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DETAILS OF INFORMATION TO BE FURNISHED TO STATE LOCAL MEDICAL AUTHORITIES OF PEROSN IN ROOM QUARANTINE. Please furnish the following details to GA and Estate Office (email fe gadmin@iimk.ac.in and estate@iimk.ac.in) for reporting/ providing intimation to the 'ocal state health authorities, immediately on arrival from outside state 1. Name of the person/s in room quarantine. Qibuyza J Poul 2.Gender&age' Wale, 26 3. Mobile no. 40 51623634 4. Place of origin of travel State & place): Kolkata , West ‘Bengal 5. Mode of travel (Bus/Train/Flight/Pv. vehicle or any other mode) Ee light 6. Dates time of arrvat: 2:00PM, 10th December 7. Place of quarantine (If at IIMK please specify quarters no/hostel no.): Hostel N, Room HOt

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