١٩- ‫ﺷﻬﺎدة ﺗﻄﻌﻴﻢ ﺿﺪ ﻓﻴﺮوس ﻛﻮروﻧﺎ ﻛﻮﻓﻴﺪ‬

COVID-19 Vaccination Certificate

Name: CLEMENS SILUVAI CRUZE :‫اﻹﺳﻢ‬

QID/Passport: 25635609416 :‫ ﺟﻮاز اﻟﺴﻔﺮ‬/ ‫رﻗﻢ اﻟﺒﻄﺎﻗﺔ اﻟﺸﺨﺼﻴﺔ‬

Date of Birth (Day / Month / Year): 09/05/1956 :(‫ اﻟﺴﻨﺔ‬/‫ اﻟﺸﻬﺮ‬/ ‫ﺗﺎرﻳﺦ اﻟﻤﻴﻼد )اﻟﻴﻮم‬

Nationality: INDIA :‫اﻟﺠﻨﺴﻴﺔ‬

‫ ﻛﻤﺎ ﻫﻮ ﻣﺸﺎر إﻟﻴﻪ‬1 9-‫اﻟﻤﺬﻛﻮر أﻋﻼه ﺣﺼﻞ ﻋﻠﻰ اﻟﺠﺮﻋﺔ اﻟﻜﺎﻣﻠﺔ ﻟــﻠﻘﺎح ﻛﻮﻓﻴﺪ‬
The above mentioned has received the full course of the following
Covid-19 vaccine as indicated

Vaccine Name: COVID-19, mRNA, LNP-S, PF, 100 mcg/ 0.5 mL dose :‫اﺳﻢ اﻟﻠﻘﺎح‬

First dose received on: 31/05/2021 :‫أﻋﻄﻴﺖ اﻟﺠﺮﻋﺔ اﻷوﻟﻰ ﺑﺘﺎرﻳﺦ‬

Second dose received on: 30/06/2021 :‫أﻋﻄﻴﺖ اﻟﺠﺮﻋﺔ اﻟﺜﺎﻧﻴﺔ ﺑﺘﺎرﻳﺦ‬

Dr. Hamad Eid Al-Romaihi ‫اﻟﺪﻛﺘﻮر ﺣﻤﺪ ﻋﻴﺪ اﻟﺮﻣﻴﺤﻲ‬

Manager of Health Protection and Communicable ‫ﻣﺪﻳﺮ ﺣﻤﺎﻳﺔ اﻟﺼﺤﺔ وﻣﻜﺎﻓﺤﺔ اﻷﻣﺮاض‬
Diseases
‫اﻻﻧﺘﻘﺎﻟﻴﺔ‬
Public Health Department
‫إدارة اﻟﺼﺤﺔ اﻟﻌﺎﻣﺔ‬
P.O. Box – 42, Doha – Qatar
‫ ﻗﻄﺮ‬،‫ – اﻟﺪوﺣﺔ‬42 .‫ب‬.‫ص‬

.‫ ﻗﻄﺮ‬،‫ﻫﺬه اﻟﺸﻬﺎدة ﻫﻲ وﺛﻴﻘﺔ رﺳﻤﻴﺔ ﻣﻮﻗﻌﺔ رﻗﻤ ﻴ ًﺎ وﺻﺎدرة ﻋﻦ وزارة اﻟﺼﺤﺔ اﻟﻌﺎﻣﺔ – اﻟﺪوﺣﺔ‬
This certificate is an official document that is digitally signed and issued by the Ministry of Public
Health, Doha, Qatar.