‫‪ 263‬ﺩﺭﻫﻡ‬ ‫ﺩﻭﻟﺔ ﺍﻻﻣﺎﺭﺍﺕ ﺍﻟﻌﺭﺑﻳﺔ ﺍﻟﻣﺗﺣﺩﺓ‬

‫ﻭﺯﺍﺭﺓ ﺍﻟﺻﺣﺔ ﻭﻭﻗﺎﻳﺔ ﺍﻟﻣﺟﺗﻣﻊ ‪ -‬ﺍﺩﺍﺭﺓ ﺍﻟﻁﺏ ﺍﻟﻭﻗﺎﺋﻲ‬

‫ﻣﺭﻛﺯ ﻣﺭﺍﻗﺑﺔ ﺍﻻﻣﺭﺍﺽ‬

‫ﺍﻻﻳﺻﺎﻝ ‪0000180060792311‬‬

‫ﺷﻬﺎﺩﺓ ﺧﻠﻭ ﻣﻥ ﺍﻻﻣﺭﺍﺽ ﺍﻟﺗﻲ ﺗﺷﻛﻝ ﺧﻁﺭ ﻋﻠﻰ ﺍﻟﺻﺣﺔ ﺍﻟﻌﺎﻣﺔ‬

‫ﺍﻟﻁﺑﻳﺔ‬ ‫ﺍﻟﺑﺭﺍﺣﺔ‬ ‫ﻣﻧﻁﻘﺔ‬

‫ﺩﺑﻲ‬ ‫ﺍﻟﻣﺭﻛﺯ ﺍﻟﻁﺑﻲ‬

‫‪2018-08-02‬‬ ‫ﺍﻟﺗﺎﺭﻳﺦ‬
‫ﺗﺟﺩﻳﺩ‬
‫ﺍﻟﺧﺎﺗﻡ ﺍﻟﺭﺳﻣﻲ‬

‫ﺑﻳﺎﻧﺎﺕ ﺧﺎﺻﺔ ﺑﻁﺎﻟﺏ ﺍﻟﻔﺣﺹ‬

‫‪Arabic Name‬‬ ‫ﻣﺣﻣﺩ ﺷﺭﻳﻑ ﷲ ﺣﺎﺟﻰ ﻣﺣﻣﺩ ﺷﻣﺱ ﺍﻟﻌﺎﻟﻡ‬ ‫ﺍﻻﺳﻡ ﻋﺭﺑﻲ‬

‫‪English Name‬‬ ‫‪MOHAMMAD SHARIF ULLAH HAJI MOHAMMAD SHAMSUL ALAM‬‬ ‫ﺍﻻﺳﻡ ﺍﻧﺟﻠﻳﺯﻱ‬

‫‪Gender‬‬ ‫ﺫﻛﺭ‬ ‫ﺍﻟﺟﻧﺱ‬ ‫‪Age‬‬ ‫‪1987-10-30‬‬ ‫ﺍﻟﻌﻣﺭ‬

‫‪Nationality‬‬ ‫ﺑﻧﻐﻼﺩﻳﺵ‬ ‫ﺍﻟﺟﻧﺳﻳﺔ‬

‫‪Entry Permit /‬‬ ‫‪201/2006/2278839‬‬ ‫ﺭﻗﻡ ﺍﺫﻥ ﺍﻟﺩﺧﻭﻝ‪ /‬ﺍﻻﻗﺎﻣﺔ‬

‫‪Residence No‬‬

‫‪EIDA Applicatio‬‬ ‫‪784198769192943‬‬ ‫ﺭﻗﻡ ﺍﻟﻬﻭﻳﺔ‬ ‫‪Unified‬‬ ‫‪56355443‬‬ ‫ﺭﻗﻡ ﻣﻭﺣﺩ‬

‫‪No.‬‬ ‫ﺃﻭ ﺍﻟﻁﻠﺏ‬ ‫‪No.‬‬

‫‪Profession‬‬ ‫ﺍﻟﻣﻬﻧﺔ‬
‫‪SALES‬‬ ‫ﺑﺎﺋﻊ‬

‫‪Sponsor Name‬‬ ‫ﺭﻛﻥ ﺍﻟﺻﻳﻥ ﺍﻟﻌﺎﻟﻣﻳﺔ ﺵ ﺫ ﻡ ﻡ‬ ‫ﺍﺳﻡ ﺍﻟﻛﻔﻳﻝ‬

‫‪Phone Number‬‬ ‫‪042943444‬‬ ‫ﻫﺎﺗﻑ ﺍﻟﻛﻔﻳﻝ‬

‫‪Sponsor Address‬‬ ‫‪DEIRA DUBAI‬‬ ‫ﻋﻧﻭﺍﻥ ﺍﻟﻛﻔﻳﻝ‬

‫ﺧﺎﺹ ﻹﺳﺗﻌﻣﺎﻝ ﺇﺩﺍﺭﺓ ﺍﻟﻁﺏ ﺍﻟﻭﻗﺎﺋﻲ‬

‫‪2018-08-05‬‬ ‫ﺗﺎﺭﻳﺦ ﺇﺟﺭﺍء ﺍﻟﻔﺣﺹ‬ ‫‪P04005EE002V7I‬‬ ‫ﺭﻗﻡ ﺍﻟﻁﺏ ﺍﻟﻭﻗﺎﺋﻲ‬

‫ﺍﻟﻁﺑﻲ‬

‫ﺇﺳﺗﻧﺎﺩ ًﺍ ﺇﻟﻰ ﺍﻟﻘﺎﻧﻭﻥ ﺍﻹﺗﺣﺎﺩﻱ ﺭﻗﻡ ‪ 27‬ﻟﺳﻧﺔ ‪ 1981‬ﻓﻲ ﺷﺄﻥ ﺍﻟﻭﻗﺎﻳﺔ ﻣﻥ ﺍﻷﻣﺭﺍﺽ ﺍﻟﺳﺎﺭﻳﺔ ‪ ،‬ﻓﻘﺩ ﺗﻡ ﺇﺟﺭﺍء ﺍﻟﻔﺣﺹ ﺍﻟﻁﺑﻲ ﺍﻟﻼﺯﻡ ﻟﻠﻣﺫﻛﻭﺭ ﺃﻋﻼﻩ ﻭﻛﺎﻧﺕ ﺍﻟﻧﺗﻳﺟﺔ‬

‫ﻻﺋﻖ ﻁﺑﻳ ًﺎ‬

‫ﻫﺫﻩ ﺍﻟﺷﻬﺎﺩﺓ ﺍﻟﻛﺗﺭﻭﻧﻳﺔ ﻭﻻ ﺗﺣﺗﺎﺝ ﺇﻟﻰ ﺧﺗﻡ ﺍﻭ ﺗﻭﻗﻳﻊ ﺍﻟﺗﺣﻘﻖ ﻣﻥ ﺻﺣﺔ ﺍﻟﺷﻬﺎﺩﺓ ﻣﻥ ﺧﻼﻝ ﺍﻟﻣﻭﻗﻊ‬
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‫ﻣﻼﺣﻅﺔ ‪ :‬ﺻﻼﺣﻳﺔ ﻫﺫﻩ ﺍﻟﺷﻬﺎﺩﺓ ﺛﻼﺛﺔ )‪ (3‬ﺃﺷﻬﺭ ﻣﻥ ﺗﺎﺭﻳﺦ ﺇﺟﺭﺍء ﺍﻟﻔﺣﺹ ﺍﻟﻁﺑﻲ‬