COVID-19

1 COVID-19 Certificate of Testing for COVID-19 Date of issue Name Passport No. , Nationality , Date of Birth , Sex COVID-19 This is to certify the following results which have been confirmed by testing for COVID-19 conducted with the sample taken from the above-mentioned person. Sample /Check one of the boxes below Testing Method for COVID-19 /Check one of the boxes below Result Test Result Date Specimen Collection Date and Time Remarks Nasopharyngeal Swab Saliva Nasopharyngeal and oropharyngeal swabs RT-PCR Nucleic acid amplification test RT-PCR LAMP Nucleic acid amplification test LAMP TMA Nucleic acid amplification test TMA TRC Nucleic acid amplification test TRC Smart Amp Nucleic acid amplification test Smart Amp NEAR Nucleic acid amplification test NEAR Next generation sequence * Quantitative antigen test* (CLEIA/ECLEIA)

2 Negative Positive No entry into Japan Date(yyyy /mm /dd) / / Date(yyyy /mm /dd) / / Time AM/PM : * Not a qualitative antigen test. Name of Medical institution Address of the institution Signature by doctor An imprint of a seal Quarantine Station, Ministry of Health, Labour and Welfare, Japanese Government Attachment 1-1 COVID-19 Certificate of Testing for COVID-19 Date of issue Name Passport No. , Nationality , Date of Birth , Sex COVID-19 This is to certify the following results which have been confirmed by testing for COVID-19 conducted with the sample taken from the above-mentioned person.

3 Sample /Check one of the boxes below Testing Method for COVID-19 /Check one of the boxes below Result Test Result Date Specimen Collection Date and Time Remarks Nasopharyngeal Swab Saliva Nasopharyngeal and oropharyngeal swabs RT-PCR Nucleic acid amplification test RT-PCR LAMP Nucleic acid amplification test LAMP TMA Nucleic acid amplification test TMA TRC Nucleic acid amplification test TRC Smart Amp Nucleic acid amplification test Smart Amp NEAR Nucleic acid amplification test NEAR Next generation sequence * Quantitative antigen test* (CLEIA/ECLEIA) Negative Positive No entry into Japan Date(yyyy /mm /dd) 2021 / 4 /2 Date(yyyy /mm /dd) 2021 / 4 /1 Time AM/PM 2 :30 * Not a qualitative antigen test.

4 Name of Medical institution Address of the institution Signature by doctor Sample An imprint of a seal Quarantine Station, Ministry of Health, Labour and Welfare, Japanese Government Attachment 1-2(2021.. ) Inspection certificates are valid only if they meet the following conditions Within 72 hours from the date of sample collection to the departure time of the flight. In principle, use the prescribed more information, please refer to the Ministry ofHealth, Labourand Welfare prescribed format can be downloaded from here. If you cannot use the prescribed format due to circumstances,you may use arbitrary format. If you are using arbitrary format, the following conditions must beincluded in the inspection certificate.

5 Conditions to be included in the inspection certificate. The test method is valid only for one of the following Sample collection method is valid only for one of the following Nasopharyngeal Swab Saliva Nasopharyngeal and Oropharyngeal SwabsMinistry of Health, Labourand Welfare Name, Passport number, Nationality, Date of birth, Sex Testing method for COVID-19 , Sample Limited to 2 and 3 below Result, Specimen collection date and time, Test result date,Date of issue Name of medical institution , Address of medical institution, Signature by doctor, An imprint of a seal All items must be written in Acid amplification TestOther realtime RT-PCRreal time reverse transcription PCR LAMPLoop- mediated isothermal amplification TMAT ranscription mediated amplification TRCT ranscription Reverse-transcription Concerted reaction Smart AmpSmart amplification process NEARN icking Enzyme amplification Reaction Next Generation Sequence Quantitative Antigen Test CLEIA/ECLEIA Nota qualitative antigen 2