‫‪.‬ﻣﺨﺘﺒﺮ ﺍﻟﻨﺨﺒﺔ ﺍﻟﺪﻭﻟﻲ ﺍﻟﺘﺨﺼﺼﻲ‪.

‬‬ ‫ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ‪ /‬ﺍﻟﺒﻴﺌﺔ‬

‫ﺩﺍﺋﺮﺓ ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﻟﻄﺒﻴﺔ ﺍﻟﺸﻌﺒﻴﺔ‬
‫ﻟﻠﺘﺤﻠﻴﻼﺕ ﺍﻟﻤﺮﺿﻴﺔ ﺍﻟﻤﺘﻘﺪﻣﺔ‬ ‫‪Republic of Iraq‬‬
‫‪Ministory of‬‬
‫ﺍﻟﻤﺠﺎﺯ ﻣﻦ ﻗﺒﻞ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺮﺍﻗﻴﺔ‬ ‫‪Health/Envoirnment‬‬
‫‪Directorate of Popular‬‬
‫‪Medical Clincs‬‬

‫‪Health Certificate‬‬ ‫ﺷﻬﺎﺩﺓ ﻓﺤﺺ ﺻﺤﻴﺔ‬

‫‪Novel Coronavirus test 2019‬‬ ‫ﻓﺤﺺ ﻓﺎﻳﺮﻭﺱ ﻛﻮﺭﻭﻧﺎ ﺍﻟﻤﺴﺘﺠﺪ‬
‫‪This certificate is upon personal request , not under any‬‬ ‫ﻣﻨﺤﺖ ﻫﺬﻩ ﺍﻟﺸﻬﺎﺩﺓ ﺑﻨﺎﺀ ﻋﻠﻰ ﺭﻏﺒﺔ ﺍﻟﺸﺨﺺ ﺩﻭﻥ ﺍﻱ ﻣﺴﺆﻭﻟﻴﺔ ﻋﻠﻰ ﺍﻟﺠﻬﺔ ﺍﻟﻤﺎﻧﺤﺔ‬
‫‪responsibility‬‬

‫‪Full Name‬‬ ‫ﻋﻠﻲ ﻗﺤﻄﺎﻥ ﻋﺒﺪ‬ ‫ﺍﻻﺳﻢ ﺍﻟﻜﺎﻣﻞ‬

‫‪Gender - Age‬‬ ‫‪Male - 34‬‬ ‫ﺍﻟﺠﻨﺲ ‪ -‬ﺍﻟﻌﻤﺮ‬
‫‪Registeration No‬‬ ‫‪2-13-6359‬‬ ‫ﺭﻗﻢ ﺍﻟﺘﺴﻠﺴﻞ‬
‫‪Passport / ID No‬‬ ‫‪2-13-6359‬‬ ‫ﺭﻗﻢ ﺍﻟﺠﻮﺍﺯ ‪ /‬ﺍﻟﺒﻄﺎﻗﺔ ﺍﻟﺘﻌﺮﻳﻔﻴﺔ‬
‫‪ID No‬‬ ‫ﺭﻗﻢ ﺍﻟﻬﻮﻳﺔ‬
‫‪Date of Report‬‬ ‫‪2022-01-21‬‬ ‫ﺗﺎﺭﻳﺦ ﺍﻟﻨﺘﻴﺠﺔ‬
‫ﺍﻟﻨﺘﻴﺠﺔ ﺍﻟﺴﺎﻟﺒﺔ ﻻ ﺗﻨﻔﻲ ﻋﺪﻡ ﺍﻻﺻﺎﺑﺔ ﺑﻤﺮﺽ ﻛﻮﻓﻴﺪ ‪ 19‬ﺍﻭ ﻋﻮﺍﻗﺒﻪ ﺑﻴﻨﻤﺎ ﺍﻟﻨﺘﻴﺠﺔ ﺍﻟﻤﻮﺟﺒﺔ ﺗﻌﻨﻲ‬
‫ﺍﻻﺻﺎﺑﺔ ﺍﻟﻔﻌﺎﻟﺔ ﺑﺎﻟﻤﺮﺽ ﻭﺍﻻﺻﺎﺑﺔ ﺑﻔﺎﻳﺮﻭﺱ ﻛﻮﺭﻭﻧﺎ ‪ 19‬ﺍﻟﻤﺴﺘﺠﺪ‪ .‬ﻳﺠﺐ ﺭﺑﻂ ﺍﻟﺤﺎﻟﺔ ﺍﻟﻄﺒﻴﺔ ﻭﺍﻟﺘﺎﺭﻳﺦ‬
‫ﺍﻟﻤﺮﺿﻲ ﻣﻊ ﻓﺤﺺ ﺍﻟﻤﺴﺤﺔ ﺍﻭ ﺍﻟﺪﻡ‬

‫‪SWAB test 2019-nCoV‬‬ ‫ﻓﺤﺺ ﻣﺴﺤﺔ)‪(nCoV-2019‬‬

‫‪WE CERTIFY THAT A SWAB from THIS PERSON is‬‬ ‫ﻧﺆﻛﺪ ﺍﻥ ﻣﺴﺤﺔ ﺍﻟﺸﺨﺺ ﺍﻋﻼﻩ ﻗﺪ ﺗﻢ ﻓﺤﺼﻬﺎ ﻟﻤﺮﺽ ‪ COVID19‬ﺑﻄﺮﻳﻘﺔ‬
‫‪tested for COVID19 BY real time-PCR‬‬ ‫)‪(real time-PCR‬‬
‫‪Result interpretation is‬‬ ‫ﻭﻇﻬﺮﺕ ﻧﺘﻴﺠﺔ ﺍﻟﻤﺴﺤﺔ ﻛﺎﻟﺘﺎﻟﻲ‬

‫‪Positive‬‬ ‫ﻣﺼﺎﺏ‬
‫‪Novel Coronavirus (2019-nCov) RNA was detected in the specimen 2019‬‬
‫‪Use The Mobile Application to Scan the QR Code‬‬ ‫ﺍﺳﺘﺨﺪﻡ ﺗﻄﺒﻴﻖ ﺍﻟﻤﻮﺑﺎﻳﻞ ﻟﻤﺴﺢ ﺍﻟﺒﺎﺭﻛﻮﺩ ﻟﻠﺘﺄﻛﺪ ﻣﻦ ﺻﺤﺔ ﺍﻟﺘﻘﺮﻳﺮ‬

‫‪TRAVEL DATE CHANGES IS NOT OUR‬‬ ‫ﺍﻟﺘﻐﻴﻴﺮﺍﺕ ﻓﻲ ﻣﻮﺍﻋﻴﺪ ﺍﻟﺴﻔﺮ ﻟﻴﺴﺖ ﻣﺴﺆﻭﻟﻴﺘﻨﺎ‬
‫‪RESPONSIBILITY‬‬

‫ﻏﻴﺮ ﻣﺴﺎﻓﺮ‬

‫‪Director‬‬ ‫‪Examination‬‬ ‫‪Authorization‬‬

‫ﻟﻼﺳﺘﻔﺴﺎﺭ ﺍﻻﺗﺼﺎﻝ ﻋﻠﻰ ﺍﻟﺮﻗﻢ ‪ 6700‬ﻳﺠﺐ ﺍﺳﺘﻼﻡ ﻧﺴﺨﺔ ﻭﺭﻗﻴﺔ‬

‫ﺧﺪﻣﺔ ‪ 24‬ﺳﺎﻋﺔ ﻭﻋﻠﻰ ﻣﺪﺍﺭ ﺍﻻﺳﺒﻮﻉ ﻭﻳﺘﻢ ﺗﺴﻠﻴﻢ ﺍﻟﻨﺘﻴﺠﺔ ﺑﻤﺎ ﻻ ﻳﺰﻳﺪ ﻋﻦ ‪ 24‬ﺳﺎﻋﺔ ﻣﻊ ﻣﺮﺍﻋﺎﺓ ﺍﻟﺤﺎﻻﺕ ﺍﻟﻄﺎﺭﺋﺔ‬