NATIONAL CRISIS PREPAREDNESS AND RESPONSE CENTRE (CPRC)

MINISTRY OF HEALTH MALAYSIA

Date of letter issued : 21/11/2021

Dear Sir/Madam,
REF: APPROVAL FOR HOSPITAL ADMISSION DURING QUARANTINE PERIOD

The above matter refers.

Please be informed that your request for hospital quarantine has been APPROVED and therefore
allowed to perform the mandatory quarantine at the stated address subject to compliance to all set
Standard Operating Procedures (SOPs), rules and regulations by the Government of Malaysia and
Ministry of Health. This approval is based on the travel details, arrival date, and residential address
including criteria declared in Appendix B.

Applicant's detail:

HQA Ref. No. : HSO201121161085

Name : LING MEE LANG

Passport No. / NRIC / : 450520085086

Address : REGENCY SPECIALIST HOSPITAL, NO.1,

JALAN SURIA, BANDAR SERI ALAM,
81750, JOHOR BHARU, JOHOR
Contact No. : +60199995800

Arrival Date : 22/11/2021

Please refer to Appendix B for the Standard Operating Procedures (SOPs), rules and regulations.
Failure to comply with the Home Surveillance Order (HSO) is an offence and chargeable in court.

Any enquiries including removal of wrist band kindly contact our staff at JKN JOHOR at +6072382217
/ +6072353306 or e-mail to cprcjknj@moh.gov.my for further information and clarification if required.
For more information on contact numbers or issues related to COVID19, you can visit
https://covid19.moh.gov.my/hotline.

Thank you.

Home Surveillance Order Committee

NATIONAL CRISIS PREPAREDNESS AND RESPONSE CENTRE (CPRC)
MINISTRY OF HEALTH MALAYSIA

The approval is only valid for one month from the date of approval and for single entry

This is a computer generated document. No signature is required.

Appendix B

This permission is granted subjected to compliance to all set Standard Operating Procedures (SOPs),
rules and regulations by the Government of Malaysia and Ministry of Health:

1. To do pre-departure PCR swab test within three (3) days before departure ;
2. This is required for all nationalities from all age group.
3. Download and register MySejahtera application before arrival;
4. Upon arrival you have to scan Mysejahtera QR code and required to
updates information.
5. The home address in MySejahtera must correspond to the address on the
approval given;
6. COVID-19 PCR swab test will be conducted on arrival;
7. Uneventful health screening outcome at the entry point;
8. Home Surveillance Order (HSO) and wristband will be given on arrival;
9. Wear a face mask and always practice physical distancing and comply with
SOPs during your quarantine period;
10. Use MySejahtera application to monitor COVID-19 symptoms and if you have
symptoms please seek treatment at the nearby health facility;
11. You must always be at the stated address during the quarantine period;
12. To do the second PCR swab test on Day 5 for 7 days quarantine, or Day 8 for
10 days quarantine;
13. Visitors are not allowed to visit you during the quarantine period;
14. To get Release Order and remove the wristband on Day 8, or Day 11 at the
nearest District Health Office.

** Note for those with digital wristband

The digital wristband must be removed at Private COVID-19 Assessment Center UELC, No 5, Jalan
51/217, Seksyen 51, 46050 Petaling Jaya , Selangor. To schedule for an appointment to remove the
digital wristband, please call the Hotline at 03-30008856.