‫ﺑﻄﺎﻗﺔ ﺗﻠﻘﻴﺢ ﺧﺎﺻﺔ ﺑﺎﻟﻜﻮﻓﻴﺪ ‪19‬‬ ‫اﻟﺠﻤﻬﻮرﻳﺔ اﻟﻠﺒﻨﺎﻧﻴﺔ‬

‫وزارة اﻟﺼﺤﺔ‬
‫‪Covid-19 Vaccination Record Card‬‬ ‫اﻟﻌﺎﻣﺔ‬

‫ﺗﺎرﻳﺦ اﻟﻮﻻدة ‪Date of birth‬‬ ‫اﻻﺳﻢ ‪Name‬‬

‫‪15/09/1996‬‬ ‫ﺣﻨﺎن ﻣﺤﻤﺪ اﻟﺴﺒﻼﻧﻲ‬
‫‪Hanan Mohamad Seblani‬‬

‫اﻟﺠﻨﺴﻴﺔ ‪Nationality‬‬ ‫رﻗﻢ ﻣﺴﺘﻨﺪ اﻟﺘﻌﺮﻳﻒ ‪ID number‬‬

‫ﻟﺒﻨﺎﻧﻲ‬ ‫‪000031997727‬‬
‫‪Lebanese‬‬

‫اﻟﺠﺮﻋﺔ اﻷوﻟﻰ ‪First Dose‬‬

‫ﻣﺮﻛﺰ اﻟﺘﻠﻘﻴﺢ ‪Vaccination Site‬‬ ‫ﺗﺎرﻳﺦ أﺧﺬ اﻟﻠﻘﺎح ‪Vaccination Date‬‬

‫ﻣﺴﺘﺸﻔﻰ دار اﻷﻣﻞ اﻟﺠﺎﻣﻌﻲ‬ ‫‪11:16 03/05/2021‬‬

‫ﻧﻮع اﻟﻠﻘﺎح ‪Manufacturer‬‬ ‫رﻗﻢ اﻟﻤﺠﻤﻮﻋﺔ ‪Lot Number‬‬

‫‪Pfizer, BioNTech‬‬ ‫‪NDC59267_1000_1‬‬

‫اﻟﺠﺮﻋﺔ اﻟﺜﺎﻧﻴﺔ ‪Second Dose‬‬

‫ﻣﺮﻛﺰ اﻟﺘﻠﻘﻴﺢ ‪Vaccination Site‬‬ ‫ﺗﺎرﻳﺦ أﺧﺬ اﻟﻠﻘﺎح ‪Vaccination Date‬‬

‫ﻣﺴﺘﺸﻔﻰ دار اﻷﻣﻞ اﻟﺠﺎﻣﻌﻲ‬ ‫‪11:16 01/06/2021‬‬

‫ﻧﻮع اﻟﻠﻘﺎح ‪Manufacturer‬‬ ‫رﻗﻢ اﻟﻤﺠﻤﻮﻋﺔ ‪Lot Number‬‬

‫‪Pfizer, BioNTech‬‬ ‫‪NDC59267-1000-1‬‬

‫اﻟﺮﻣﺰ اﻟﻤﺸﻔﺮ ‪QR Code‬‬

‫اﻟﺨﺼﻮﺻﻴﺔ ‪ -‬اﻟﺒﻨﻮد‬