Document info

Result type: COVID-19 Vaccination Certificate

Result date: 28 Apr 2021 23:12
Result status: authenticated

COVID-19 Vaccination Certificate

STEPHANIE
Patient: DOB: 10 Jan 1985
TANEO

COVID-19 Vaccination Certificate

 19-‫ﺷﻬﺎﺩﺓ ﺗﻄﻌﻴﻢ ﺿﺪ ﻓﻴﺮﻭﺱ ﻛﻮﻓﻴﺪ‬
COVID-19 Vaccination Certificate
‫ﺇﻟﻰ ﻣﻦ ﻳﻬﻤﻪ ﺍﻷﻣﺮ‬
To whomsoever it may concern
This is to certify that: :‫ﺗﺆﻛﺪ ﻫﺬﻩ ﺍﻟﻮﺛﻴﻘﺔ ﺃﻥ‬

Order ID: 7062882798 :‫ﺭﻗﻢ ﻃﻠﺐ‬

Name: STEPHANIE LATOSA TANEO :‫ﺍﻹﺳﻢ‬

QID/Visa/Passport: 28560809468 :‫ﺟﻮﺍﺯ ﺍﻟﺴﻔﺮ‬/‫ﺍﻟﺘﺄﺷﻴﺮﺓ‬/‫ﺭﻗﻢ ﺍﻟﺒﻄﺎﻗﺔ ﺍﻟﺸﺨﺼﻴﺔ‬

Medical Record No.: HC02810982 :‫ﺭﻗﻢ ﺍﻟﻤﻠﻒ ﺍﻟﻄﺒﻲ‬

Date of Birth: 10-Jan-1985 :‫ﺗﺎﺭﻳﺦ ﺍﻟﻤﻴﻼﺩ‬

Nationality: Filipino :‫ﺍﻟﺠﻨﺴﻴﺔ‬

The above mentioned has received

the two doses of the vaccine as :‫ﺃﻋﻄﻲ ﺍﻟﻤﺬﻛﻮﺭ ﺃﻋﻼﻩ ﺟﺮﻋﺘﻴﻦ ﻣﻦ ﻟﻘﺎﺡ‬
follows:

First dose received on: SARS-CoV-2 (Moderna) - 29-Mar-2021 :‫ﺃﻋﻄﻴﺖ ﺍﻟﺠﺮﻋﺔ ﺍﻷﻭﻟﻰ ﺑﺘﺎﺭﻳﺦ‬

Second dose received on: SARS-CoV-2 (Moderna) - 28-Apr-2021 :‫ﺃﻋﻄﻴﺖ ﺍﻟﺠﺮﻋﺔ ﺍﻟﺜﺎﻧﻴﺔ ﺑﺘﺎﺭﻳﺦ‬