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ACCOMMODATIONDEPARTMENT

REQUESTFORACCOMMODATION
(TOBEFILLEDINBLOCKLETTERS)

RS
SB
RADHASOAMISATSANGBEAS
BEAS,PUNJABPINCODE143204
DERABABAJAIMALSINGH,

TO:THEACCOMMODATIONDEPARTMENT
DATE:
AADHAARNO.:
ID:
ToEnquireBookingStatusViaSMSPhoneNo07087012700Type
ABS?ForHelp

TELEPHONE
:
01853271500

(Mr./Mrs./Ms.):
(FirstName)
(MiddleName)
(LastName)

DATEOFBIRTH/AGE:
INITIATED(YES/NO):

RESIDENTIALADDRESS:

CITY:
DISTRICT:
FOROFFICEUSEONLY
DURATIONOFSTAY:
FROM:

TO:
NUMBEROFPEOPLE:
ACCOMMODATIONALLOTED:
REGISTRATIONNO.:
AUTHORIZEDSIGNATURE:
ACCOM/RE/15/01
DATE:
REMARKS:
DURATIONOFSTAY:
ARRIVALDATE:

DEPARTURE:

SIGNATUREOFAPPLICANT

S.No.
1.2.3.4.5.6.
NAME

DATEOFBIRTH
AADHAARNO.
RELATION

PARTICULARSOFACCOMPANYINGPERSONS
ONLYDEPENDENTFAMILYMEMBERS
STAYINGATSAMEADDRESS

PIN:
STATE:
MOB.No.:
PROFESSION/WORK:
DISABILITYIFANY:
DESTINATION:

PREVIOUSVISIT:
ACCOMMODATIONAVAILED:
DURATIONOFSTAY: