<table border="1" cellspacing="0" style="width:330pt"> <tbody> <tr> <td colspan="2" style="background-color:#ededed; height:21.0pt; text-align:center; vertical-align:middle; white-space:nowrap; width:157pt">Nombres y Apellidos Completos</td> <td style="height:21.0pt; vertical-align:bottom; white-space:nowrap; width:173pt">OSCAR ALFONSO ORTIZ ESPINOZA</td> </tr> <tr> <td colspan="2" style="background-color:#ededed; height:21.0pt; text-align:center; vertical-align:middle; white-space:normal; width:157pt"># Dorsal o Polera</td> <td style="height:21.0pt; text-align:center; vertical-align:bottom; white-space:nowrap">23</td> </tr> <tr> <td colspan="2" style="background-color:#ededed; height:21.0pt; text-align:center; vertical-align:middle; white-space:normal; width:157pt">Edad</td> <td style="height:21.0pt; text-align:center; vertical-align:bottom; white-space:nowrap">23</td> </tr> <tr> <td colspan="2" style="background-color:#ededed; height:21.0pt; text-align:center; vertical-align:middle; white-space:normal; width:157pt">Carnet de Identidad</td> <td style="height:21.0pt; text-align:center; vertical-align:bottom; white-space:nowrap">12448124</td> </tr> <tr> <td colspan="2" style="background-color:#ededed; height:21.0pt; text-align:center; vertical-align:middle; white-space:nowrap">Categoría</td> <td style="height:21.0pt; text-align:center; vertical-align:bottom; white-space:nowrap">-</td> </tr> <tr> <td colspan="2" style="background-color:#ededed; height:21.0pt; text-align:center; vertical-align:middle; white-space:nowrap">Nombre de Misión Completa</td> <td style="height:21.0pt; text-align:left; vertical-align:bottom; white-space:nowrap">Uruguay - Montevideo Oeste</td> </tr> <tr> <td colspan="2" style="background-color:#ededed; height:21.0pt; text-align:center; vertical-align:middle; white-space:normal; width:157pt">Año Inicio </td> <td style="height:21.0pt; text-align:center; vertical-align:bottom; white-space:nowrap">2018</td> </tr> <tr> <td colspan="2" style="background-color:#ededed; height:21.0pt; text-align:center; vertical-align:middle; white-space:nowrap">Barrio</td> <td style="height:21.0pt; vertical-align:bottom; white-space:nowrap">Los Chacos</td> </tr> <tr> <td colspan="2" style="background-color:#ededed; height:21.0pt; text-align:center; vertical-align:middle; white-space:nowrap">Estaca</td> <td style="height:21.0pt; vertical-align:bottom; white-space:nowrap">Paraiso</td> </tr> <tr> <td colspan="2" style="background-color:#ededed; height:21.0pt; text-align:center; vertical-align:middle; white-space:nowrap">Equipo Anterior</td> <td style="height:21.0pt; vertical-align:bottom; white-space:nowrap">Junior´s</td> </tr> <tr> <td colspan="2" style="background-color:#ededed; height:21.0pt; text-align:center; vertical-align:middle; white-space:normal; width:157pt">Seguro de Univida </td> <td style="height:21.0pt; text-align:center; vertical-align:bottom; white-space:nowrap">Si</td> </tr> <tr> <td colspan="2" style="background-color:#ededed; height:21.0pt; text-align:center; vertical-align:middle; white-space:normal; width:157pt">Fotocopia C.I.</td> <td style="height:21.0pt; text-align:center; vertical-align:bottom; white-space:nowrap">Si</td> </tr> <tr> <td colspan="2" style="background-color:#ededed; height:21.0pt; text-align:center; vertical-align:middle; white-space:normal; width:157pt">VACUNA</td> <td style="height:21.0pt; text-align:center; vertical-align:bottom; white-space:nowrap">Si</td> </tr> <tr> <td colspan="2" style="background-color:#ededed; height:21.0pt; text-align:center; vertical-align:middle; white-space:normal; width:157pt">QUE VACUNA</td> <td style="height:21.0pt; vertical-align:bottom; white-space:nowrap">SINOPHARN</td> </tr> <tr> <td colspan="2" style="background-color:#ededed; height:21.0pt; text-align:center; vertical-align:middle; white-space:normal; width:157pt">DOSIS</td> <td style="height:21.0pt; vertical-align:bottom; white-space:nowrap">SEGUNDA DOSIS</td> </tr> <tr> <td colspan="2" style="background-color:#ededed; height:21.0pt; text-align:center; vertical-align:middle; white-space:normal; width:157pt">FECHA PRIMER DOSIS</td> <td style="height:21.0pt; text-align:center; vertical-align:bottom; white-space:nowrap">07/04/2021</td> </tr> <tr> <td colspan="2" style="background-color:#ededed; height:21.0pt; text-align:center; vertical-align:middle; white-space:normal; width:157pt">FECHA SEGUNDA DOSIS</td> <td style="height:21.0pt; text-align:center; vertical-align:bottom; white-space:nowrap">28/07/2021</td> </tr> <tr> <td colspan="2" style="background-color:#ededed; height:21.0pt; text-align:center; vertical-align:middle; white-space:normal; width:157pt">FECHA DE NACIMIENTO / COMENTARIOS</td> <td style="height:21.0pt; text-align:left; vertical-align:bottom; white-space:nowrap">06/01/1998</td> </tr> </tbody> </table>