GOVERNMENT OF UTTARAKHAND

E-REGISTRATION FOR MOVEMENT OF PERSONS

Lockdown Pass
This pass is not valid for people travelling from abroad (separate instructions has been issued by GOI)

1. Pass No.: I1310000939598220936

1(a). Pass Category: FAMILY / PERSONAL REASON (SHORT VISIT UPTO 7DAYS) - MARRIAGE / SMALL PARTY ETC.
2. Name: ARIF IQBAL, Age: 36 yrs.
3. Aarogya Setu App Status: Green
4. From State: Himachal Pradesh
5. No. of Family Members(if any): 1
6. Valid Upto: Your Stay in Uttarakhand is Valid upto 7 days i.e. till 21-08-2020

PERMISSION TO ENTER STATE OF UTTARAKHAND AFTER SCREENING AT BORDER CHECK POINTS

Journey Details
1. Mode of Travel: TRAIN
2. Travel Start Date & Time: 14-08-2020 - 06:00 AM
3. Travel Start Location: Paonta Sahib
4. Travel End Date & Time: 14-08-2020 - 07:00 PM
5. Travel End Location: Dehradun//Teliwala Doiwala Dehradun
6. Remarks: APPROVED. FOLLOW RULES AS MENTIONED IN E-PASS
7. Other Family Members allowed in Pass:

SR. NO. FAMILY MEMBER NAME GENDER AGE MOBILE NO.

1. SHAMA IQBAL FEMALE 31 8278856563 (TEL:8278856563)

This pass is issued on the basis of the declaration given by the applicant that:
1. He/She has read the Government order number 505/USDMA/792(2020) dated 4th August, 2020 of Unlock 3 mentioned under
Instruction section and undertakes to abide by the same.
2. The information provided by him/her is accurate to the best of his/her knowledge and he/she is aware that if the information
provided by him is found false action may be initiated in Epidemic act or disaster management act.
3. The applicant is aware that he/she may have to undergo quarantine as per the order dated 4th August, 2020.
4. The Applicant is not from containment zone in his/her City/ District.
5. The applicant solemnly affirms that he/she doesn't have any symptoms of COVID-19 like fever, dry cough etc.

The applicant is supposed to bring medical test negative report / certificate with him, which will be checked at border check post,
in case he has declared as per the order dated 4th August, 2020 that he/she has undergone RT-PCR test.

If any of the information/declaration is found false or if any person violates any terms & conditions of the issuing authority then this
pass will be automatically considered null & void & action will be initiated against the person under IPC, The Epidemic Act 1897
and The Disaster Management Act 2005.

Note: If you or your family members are coming from containment area / Institutional Quarantine Centres then this pass
will be treated as cancelled automatically.

Authorized Signatory,
DISTRICT ADMINISTRATION, DEHRADUN

Note: This is computer generated Pass. Signature not required. You can verify pass authencity from
http://smartcitydehradun.uk.gov.in/e-pass