‫‪Kingdom of Saudi Arabia‬‬ ‫ﺍﻟﻤﻤﻠﻜﺔ ﺍﻟﻌﺮﺑﻴﺔ ﺍﻟﺴﻌﻮﺩﻳﺔ‬

‫‪Ministry of National Guard Health Affairs‬‬ ‫ﻭﺯﺍﺭﺓ ﺍﻟﺤﺮﺱ ﺍﻟﻮﻃﻨﻲ ﺍﻟﺸﺆﻭﻥ ﺍﻟﺼﺤﻴﺔ‬

‫‪Ahsa Primary Health Care Center‬‬ ‫ﻣﺮﻛﺰ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻷﻭﻟﻴﺔ ‪ -‬ﺍﻷﺣﺴﺎﺀ‬

‫ﺗــﺬﻛــﺮﺓ ﻣـــﻮﻋــــﺪ‬
‫‪Appointment Slip‬‬

‫‪Name:‬‬ ‫‪Alharbi,Zeyad Ghazi Saleh‬‬ ‫ﺯﻳﺎﺩ ﻏﺎﺯﻱ ﺻﺎﻟﺢ ﺍﻟﺤﺮﺑﻲ‬ ‫ﺍﻻﺳﻢ ‪:‬‬

‫‪MEDICAL‬‬ ‫‪DATE OF‬‬

‫‪SEX‬‬ ‫‪ELG‬‬ ‫‪COV‬‬ ‫ﺍﻟﺠﻨﺲ‬ ‫ﺗﺎﺭﻳﺦ ﺍﻟﻤﻴﻼﺩ‬ ‫ﺭﻗﻢ ﺍﻟﻤﻠﻒ ﺍﻟﻄﺒﻲ‬
‫‪RECORD NO.‬‬ ‫‪BIRTH‬‬
‫‪769119‬‬ ‫‪23/10/2006‬‬ ‫‪M‬‬ ‫‪02‬‬ ‫‪001‬‬ ‫ﺫﻛﺮ‬ ‫‪١٤٢٧/١٠/٠١‬‬ ‫‪٧٦٩١١٩‬‬

‫‪DOCTOR / SERVICES‬‬ ‫‪TYPE OF VISIT‬‬ ‫ﻧﻮﻉ ﺍﻟﺰﻳﺎﺭﺓ‬ ‫ﺍﻟﻄﺒﻴﺐ ‪ /‬ﺍﻟﻘﺴﻢ‬

‫‪General 1‬‬ ‫‪General 1‬‬
‫‪First Visit‬‬ ‫ﺍﻟﺰﻳﺎﺭﻩ ﺍﻻﻭﻟﻰ‬
‫‪XHSPFM008‬‬ ‫‪XHSPFM٠٠٨‬‬
‫‪SPECIALITY‬‬ ‫ﺍﻹﺧﺘﺼﺎﺹ‬
‫‪[PHC] FM Male and‬‬
‫ﻃﺐ ﺍﻷﺳﺮﺓ ﺭﺟﺎﻝ ﻭﺃﻃﻔﺎﻝ‬
‫)‪Pediatric (Portal‬‬ ‫‪TIME‬‬ ‫‪10:00 AM‬‬ ‫‪ ١٠:٠٠‬ﺻﺒﺎﺣﺎً‬ ‫ﺍﻟﻮﻗﺖ‬

‫‪LOCATION‬‬ ‫‪DAY‬‬ ‫‪MONDAY‬‬ ‫ﺍﻹﺛﻨﻴﻦ‬ ‫ﺍﻟﻴﻮﻡ‬ ‫ﻣﻜﺎﻥ ﺍﻟﻔﺤﺺ‬

‫‪Outpatient Clinics‬‬ ‫ﺍﻟﻤﺮﻛﺰ ﺍﻟﺮﺋﻴﺴﻲ‬

‫‪DATE‬‬ ‫‪22/01/2024‬‬ ‫‪٢٠٢٤/٠١/٢٢‬‬ ‫ﺍﻟﺘﺎﺭﻳﺦ‬
‫‪INFORMATION‬‬
‫‪CENTER EXT.‬‬
‫‪HIEGRA‬‬ ‫‪10/07/1445‬‬ ‫‪١٤٤٥/٠٧/١٠‬‬ ‫ﺍﻟﻤﻮﺍﻓﻖ‬ ‫ﺗﺤﻮﻳﻠﺔ ﻣﺮﻛﺰ ﺍﻟﻤﻌﻠﻮﻣﺎﺕ‬

‫‪0135338867‬‬ ‫‪٠١٣٥٣٣٨٨٦٧‬‬

‫‪NOTE:‬‬ ‫ﻣﻼﺣﻈﺔ‪:‬‬
‫ﻓﻲ ﺣﺎﻟﺔ ﺍﺧﺘﻼﻑ ﺍﻟﺘﺎﺭﻳﺦ ﺍﻟﻬﺠﺮﻱ ﻋﻦ ﺍﻟﻴﻮﻡ ﺍﻟﻤﻮﺿﺢ ﻓﻲ ﺍﻟﻤﻮﻋﺪ‬
‫ﺍﻟﺮﺟﺎﺀ ﺍﻟﺘﻘﻴﺪ ﺑﺎﻟﻴﻮﻡ‬
‫ﻟﻠﺘﺄﺟﻴﻞ ﺍﻹﺗﺼﺎﻝ ﻋﻠﻰ ﺍﻟﺮﻗﻢ ﺍﻟﻤﻮﺿﺢ ﺃﻋﻼﻩ ﻗﺒﻞ ﺍﻟﻤﻮﻋﺪ ﺏ ‪24‬‬
‫ﺳﺎﻋﺔ ﻋﻠﻰ ﺍﻷﻗﻞ‬
‫‪Scheduler : XPOR01‬‬

‫‪REF.DOCTOR:‬‬ ‫‪LOCATION:‬‬ ‫‪ISSUED BY:‬‬ ‫‪ENTERED BY:‬‬ ‫‪XPOR01‬‬ ‫‪DATE:‬‬ ‫‪22/01/2024‬‬

 IMPORTANT INFORMATION ‫ﺗﻌﻠﻴﻤﺎﺕ ﻫﺎﻣﺔ‬
Sunday through Thursday : 5 ‫ ﺻﺒﺎﺣﺎً ﺇﻟﻰ‬8 ‫ ﻣﻦ‬: ‫ﻣﻦ ﺍﻷﺣﺪ ﺇﻟﻰ ﺍﻟﺨﻤﻴﺲ‬
Hospital Office Hours ‫ﺃﻭﻗﺎﺕ ﺍﻟﺪﻭﺍﻡ ﺍﻟﺮﺳﻤﻲ ﺑﺎﻟﻤﺴﺘﺸﻔﻰ‬
08:00 - 17:00 hours ً‫ﻣﺴﺎﺀ‬
Your attention is drawn to the Hospital Rules & Regulations
:‫ ﺍﻟﺮﺟﺎﺀ ﺍﻟﺘﻘﻴﺪ ﺑﺎﻷﻧﻈﻤﺔ ﻭﺍﻟﺘﻌﻠﻴﻤﺎﺕ ﺍﻟﺘﺎﻟﻴﺔ‬,‫ﻋﺰﻳﺰﻱ ﺍﻟﻤﺮﺍﺟﻊ‬
which you need to know and observe.
‫ﻋﻨﺪ ﺣﺪﻭﺙ ﺃﻱ ﺗﻐﻴﻴﺮ ﻓﻲ ﺍﻟﻤﻌﻠﻮﻣﺎﺕ ﺍﻟﻤﺴﺠﻠﺔ ﻟﺪﻯ ﺍﻟﻤﺴﺘﺸﻔﻰ ﻣﺜﻞ )ﺣﺎﻟﺘﻚ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﺃﻭ‬
Any changes in registered information ,such as change status,
.‫ﻋﻨﻮ ﺍﻧﻚ ﺃﻭ ﺭﻗﻢ ﺍﻟﺘﻠﻴﻔﻮﻥ( ﻓﻴﺠﺐ ﺇﺷﻌﺎﺭ ﻣﻜﺘﺐ ﺍﻟﺘﺴﺠﻴﻞ‬
a change address, or a change of telephone number, must be
reported to the Registration Office.
‫ ﻋﺪﺍ‬،‫ﺍﻟﻤﺴﺘﺸﻔﻰ ﻣﻠﺰﻡ ﺑﺘﻮﻓﻴﺮ ﺍﻟﻌﻼﺝ ﻟﻠﺤﺎﻟﺔ ﺍﻟﻤﺮﺿﻴﺔ ﺍﻟﺘﻲ ﺗﻤﺖ ﺍﻹﺣﺎﻟﺔ ﻣﻦ ﺃﺟﻠﻬﺎ ﻓﻘﻂ‬ ●

● We are committed to provide treatment only for the .‫ﺍﻟﺤﺎﻻﺕ ﺍﻟﻄﺎﺭﺋﺔ‬

condition that necessitated your referral to this Hospital .‫ﺃﻭﺍﻣﺮ ﺍﻟﻌﻼﺝ ﺳﺎﺭﻳﺔ ﺍﻟﻤﻔﻌﻮﻝ ﺣﺘﻰ ﺍﻧﺘﻬﺎﺀ ﻓﺘﺮﺓ ﺍﻷﻣﺮ ﺍﻟﻤﻮﺿﺤﺔ ﻓﻲ ﺑﻄﺎﻗﺔ ﺍﻟﻤﺴﺘﺸﻔﻰ‬ ●

,except in an emergency . ‫ﺍﺳﺘﺨﺪﺍﻣﻚ ﻟﺒﻄﺎﻗﺔ ﻣﺮﻳﺾ ﺁﺧﺮ ﺃﻣﺮ ﻓﻲ ﻏﺎﻳﺔ ﺍﻟﺨﻄﻮﺭﺓ ﻣﻦ ﺍﻟﻨﺎﺣﻴﺔ ﺍﻟﻄﺒﻴﺔ ﻭﺳﻴﻌﺮﺿﻚ‬ ●

● A referral order (Letter of Exception) is valid only up to the .‫ﻟﻠﻤﺴﺎﺀﻟﺔ‬

expiration date indicated on your medical card. ‫ﻋﻨﺪ ﻣﺮﺍﺟﻌﺘﻚ ﻟﻠﻌﻴﺎﺩﺓ ﻳﺠﺐ ﺇﺣﻀﺎﺭ ﺍﻟﺘﻘﺎﺭﻳﺮ ﺍﻟﻄﺒﻴﺔ ﻭﺍﻟﻔﺤﻮﺻﺎﺕ ﺍﻟﻤﺨﺒﺮﻳﺔ ﻭﺍﻷﺩﻭﻳﺔ‬ ●

● IT IS EXTREMELY DANGEROUS TO USE THE MEDICAL .(‫)ﺍﻥ ﻭﺟﺪﺕ‬

CARD OF SOMEONE ELSE, AND COULD EXPOSE YOU ‫ ﺍﻥ‬،‫ﻳﺠﺐ ﻋﻠﻴﻚ ﺍﻟﺤﻀﻮﺭ ﻗﺒﻞ ﻣﻮﻋﺪﻙ ﺑﺨﻤﺲ ﻋﺸﺮ ﺩﻗﻴﻘﺔ ﺇﻻ ﺇﺫﺍ ﻃﻠﺐ ﻣﻨﻚ ﻏﻴﺮﺫﻟﻚ‬ ●

TO QUESTIONING. .‫ﺣﻀﻮﺭﻙ ﻣﺒﻜﺮﺍ ﻗﺒﻞ ﻫﺬﺍ ﺍﻟﻮﻗﺖ ﻳﺆﺩﻯ ﺇﻟﻰ ﺍﺯﺩﺣﺎﻡ ﺍﻟﻌﻴﺎﺩﺓ ﻭﺗﺄﺧﺮ ﺩﺧﻮﻟﻚ ﻟﻠﻄﺒﻴﺐ‬
● On your first visit to the Clinic, you are requested to bring .‫ﻳﻤﻨﻊ ﻣﻨﻌﺎ ﺑﺎﺗﺎ ﺇﺣﻀﺎﺭ ﺍﻷﻃﻔﺎﻝ ﻏﻴﺮ ﺍﻟﻤﺮﺿﻰ ﻟﻠﻤﺴﺘﺸﻔﻰ‬ ●

with you any medical reports, laboratory tests, and any ‫ﻳﺠﺐ ﺇﻟﻐﺎﺀ ﺍﻟﻤﻮﻋﺪ ﺃﻭ ﺗﻐﻴﻴﺮﻩ ﻓﻲ ﺣﺎﻟﺔ ﻋﺪﻡ ﺗﻤﻜﻨﻚ ﻣﻦ ﺍﻟﺤﻀﻮﺭ ﻭﺫﻟﻚ ﻗﺒﻞ ﺍﻟﻤﻮﻋﺪ‬ ●

prescribed medications (if available.) This will help the . ‫ﺑﺄﺭﺑﻊ ﻭﻋﺸﺮﻭﻥ ﺳﺎﻋﺔ ﻋﻠﻰ ﺍﻻﻗﻞ‬
physician in providing the most appropriate treatment. ‫ﺇﻥ ﻋﺪﻡ ﺍﻟﺤﻀﻮﺭ ﻓﻲ ﺍﻟﻤﻮﻋﺪ ﺍﻟﻤﺤﺪﺩ ﺩﻭﻥ ﺇﺷﻌﺎﺭ ﺍﻟﻤﺴﺘﺸﻔﻰ ﺑﺎﻹﻟﻐﺎﺀ ﺃﻭ ﺍﻟﺘﺄﺟﻴﻞ ﻗﺪ‬ ●

● You should come to the clinic no more than 15 minutes ‫ﻳﺆﺩﻱ ﺍﻟﻰ ﺍﺣﺎﻟﺘﻚ ﺍﻟﻰ ﻣﺮﻛﺰ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻠﻔﺤﺺ ﺍﻟﻤﺒﺪﺋﻲ ﻭﺗﻘﻮﻳﻢ ﺍﻟﺤﺎﺟﺔ ﻟﻠﻌﻼﺝ‬
prior to your appointment time. To avoid overcrowding and .‫ﻓﻲ ﺍﻟﻤﺴﺘﺸﻔﻰ‬
congestion. you should not attend earlier than this, unless
instructed to do so.
● BRINGING CHILDREN TO THE HOSPITAL IS
PROHIBITED, UNLESS THEY ARE THE PATIENTS.
● If it is necessary to cancel/change an appointment, this
should be done no later than 24 hours prior to the
appointment time.
● Failing to attend for an appointment could result in you
being referred back to a Primary Health Care Facility for
assessment and re-referral.