GOVERNMENT OF KARNATAKA

No: RD813S201009298 Dated: 15/08/2020

Acknowledgement of Self Registration

Origin State Category

ANDHRA PRADESH Inter-State Business Traveller

Following person(s) are registered to travel by Road from Karnataka.

Following person(s) are registered to travel by Road to Karnataka.

From: ANDHRA PRADESH

To: Raghavendra. S Ministry of Labour ESIC Branch office Plot No 38-39 B.Kattihalli Arasikere Road Hass, Raghavendra. S
Ministry of Labour ESIC Branch office Plot No 38-39 B.Kattihalli Arasikere Road Hass, Kattihalli arasukere road, Hassan, HASSAN
KARNATAKA - 518006

Sl No Name of the family member Relationship with Traveller Age Mobile Number
1 Gorantla satyanarayana Self 50 8142555509

Date of Entry Entry Place

Bagepalli Toll Plaza,
15/08/2020
Bagepalli Taluk
Date of Exit Exit Place
15/08/2020 Kamalnagar Checkpost

Terms and Conditions:

1. Quarantine Norm: Quarantine norms prevailing as on actual entry date will apply. Please
check at https://sevasindhu.karnataka.gov.in/PDF/SOP.pdf for the prevailing norms.

2. It is recommended to incoming travellers by road to arrive at the checkpost between 7AM

and 7PM to ensure minimal delays in border verification and medical screening process.