spf.safesecurity.sa Open in urlscan Pro
185.10.112.54 Public Scan

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Submitted URL:
http://spf.safesecurity.sa/GuardApplicationRequest
Effective URL:
https://spf.safesecurity.sa/GuardApplicationRequest
Submission: On August 27 via api (August 27th 2023, 2:38:45 pm UTC) from SA — Scanned from DE

Form analysis
1 forms found in the DOM

<form>
  <div id="guardInfo" class="row">
    <div class="col-md-6">
      <div class="auth-form-group"><label class="auth-form-label">الاسم الكامل</label>
        <div class="row">
          <div class="col-md-3">
            <div class="auth-control-wrapper"><input type="text" custom="chars" maxlength="25" placeholder="الاسم الأول" class="auth-form-control"></div>
          </div>
          <div class="col-md-3">
            <div class="auth-control-wrapper"><input type="text" custom="chars" maxlength="25" placeholder="الاسم الثاني" class="auth-form-control"></div>
          </div>
          <div class="col-md-3">
            <div class="auth-control-wrapper form-not-required"><input type="text" custom="chars" maxlength="25" placeholder="الاسم الثالث" class="auth-form-control"></div>
          </div>
          <div class="col-md-3">
            <div class="auth-control-wrapper"><input type="text" custom="chars" maxlength="25" placeholder="اسم العائله" class="auth-form-control"></div>
          </div>
        </div> <span class="form-error-text">هذا الحقل مطلوب</span>
      </div>
    </div>
    <div class="col-md-6">
      <div class="auth-form-group"><label class="auth-form-label">رقم الهوية الوطنية</label>
        <div class="auth-control-wrapper"><input custom="num" maxlength="10" type="text" placeholder="الرجاء إدخال رقم الهوية الوطنية 1xxxxxxxxx" class="auth-form-control"></div> <span class="form-error-text">هذا الحقل مطلوب</span>
      </div>
    </div>
    <div class="col-md-6">
      <div class="auth-form-group"><label class="auth-form-label">رقم الجوال</label>
        <div class="auth-control-wrapper"><input custom="num" maxlength="10" id="phoneNumber" dir="ltr" type="text" placeholder="05X XXX XXXX" class="auth-form-control"></div> <span class="form-error-text">هذا الحقل مطلوب</span>
      </div>
    </div>
    <div class="col-md-6">
      <div class="auth-form-group"><label class="auth-form-label">التاريخ الميلاد</label>
        <div class="row">
          <div class="col-md-4">
            <div class="auth-control-wrapper">
              <div role="combobox" class="v-input auth-form-control v-text-field v-text-field--placeholder v-select v-select--chips theme--light">
                <div class="v-menu__content theme--light " style="max-height: 300px; min-width: 0px; top: 0px; left: 0px; transform-origin: left top; z-index: 0; display: none;">
                  <div class="v-select-list v-card theme--light">
                    <div role="list" class="v-list theme--light">
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">1</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">2</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">3</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">4</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">5</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">6</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">7</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">8</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">9</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">10</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">11</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">12</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">13</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">14</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">15</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">16</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">17</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">18</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">19</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">20</div></div></a></div>
                    </div>
                  </div>
                </div>
                <div class="v-input__control">
                  <div class="v-input__slot">
                    <div class="v-select__slot">
                      <div class="v-select__selections"><input name="BirthDay" custom="num" readonly="readonly" type="text" placeholder="اليوم" autocomplete="on" aria-readonly="false"></div>
                      <div class="v-input__append-inner">
                        <div class="v-input__icon v-input__icon--append"><i aria-hidden="true" class="v-icon material-icons theme--light">arrow_drop_down</i></div>
                      </div>
                    </div>
                    <div class="v-menu"></div>
                  </div>
                  <div class="v-text-field__details">
                    <div class="v-messages theme--light">
                      <div class="v-messages__wrapper"></div>
                    </div>
                  </div>
                </div>
              </div>
            </div>
          </div>
          <div class="col-md-4">
            <div class="auth-control-wrapper">
              <div role="combobox" class="v-input auth-form-control v-text-field v-text-field--placeholder v-select v-select--chips theme--light">
                <div class="v-menu__content theme--light " style="max-height: 300px; min-width: 0px; top: 0px; left: 0px; transform-origin: left top; z-index: 0; display: none;">
                  <div class="v-select-list v-card theme--light">
                    <div role="list" class="v-list theme--light">
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">يناير</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">فبراير</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">مارس</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">أبريل</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">مايو</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">يونيو</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">يوليو</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">اغسطس</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">سبتمبر</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">أكتوبر</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">نوفمبر</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">ديسمبر</div></div></a></div>
                    </div>
                  </div>
                </div>
                <div class="v-input__control">
                  <div class="v-input__slot">
                    <div class="v-select__slot">
                      <div class="v-select__selections"><input name="BirthMonth" custom="num" readonly="readonly" type="text" placeholder="الشهر" autocomplete="on" aria-readonly="false"></div>
                      <div class="v-input__append-inner">
                        <div class="v-input__icon v-input__icon--append"><i aria-hidden="true" class="v-icon material-icons theme--light">arrow_drop_down</i></div>
                      </div>
                    </div>
                    <div class="v-menu"></div>
                  </div>
                  <div class="v-text-field__details">
                    <div class="v-messages theme--light">
                      <div class="v-messages__wrapper"></div>
                    </div>
                  </div>
                </div>
              </div>
            </div>
          </div>
          <div class="col-md-4">
            <div class="auth-control-wrapper">
              <div role="combobox" class="v-input auth-form-control v-text-field v-text-field--placeholder v-select v-select--chips theme--light">
                <div class="v-menu__content theme--light " style="max-height: 300px; min-width: 0px; top: 0px; left: 0px; transform-origin: left top; z-index: 0; display: none;">
                  <div class="v-select-list v-card theme--light">
                    <div role="list" class="v-list theme--light">
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">1960</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">1961</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">1962</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">1963</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">1964</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">1965</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">1966</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">1967</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">1968</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">1969</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">1970</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">1971</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">1972</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">1973</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">1974</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">1975</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">1976</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">1977</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">1978</div></div></a></div>
                      <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">1979</div></div></a></div>
                    </div>
                  </div>
                </div>
                <div class="v-input__control">
                  <div class="v-input__slot">
                    <div class="v-select__slot">
                      <div class="v-select__selections"><input name="BirthYear" custom="num" readonly="readonly" type="text" placeholder="السنة" autocomplete="on" aria-readonly="false"></div>
                      <div class="v-input__append-inner">
                        <div class="v-input__icon v-input__icon--append"><i aria-hidden="true" class="v-icon material-icons theme--light">arrow_drop_down</i></div>
                      </div>
                    </div>
                    <div class="v-menu"></div>
                  </div>
                  <div class="v-text-field__details">
                    <div class="v-messages theme--light">
                      <div class="v-messages__wrapper"></div>
                    </div>
                  </div>
                </div>
              </div>
            </div>
          </div>
        </div> <span class="form-error-text">هذا الحقل مطلوب</span>
      </div>
    </div>
    <div class="col-md-6">
      <div class="auth-form-group"><label class="auth-form-label">المستوى الدراسي</label>
        <div class="auth-control-wrapper">
          <div class="v-input auth-form-control v-text-field v-text-field--placeholder v-select v-select--chips v-autocomplete theme--light">
            <div class="v-menu__content theme--light v-autocomplete__content" style="max-height: 400px; min-width: 0px; top: 0px; left: 0px; transform-origin: left top; z-index: 0; display: none;">
              <div class="v-select-list v-card theme--light">
                <div role="list" class="v-list theme--light">
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">ثانوية عامة </div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">دبلوم</div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">بكالوريوس</div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">ماجستير</div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">دكتوراه</div></div></a></div>
                </div>
              </div>
            </div>
            <div class="v-input__control">
              <div class="v-input__slot">
                <div class="v-select__slot">
                  <div class="v-select__selections"><input name="EducationalLevel" type="text" placeholder="المستوى الدراسي" autocomplete="off" role="combobox"></div>
                  <div class="v-input__append-inner">
                    <div class="v-input__icon v-input__icon--append"><i aria-hidden="true" class="v-icon material-icons theme--light">arrow_drop_down</i></div>
                  </div>
                </div>
                <div class="v-menu"></div>
              </div>
              <div class="v-text-field__details">
                <div class="v-messages theme--light">
                  <div class="v-messages__wrapper"></div>
                </div>
              </div>
            </div>
          </div>
        </div> <span class="form-error-text">هذا الحقل مطلوب</span>
      </div>
    </div>
    <div class="col-md-6">
      <div class="auth-form-group"><label class="auth-form-label">المكان الأقرب لإجراء الفحص الطبي</label>
        <div class="auth-control-wrapper">
          <div class="v-input auth-form-control v-text-field v-text-field--placeholder v-select v-select--chips v-autocomplete theme--light">
            <div class="v-menu__content theme--light v-autocomplete__content" style="max-height: 400px; min-width: 0px; top: 0px; left: 0px; transform-origin: left top; z-index: 0; display: none;">
              <div class="v-select-list v-card theme--light">
                <div role="list" class="v-list theme--light">
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">الرياض - دار العرب</div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">الرياض - مركز أوتار </div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">الدمام  - مركز أوتار </div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">جازان - مركز أوتار </div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">القصيم - مركز أوتار </div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">مكة - مركز أوتار </div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">المدينة - مركز أوتار </div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">جدة - مركز أوتار </div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">تبوك  - مركز أوتار </div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">أبها  - مركز البرج </div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">أبو عريش - مركز البرج </div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">الباحة - مركز البرج </div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">الخبر - مركز البرج </div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">القصيم - مركز البرج</div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">بيشة - مركز البرج</div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">الدمام - مركز البرج</div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">حائل - مركز البرج</div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">الإحسا - مركز البرج</div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">جدة - مركز البرج</div></div></a></div>
                  <div role="listitem"><a class="v-list__tile v-list__tile--link theme--light"><div class="v-list__tile__content"><div class="v-list__tile__title">جزان - مركز البرج</div></div></a></div>
                </div>
              </div>
            </div>
            <div class="v-input__control">
              <div class="v-input__slot">
                <div class="v-select__slot">
                  <div class="v-select__selections"><input name="CheckUpLocation" type="text" placeholder="المكان الأقرب لإجراء الفحص الطبي" autocomplete="off" role="combobox"></div>
                  <div class="v-input__append-inner">
                    <div class="v-input__icon v-input__icon--append"><i aria-hidden="true" class="v-icon material-icons theme--light">arrow_drop_down</i></div>
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                <div class="v-menu"></div>
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              <div class="v-text-field__details">
                <div class="v-messages theme--light">
                  <div class="v-messages__wrapper"></div>
                </div>
              </div>
            </div>
          </div>
        </div> <span class="form-error-text">هذا الحقل مطلوب</span>
      </div>
    </div>
  </div>
  <div class="auth-form-group form-error"><label for="Authorization" class="form-check-label"><span class="form-check-control"><input id="Authorization" type="checkbox" class="form-check-input"> <span class="form-check-control-check"><svg
            xmlns="http://www.w3.org/2000/svg" width="10" height="8.251" viewBox="0 0 10 8.251">
            <path d="M4.272,23.4a.241.241,0,0,1-.351.018L.079,19.783a.255.255,0,0,1-.01-.36L1.293,18.13a.255.255,0,0,1,.36-.01l2.1,1.986a.241.241,0,0,0,.351-.018l4.1-4.764a.255.255,0,0,1,.359-.027l1.35,1.162a.255.255,0,0,1,.027.359Z"
              transform="translate(0 -15.236)" fill="#1c1f2c"></path>
          </svg></span></span> <span class="form-check-label-txt">أقر بصحة جميع البيانات المذكورة وأوافق على القيام بإجراءات الفحص الطبي لإكمال الطلب.</span></label> <!----></div> <input id="captchaToken" style="display: none;">
  <div class="col-xs-12 col-sm-12 col-md-12 col-lg-12 col-xl-12 rs_skip">
    <div data-sitekey="6LdM27EcAAAAAKM6uLnquoUCsUzGKTHv-xFlRcVG" data-expired-callback="onExpire" data-callback="onSubmit" class="g-recaptcha">
      <div style="width: 304px; height: 78px;">
        <div><iframe title="reCAPTCHA"
            src="https://www.google.com/recaptcha/api2/anchor?ar=1&amp;k=6LdM27EcAAAAAKM6uLnquoUCsUzGKTHv-xFlRcVG&amp;co=aHR0cHM6Ly9zcGYuc2FmZXNlY3VyaXR5LnNhOjQ0Mw..&amp;hl=ar&amp;v=0hCdE87LyjzAkFO5Ff-v7Hj1&amp;size=normal&amp;cb=7k1jrehbg17n"
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          style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
      </div><iframe style="display: none;"></iframe>
    </div>
  </div>
</form>

Text Content

الأحد - 27 أغسطس 2023 - 11 صفر 1445

 * A
   تباين الألوان

EN
 * عن المنصة
 * الأسئلة الشائعة

 * تسجيل الدخول


التقديم

الاسم الكامل

هذا الحقل مطلوب
رقم الهوية الوطنية

هذا الحقل مطلوب
رقم الجوال

هذا الحقل مطلوب
التاريخ الميلاد
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
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يناير
فبراير
مارس
أبريل
مايو
يونيو
يوليو
اغسطس
سبتمبر
أكتوبر
نوفمبر
ديسمبر
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1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
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هذا الحقل مطلوب
المستوى الدراسي
ثانوية عامة
دبلوم
بكالوريوس
ماجستير
دكتوراه
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هذا الحقل مطلوب
المكان الأقرب لإجراء الفحص الطبي
الرياض - دار العرب
الرياض - مركز أوتار
الدمام - مركز أوتار
جازان - مركز أوتار
القصيم - مركز أوتار
مكة - مركز أوتار
المدينة - مركز أوتار
جدة - مركز أوتار
تبوك - مركز أوتار
أبها - مركز البرج
أبو عريش - مركز البرج
الباحة - مركز البرج
الخبر - مركز البرج
القصيم - مركز البرج
بيشة - مركز البرج
الدمام - مركز البرج
حائل - مركز البرج
الإحسا - مركز البرج
جدة - مركز البرج
جزان - مركز البرج
arrow_drop_down


هذا الحقل مطلوب
أقر بصحة جميع البيانات المذكورة وأوافق على القيام بإجراءات الفحص الطبي لإكمال
الطلب.

إرسال


رمز التحقق

رمز التحقق

هذا الحقل مطلوب
إعادة إرسال رمز التحقق
ارسال إلغاء


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