻗﺎﻣﺔ‬/ ‫( رﻗﻢ اﻟﻬﻮﻳﺔ اﻟﻮﻃﻨﻴﺔ‬tel:1111366793)

Full Name : FUTUN SAUD RATIB ALRUWAILI ‫ ﻓﺘﻮن ﺳﻌﻮد راﺗﺐ اﻟﺮوﻳﻠﻲ‬: ‫اﻻﺳﻢ اﻟﻜﺎﻣﻞ‬

Sick Leave Date : 2020-07-09 18-11-1441 : ‫ﺗﺎرﻳﺦ اﻻﺟﺎزة‬

Gender :Female ‫ أﻧﺜﻰ‬: ‫اﻟﺠﻨﺲ‬

Date of Birth : 2001-04-22 1422-01-28 : ‫ﺗﺎرﻳﺦ اﻟﻤﻴﻼد‬

Nationality : Saudi Arabia ‫ اﻟﺴﻌﻮدﻳﺔ‬: ‫اﻟﺠﻨﺴﻴﺔ‬

Employer : : ‫ﺟﻬﺔ اﻟﻌﻤﻞ‬

Occupation : : ‫اﻟﻤﻬﻨﺔ‬

Visit Date : 2020-07-01 10-11-1441 : ‫ﺗﺎرﻳﺦ اﻟﺪﺧﻮل‬

Discharge Date : 2020-07-01 10-11-1441 : ‫ﺗﺎرﻳﺦ اﻟﺨﺮوج‬
Revisit Date : : ‫ﺗﺎرﻳﺦ اﻟﻤﺮاﺟﻌﺔ‬

R
Reeccom
ommmeend
ndat
atiioon
n ‫ت‬
‫ﻮﺻﻴﻴﺎﺎت‬
‫ااﻟﻟﺘﺘﻮ ﺻ‬

Sick Leave for 1 days ‫ أﻳﺎم‬1 ‫ﺗﻢ ﻣﻨﺤﻪ إﺟﺎزة ﻣﺮﺿﻴﺔ ﻟﻤﺪة‬

From : 2020-07-01 10-11-1441 : ‫ﻣﻦ ﺗﺎرﻳﺦ‬

To : 2020-07-01 10-11-1441 : ‫ﺣﺘﻰ ﺗﺎرﻳﺦ‬

Consultation Date : : ‫ﻣﺮاﺟﻌﺔ اﻟﻄﺒﻴﺐ اﻟﻤﻌﺎﻟﺞ ﻗﺒﻞ اﻧﺘﻬﺎء إﺟﺎزﺗﻪ‬

Attend
Atte ndiing
ng PPhys
hysic
iciian
an IInf
nform
ormat
ation
ion ‫ﺞ‬
‫ﻤﻌﺎﺎﻟﻟﺞ‬
‫ﻴﺐ ااﻟﻟﻤ ﻌ‬
‫ﻟﻄ ﺒﻴﺐ‬
‫ﺎت ااﻟ ﻄ‬
‫ﺎﻧﺎ ت‬
‫ﺑﺑﻴﻴﺎ ﻧ‬

Name : NAYZ AHMAD - MOULVI ‫ ﻧﻴﺎز اﺣﻤﺪ ﻣﻮﻟﻮي‬: ‫اﻻﺳﻢ‬

Position : General Practitioner ‫ ﻃﺒﻴﺐ ﻋﺎم‬: ‫اﻟﻤﺴﻤﻰ اﻟﻮﻇﻴﻔﻲ‬

Alte
Alt errn aattee PPhysi
hysicciian
an IInf
nform
ormat
atiion
on ‫وب‬
‫ﻤﻨﻨﺎﺎوب‬
‫ﺐ ااﻟﻟﻤ‬
‫ﻄﺒﺒﻴﻴﺐ‬
‫ت ااﻟﻟﻄ‬
‫ﺑﻴﺎﺎﻧﻧﺎﺎت‬
‫ﺑﻴ‬

Name : : ‫اﻻﺳﻢ‬
Position : : ‫اﻟﻤﺴﻤﻰ اﻟﻮﻇﻴﻔﻲ‬