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Kingdom of Saudi Arabia

‫ﻣ ﺸ ﻬ ﺪ ﻣ ﺮا ﺟ ﻌ ﺔ‬
Statement of Visit
Leave ID GSL23052112966 ‫ر ﻣ ﺰ ا ﻹ ﺟﺎ ز ة‬

Admission Date/Time 2023-05-21 - 8:0 AM ‫ ﺻﺒﺎﺣ ّﺎ‬8:0 - 01-11-1444 ‫ و ﻗ ﺖ اﻟ ﺪ ﺧ ﻮ ل‬/ ‫ﺗ ﺎ ر ﻳ ﺦ‬

Discharge Date/Time 2023-05-21 - 10:38 AM ‫ ﺻﺒﺎﺣ ّﺎ‬10:38 - 01-11-1444 ‫ و ﻗ ﺖ اﻟ ﺨ ﺮ و ج‬/ ‫ﺗ ﺎ ر ﻳ ﺦ‬

Waiting Period 2 hours and 38 mins ‫ دﻗﻴﻘﺔ‬38 ‫ ﺳﺎﻋﺔ و‬2 ‫ﻓ ﱰ ة ا ﻻ ﻧ ﺘ ﻈﺎ ر‬

Issue Date 21-05-2023 ‫ﺗ ﺎ ر ﻳ ﺦ ا ﺻ ﺪا ر اﻟ ﺘ ﻘ ﺮ ﻳ ﺮ‬

Name MOAYAD AHMED ALI MADKHALI ‫ﻣ ﺆﻳﺪ ا ﺣ ﻤﺪ اﺑ ﻦ ﻋﻠ ﻲ ﻣﺪ ﺧﻠ ﻲ‬ ‫اﻻ ﺳﻢ‬

National ID/Iqama 1138162589 ‫ا ﻹ ﻗ ﺎ ﻣ ﺔ‬/ ‫ر ﻗ ﻢ اﻟ ﻬ ﻮ ﻳ ﺔ‬

Nationality Saudi Arabia ‫اﻟ ﺴ ﻌ ﻮ د ﻳ ﺔ‬ ‫اﻟ ﺠ ﻨ ﺴ ﻴ ﺔ‬

Employer ‫ﺟ ﻬ ﺔ اﻟ ﻌ ﻤ ﻞ‬

Physician Name RADEIF ESSA RADEIF SHAMAKHI ‫ر د ﻳ ﻒ ﻋ ﻴ ﴘ ر د ﻳ ﻒ ﺷ ﻤﺎ ﺧ ﻲ‬ ‫ا ﺳ ﻢ اﻟ ﻄ ﺒ ﻴ ﺐ اﻟ ﻤ ﻌ ﺎﻟ ﺞ‬

Position Medicine and Surgery ‫ﻃﺐ ﺑ ﴩي‬ ‫اﻟ ﻤ ﺴ ﻤ ﻰ اﻟ ﻮ ﻇ ﻴ ﻔ ﻲ‬

Visit Type OutPatient ‫ﻋ ﻴﺎ د ا ت‬ ‫ﻧ ﻮ ع اﻟ ﺰ ﻳ ﺎ ر ة‬

‫ﻗﻢ ﺑﻤﺴﺢ اﻟﺒﺎرﻛﻮد ﻟﻠﺘﺤﻘﻖ ﻣﻦ اﻟﺘﻘ ﺮ ﻳﺮ إﻟﻜﱰوﻧًﻴﺎ ﺗﺄﻛﺪ ﻣﻦ ﻣﻄﺎﺑﻘﺔ‬


‫ﺑ ﻴ ﺎ ﻧ ﺎ ت اﻟ ﺘ ﻘ ﺮ ﻳ ﺮ ﺑ ﺮ ﻗ ﻢ اﻟ ﻬ ﻮ ﻳ ﺔ اﻟ ﻮ ﻃ ﻨ ﻴ ﺔ أ و ا ﻹ ﻗ ﺎ ﻣ ﺔ‬ ‫ﻣ ﺴﺘ ﺸ ﻔ ﻰ ا ﻻ ﻣ ﲑ ﻣ ﺤ ﻤ ﺪ ﺑ ﻦ ﻧﺎ ﴏ ﺑ ﺠﺎ زا ن‬

Scan the QR code to electronically check the report, make sure PRINCE MOHAMMED BIN NASSER GAZAN

the information in this report matches the National/ Iqama Id

6:25 AM
Monday, 16 October 2023

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