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    This document provides details of an outpatient appointment for Muhammad Ashraf Ali at the Christian Medical College in Vellore, India on March 4, 2021. It lists his personal details including name, date of birth, nationality, contact information and passport details. It also provides details of the appointment such as report time, clinic location, treating doctor, mode of payment and attendant details. General instructions for the appointment are also listed.

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    This document provides details of an outpatient appointment for Muhammad Ashraf Ali at the Christian Medical College in Vellore, India on March 4, 2021. It lists his personal details including name, date of birth, nationality, contact information and passport details. It also provides details of the appointment such as report time, clinic location, treating doctor, mode of payment and attendant details. General instructions for the appointment are also listed.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    68 views2 pages

    CMC Private New New Styoe

    Uploaded by

    Travels world
    This document provides details of an outpatient appointment for Muhammad Ashraf Ali at the Christian Medical College in Vellore, India on March 4, 2021. It lists his personal details including name, date of birth, nationality, contact information and passport details. It also provides details of the appointment such as report time, clinic location, treating doctor, mode of payment and attendant details. General instructions for the appointment are also listed.

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    © All Rights Reserved
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    of 2

    CHRISTIAN MEDICAL COLLEGE

    VELLORE - 632 004, TAMIL NADU, INDIA.


    Out Patient Appointment

    INTERNATIONAL-PATIENT
    Patient ID
    2102179866
    057724P

    057724P
    057724P
    SCAN HERE TO VERIFY
    BANGLADESH
    NATIONALITY - BANGLADESH

    Name : MUHAMMAD ASHRAF ALI


    DOB / Age / Gender : 25 May 1979 / 41 - Male
    Mobile No : 8801911863142 Token No : __________
    Email ID : timirnondon@gmail.com

    Passport No : EA0735982 Room No : __________


    Validity : 21/MAY/2019 - 20/MAY/2024
    057724P

    057724P
    Visa No : NA
    Visa Expiry Date : NA

    Appointment Date : 04 March 2021


    Report Time : Report to MRO at: 7:30 AM

    Clinic : MEDICINE 4
    Location : OPD BUILDING SECOND FLOOR 210 B
    Doctor : Dr. DIVYA ELIZABETH MATHEW
    Mode of Payment : UPI

    Invoice No : W3150469
    Bill No : A002675833
    Receipt No : WEBAPT518671
    Paid on : 17/02/2021 12:06 PM
    057724P

    057724P
    Amount : Rs. 870/-

    Address : TARAKANDA, MUMAMIAKANDA, MYMENSINGH, BANGLADESH.

    Before reporting to MEDICAL RECORDS OFFICER, Please contact IRO (900B) to complete the formalities.

    Printed on 17/02/2021 12:02 PM Page 1 of 2


    CHRISTIAN MEDICAL COLLEGE
    VELLORE - 632 004, TAMIL NADU, INDIA.
    Out Patient Appointment
    Attendant Details
    Name : MILTON SARKER
    Passport No : EA0666257
    Validity : 16/MAY/2019 - 15/MAY/2024
    Visa No : NA
    Visa Expiry Date :
    2102179866 NA

    Name : FAHMINA NAZNIN


    Passport No : EA0741449
    057724P

    057724P
    Validity : 21/MAY/2019 - 20/MAY/2019
    Visa No : NA
    Visa Expiry Date : NA

    Name : ELIZA ANZUM


    Passport No : EA0917901
    Validity : 09/JUN/2019 - 08/JUN/2024
    Visa No : NA
    Visa Expiry Date : NA
    General Instructions
    1. If the patient requires in-patient admission a female attendant is mandatory.
    2. Appointment booked online will Not be refunded.
    3. Change of Department/Unit Not allowed.
    4. Change In appointment Date will be allowed only once, upto one day prior To the appointment Date.
    057724P

    057724P
    5. Please provide atleast Government Related ID proof When you present yourself at the Entrance / MRO counter.
    6. Please contact Counter No: 2, 3, 4 (General) OR 402 (Private) in ISSCC Building Ground Floor to collect your Hospital Number Card.
    7. Request for appointments via post / phone will Not be accepted.
    8. Demand Drafts will only be accepted at cash counters, Not via post.
    057724P

    057724P

    Printed on 17/02/2021 12:02 PM Page 2 of 2

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