USER REGISTRATION
*
Employee Name
*
Gender
[ Select ]
Male
Female
*
Social status
[ Select ]
Single
Married
*
Nationality
[ Select ]
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Central African Republic (CAR)
Chad
Chile
China
Colombia
Comoros
Democratic Republic of the Congo
Republic of the Congo
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar (Burma)
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
North Korea
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates (UAE)
United Kingdom (UK)
United States of America (USA)
Uruguay
Uzbekistan
Vanuatu
Vatican City (Holy See)
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
*
Religion
[ Select ]
Muslim
Non Muslim
*
Date of Birth
Hijri
English
1379
1380
1381
1382
1383
1384
1385
1386
1387
1388
1389
1390
1391
1392
1393
1394
1395
1396
1397
1398
1399
1400
1401
1402
1403
1404
1405
1406
1407
1408
1409
1410
1411
1412
1413
1414
1415
1416
1417
1418
1419
1420
1421
1422
1423
1424
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1436
1437
1438
1439
1440
1441
1442
1443
1444
1445
1446
1447
1448
1449
1450
1451
1452
1453
1454
1455
1456
محرم
صفر
ربيع الأول
ربيع الثاني
جمادي الأول
جمادي الثاني
رجب
شعبان
رمضان
شوال
ذو القعدة
ذو الحجة
ذو القعدة 1446
الأحد
الإثنين
الثلاثاء
الأربعاء
الخميس
الجمعة
السبت
29
30
1
2
3
4
5
6
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8
9
10
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*
Position Title
[ Select ]
Hospital Director
Director
Deputy nursing director
Head
Chief
Charge Nurse
Senior Nurse
Employee
Allocation Date
*
Saudi ID \ Iqama Number
*
Issue date
Hijri
English
1379
1380
1381
1382
1383
1384
1385
1386
1387
1388
1389
1390
1391
1392
1393
1394
1395
1396
1397
1398
1399
1400
1401
1402
1403
1404
1405
1406
1407
1408
1409
1410
1411
1412
1413
1414
1415
1416
1417
1418
1419
1420
1421
1422
1423
1424
1425
1426
1427
1428
1429
1430
1431
1432
1433
1434
1435
1436
1437
1438
1439
1440
1441
1442
1443
1444
1445
1446
1447
1448
1449
1450
1451
1452
1453
1454
1455
1456
محرم
صفر
ربيع الأول
ربيع الثاني
جمادي الأول
جمادي الثاني
رجب
شعبان
رمضان
شوال
ذو القعدة
ذو الحجة
ذو القعدة 1446
الأحد
الإثنين
الثلاثاء
الأربعاء
الخميس
الجمعة
السبت
29
30
1
2
3
4
5
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8
9
10
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13
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22
23
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27
28
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2
3
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6
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10
11
*
Expire date
Hijri
English
1379
1380
1381
1382
1383
1384
1385
1386
1387
1388
1389
1390
1391
1392
1393
1394
1395
1396
1397
1398
1399
1400
1401
1402
1403
1404
1405
1406
1407
1408
1409
1410
1411
1412
1413
1414
1415
1416
1417
1418
1419
1420
1421
1422
1423
1424
1425
1426
1427
1428
1429
1430
1431
1432
1433
1434
1435
1436
1437
1438
1439
1440
1441
1442
1443
1444
1445
1446
1447
1448
1449
1450
1451
1452
1453
1454
1455
1456
محرم
صفر
ربيع الأول
ربيع الثاني
جمادي الأول
جمادي الثاني
رجب
شعبان
رمضان
شوال
ذو القعدة
ذو الحجة
ذو القعدة 1446
الأحد
الإثنين
الثلاثاء
الأربعاء
الخميس
الجمعة
السبت
29
30
1
2
3
4
5
6
7
8
9
10
11
12
13
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Hafiza Number
Passport Number
Expire date
Hijri
English
1379
1380
1381
1382
1383
1384
1385
1386
1387
1388
1389
1390
1391
1392
1393
1394
1395
1396
1397
1398
1399
1400
1401
1402
1403
1404
1405
1406
1407
1408
1409
1410
1411
1412
1413
1414
1415
1416
1417
1418
1419
1420
1421
1422
1423
1424
1425
1426
1427
1428
1429
1430
1431
1432
1433
1434
1435
1436
1437
1438
1439
1440
1441
1442
1443
1444
1445
1446
1447
1448
1449
1450
1451
1452
1453
1454
1455
1456
محرم
صفر
ربيع الأول
ربيع الثاني
جمادي الأول
جمادي الثاني
رجب
شعبان
رمضان
شوال
ذو القعدة
ذو الحجة
ذو القعدة 1446
الأحد
الإثنين
الثلاثاء
الأربعاء
الخميس
الجمعة
السبت
29
30
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
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21
22
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28
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2
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9
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11
*
Speciality
[ Select ]
Healthcare Assistant
Technician
Specialist
Senior specialist
Consultant Specialist
Pharmacist
Senior pharmacist
Consultant pharmacist
Resident doctor
Specialist Doctor
Consultant doctor
Administrative
Student
*
Type of Contract
[ Select ]
MOH
AGH. HOP
KFSH. HOP
KSH. HOP
MCH. HOP
BCH. HOP
QGH. HOP
Psychiatric Hospital
Dhariya phc
Oklasukur phc
Nabaniya phc
Bukariyah phc
Riyad alkabra
Badayah
Contract Number
Duration of the contract
[ Select ]
1 Month
3 Month
6 Month
12 Month
Date of Contract
Hijri
English
1379
1380
1381
1382
1383
1384
1385
1386
1387
1388
1389
1390
1391
1392
1393
1394
1395
1396
1397
1398
1399
1400
1401
1402
1403
1404
1405
1406
1407
1408
1409
1410
1411
1412
1413
1414
1415
1416
1417
1418
1419
1420
1421
1422
1423
1424
1425
1426
1427
1428
1429
1430
1431
1432
1433
1434
1435
1436
1437
1438
1439
1440
1441
1442
1443
1444
1445
1446
1447
1448
1449
1450
1451
1452
1453
1454
1455
1456
محرم
صفر
ربيع الأول
ربيع الثاني
جمادي الأول
جمادي الثاني
رجب
شعبان
رمضان
شوال
ذو القعدة
ذو الحجة
ذو القعدة 1446
الأحد
الإثنين
الثلاثاء
الأربعاء
الخميس
الجمعة
السبت
29
30
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
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4
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8
9
10
11
Job alloted
[ Select ]
AGH. MOH
KFSH. MOH
KSH. MOH
MCH. MOH
BCH. MOH
QGH. MOH
*
Employment Date in MOH
Hijri
English
1379
1380
1381
1382
1383
1384
1385
1386
1387
1388
1389
1390
1391
1392
1393
1394
1395
1396
1397
1398
1399
1400
1401
1402
1403
1404
1405
1406
1407
1408
1409
1410
1411
1412
1413
1414
1415
1416
1417
1418
1419
1420
1421
1422
1423
1424
1425
1426
1427
1428
1429
1430
1431
1432
1433
1434
1435
1436
1437
1438
1439
1440
1441
1442
1443
1444
1445
1446
1447
1448
1449
1450
1451
1452
1453
1454
1455
1456
محرم
صفر
ربيع الأول
ربيع الثاني
جمادي الأول
جمادي الثاني
رجب
شعبان
رمضان
شوال
ذو القعدة
ذو الحجة
ذو القعدة 1446
الأحد
الإثنين
الثلاثاء
الأربعاء
الخميس
الجمعة
السبت
29
30
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
1
2
3
4
5
6
7
8
9
10
11
*
Empioyee ID
*
Empioyee File No.
Grade
[ Select ]
1
2
3
4
Level
[ Select ]
1
2
3
4
5
6
7
*
Orientation Checklest
[ Select ]
Hospital
Department
Unit
All
Nil
Coordinator
[ Select ]
Qm Coordinator
IC Coordinator
Safety and Security Coordinator
Training Coordinator
Preceptor
disaster co ordinator
Qualification
[ Select ]
Gained 24hours in master
Gained 30 hours in Bachelor
Gained 60 hours in Bachelor
Gained 90 hours in Bachelor
Primary
Technical secondary school for the deaf
Medium university
Irish fellowship
British fellowship
Swedish fellowship
The certificate is unavailable
Medium scientific institute
Qualification Unknown
First seconary
First intermediate
First primary
Bachelor
Board
Primary third
Commercial secondary
Secondary of Industrial
General secondary
Second of primary
Second secondary
Second intermediate
Fifth of primary
Diploma
Diploma of pharmacy
Technical college diploma
Health college diploma
Intermediate college diploma
Diploma secondary institutes for the Technicians Inspectors
Diploma professional Institutes
Nursing Diploma
Three years diploma after the elementary
Three years diploma after the secondary
Three years diploma after the efficiency
Three and half years diploma after the secondary
Diploma in computer
Diploma year post primary
Diploma year post bachelor
Diploma year post secondary
Post efficiency year Diploma
Year and half secondary post Diploma
Year and half Diploma after efficiency
Two year Diploma after elementary
Two year Diploma after BA
Two year Diploma after secondary
Two year Diploma after efficiency
Two and half years Diploma post secondary
Higher diploma
Disabled institute diploma
Institute Noor Diploma
PH.D
Primary fourth
Fellowship
Specialist fellowship
Fellowship king saud university
Fellowship king faisal university
Saudi arabia competence certificate
Board certified german
Board certified american
Board certified canada
Jordanian medical council certificate
Board certified arabian
Membership
Unknown so far
Medium efficiency
He dose not read also he dose not write
M.A.
Reads and write
*
Sub Speciality
[ Select ]
Administrative Sciences
Allergy and Immunology
Anesthesia
Anesthesia and recovery
Assistant
Binoculars digestive system and esoteric
Biochemistry
Biology
Biomedical
Blood Bank
Bloody vascular
Born Neonatal
Cardiac
Cardiac Profusion
Cardiothoracic
Chest
Clinical Anatomy
Clinical Pharmacy
Clinical psychologist
Clinical Psychology
Clinical social
Community
Community Medicine
Computer Information Systems
Dental
Dental care
Dental fittings
Dental Hygiene
Dental Society
Dental Technology
Dentistry
Dermatology
Disaster
Disease
Diseases - Gastroenterology
Driver
Electrocardiograph
Emergency
Endocrinology
Endocrinology, Diabetes
Endodontics
Engineering
ENT
Fever
Food science and technology
Gastroenterology
General
General Dentistry
Health
Health Awareness
Health education
Health Information
Health Information Systems Technology
Health services
Health services administration
Healthy observer
Healthy server
Hematology and Blood Transfusion
Hematology, oncology
Histopathology and Cytology
Hospitals Administration
Immunology
Infectious
Infectious diseases
Intensive care
Laboratory
Laparoscopic
Laparoscopic and morbid obesity
Leather and venereal
Magnetic resonance technology
Management Information Systems
Medical Laboratory Technology
Medical labs
Medical records
Medical secretary
Microbiology
Midwifery
Nephrology
Neuro
Neuroprotective
Neuroprotective children
No specialization
Nursing
Ob/Gyne
Operations
Ophthalmology
optics
Oral
Orthodontics
Orthopedic
Orthopedics surgery
Pediatric
Pediatric dentistry
Pediatric Emergency
Pediatrics
Periodontics
Personnel Officer
Pharmacy
Physiotherapy
Plastic
Primary health care
Psychological
Psychological and neurological
Psychology
Public relations
Quality
Radiation treatment
Radiology.
Ray diagnostic
Respiratory therapy
Rheumatology
Secretariat
Sterilization
Surgery
The epidemiology
The immune system and allergies
Therapeutic feeding
Treatment of gums
Urology
Warehouse management
*
Graduation place
[ Select ]
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Central African Republic (CAR)
Chad
Chile
China
Colombia
Comoros
Democratic Republic of the Congo
Republic of the Congo
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar (Burma)
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
North Korea
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates (UAE)
United Kingdom (UK)
United States of America (USA)
Uruguay
Uzbekistan
Vanuatu
Vatican City (Holy See)
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
*
Graduation year
*
Do you have Saudi Council
No
Yes
Release Date
Validity period
[ Select ]
3 Year
5 Year
*
Do you have BLS Certificate
No
Yes
Release Date( English date )
*
Do you have ACLS Certificate
No
Yes
Release Date(English date)
*
Do you have NRP Certificate
No
Yes
Release Date(English date)
Do you have PALS Certificate
No
Yes
*
Release Date(English date)
*
Do you have ATLS Certificate
No
Yes
*
Release Date(English date)
*
Do you have BLSO Certificate
No
Yes
*
Release Date(English date)
*
Blood Group
[ Select ]
A+
A-
B+
B-
AB+
AB-
O+
O-
*
Do you wear eye glass
No
Yes
*
Do you have Diabetes Mellitus
No
Yes
If yes with Medicine
[ Select ]
Yes
No
*
Do you have Hypertension
No
Yes
If yes with Medicine
[ Select ]
Yes
No
*
Any other medical History
No
Yes
If yes mention the Disease
[ Select ]
Anemia
Asthma
Arthritis
Allergies
Appendicitis
Epilepsy
Gall Stones
Glaucoma
Hepatitis
Kidney Disease
Migraine
Thyroid Diseases
*
Any Surgical history
No
Yes
If yes mention the surgery
[ Select ]
Appendicectomy
Breast mass excision
Cholecystectomy
Cesarean Section
Hernia Repair
Laperotomy
OB/Gyne Surgeries
Thyroidectomy
Tonsillectomy
*
History of any communicable disease
No
Yes
If yes mention communicable the disease
[ Select ]
Chicken pox
Measles
Mumps
Rubella
Tuberculosis
H1 N1
*
Do you have history of chicken pox
No
Yes
*
Have you had blood transfusion any time
No
Yes
*
Have you had positive Tuberculosis test(TB)
No
Yes
*
Have you had Rheumatic fever
No
Yes
*
Have you have any drug allergy
No
Yes
*
Have you have latex allergy
No
Yes
*
Do you suffer from any serious diseases or conditions would prevent you from wearing or working while you wearing (RPE)
No
Yes
*
Will you undertake to remain clean shaven ( not more than 24 houres hair growth ) when wearing RPE
No
Yes
*
Contact Number
*
Email
*
Department
[ Select ]
Endoscopy
OR Dept.
RTU
X-Ray
Laboratory Dept.
Home Care Dept.
Public Health Dept.
CSSD
Mortuary Dept.
ER
NICU
DR
ICU
OBW 1
Nursiry
PW
FMW
MMW
MSW
FSW
MOW
AKU
Day Surgery Unit
Plastic Surgery Clinic
CS - Dept.
Dental Clinic 1
Dental Clinic 2
Dental Clinic 3
Dental Clinic 4
Dental Clinic 5
Dental Clinic 7
Dental Clinic 8
Dental Clinic 9
Dental Clinic 10
Dental Clinic 11
Dental Clinic 6
Dental Clinic 12
Dental Lab
Minor SOPD
Ortho Clinic
OBW 2
Optha. C
SOPD
OBC 1
OBC 2
Ent. C
Uro. C
Derma. C
Diabetic Foot
Dental Clinic ( 143 )
Phc Algoraif
Alkhazan phc
Aldulamiah PHC
Blood Bank
Phc Alhota
Dental 14
IV Admixture & TPN
Qasser Bin Oqaeel
Phc Almatar
Phc Alqushabi
Phc Aljandal
Phc Al-Dahleh
Phc Dokna
Phc Algarbi
Phc Algerthawia
Phc Alreqnah
Phc-King Abdulaziz
Phc Embary
Phc Sahoq
Phc Aldahlah
Phc Dokna
PHC - King Kaled
PHC - Almuhilany
Phc - Rafayah Alheeb
Phc Alneqra
Phc Al-Haysonia
Phc-Algadya & Solmat
Phc Dulaah Rasheed
Phc - AlShobiqia
Phc-Aldalfah
Phc Ouglat Alsoquor
Cathlab
Phc QAFH Dental 3
Phc QAFH Dental 4
Phc QAFH ENT
Phc QAFH Sargery
Phc - Alroodh
Phc Alsegen
PICU
Algaeia and Radem
AICU
SDICU
Phc. Alhamga
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