(19-‫اﻟﺘﻘﺮﻳﺮ اﻟﻄﺒﻲ ﻟﺘﻄﻌﻴﻢ ﻓﺎﻳﺮوس ﻛﻮروﻧﺎ )ﻛﻮﻓﻴﺪ‬

COVID-19 Vaccine Medical Report

Full Name MAYS ABDULAZIZ BIN ZAID ALSHARIF ‫ﻣﻴﺲ ﻋﺒﺪاﻟﻌﺰ ﻳﺰ ﺑﻦ ز ﻳﺪ اﻟﺸﺮ ﻳﻒ‬ ‫اﻻﺳﻢ‬

ID Number 1127722179 1127722179 ‫ر ﻗ ﻢ ا ﻟ ﻬ ﻮﻳ ﺔ‬

Date of birth 08 Dec 2004 2004 ‫ ​ دﻳﺴﻤﺒﺮ‬08 ‫ﺗﺎرﻳﺦ اﳌﻴﻼد‬

Nationality Saudi Arabia ‫ا ﻟ ﺴ ﻌ ﻮ دﻳ ﺔ‬ ‫اﻟ ﺠﻨ ﺴﻴ ﺔ‬

Vaccine Type Pfizer-BionTech (COMIRNATY®) ‫ﺑ ﻴ ﻮﻧ ﺘ ﻚ‬- ‫ﻓ ﺎﻳ ﺰ ر‬ ‫ﻧ ﻮ ع اﻟﺘ ﻄ ﻌﻴ ﻢ‬

Date 2021-08-22 2021 ‫ ​ أﻏﺴﻄﺲ‬22 ‫اﻟﺘﺎرﻳﺦ‬

Batch Number FF7416 FF7416 ‫ر ﻗ ﻢ اﻟﺘ ﺸ ﻐﻴ ﻠ ﺔ‬

Vaccine Type Pfizer-BionTech (COMIRNATY®) ‫ﺑ ﻴ ﻮﻧ ﺘ ﻚ‬- ‫ﻓ ﺎﻳ ﺰ ر‬ ‫ﻧ ﻮ ع اﻟﺘ ﻄ ﻌﻴ ﻢ‬

Date 2021-09-10 2021 ‫ ​ ﺳﺒﺘﻤﺒﺮ‬10 ‫اﻟﺘﺎرﻳﺦ‬

Batch Number FG3526 FG3526 ‫ر ﻗ ﻢ اﻟﺘ ﺸ ﻐﻴ ﻠ ﺔ‬

Vaccine Type Moderna (SPIKEVAX®) ‫ﻣ ﻮ دﻳ ﺮﻧ ﺎ‬ ‫ﻧ ﻮ ع اﻟﺘ ﻄ ﻌﻴ ﻢ‬

Date 2022-01-21 2022 ‫ ​ ﻳﻨﺎﻳﺮ‬21 ‫اﻟﺘﺎرﻳﺦ‬

Batch Number 939916 939916 ‫ر ﻗ ﻢ اﻟﺘ ﺸ ﻐﻴ ﻠ ﺔ‬

‫ اﳌﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‬،‫ﺗﻢ إﺻﺪار ﻫﺬا اﻟﺘﻘﺮ ﻳﺮ ﻣﻦ ﻗﺒﻞ وزارة اﻟﺼﺤﺔ‬

‫ﻫﺬا اﻟﺘﻘﺮ ﻳﺮ ﻟﻺﺳﺘﺨﺪام اﻟﻄﺒﻲ ﺧﺎرج اﳌﻤﻠﻜﺔ ﰲ اﻟﺪول اﻟﱵ ﻟﻢ ﺗﺮﺗﺒﻂ إﻟﻜﺘﺮوﻧﻴﺎ ﻣﻊ اﻷﻧﻈﻤﺔ اﻟﺤﻜﻮﻣﻴﺔ ﰲ اﳌﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‬

This Report has been issued by the Ministry of Health, Kingdom of Saudi Arabia

This report is intended to be used for medical purposes outside the Kingdom of Saudi Arabia, in the countries that are not integrated with
the Kingdom's government systems.

Kindly scan the QR code to vaildate Report No. ‫رﻗﻢ اﻟﺘﻘﺮ ﻳﺮ‬ ‫ﻳﺮﺟﻰ ﻣﺴﺢ اﻟﺒﺎرﻛﻮد ﻟﻠﺘﺤﻘﻖ ﻣﻦ ﺻﺤﺔ‬

this report VCC010921116835 ‫ﻫﺬا اﻟﺘﻘﺮ ﻳﺮ‬

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