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  • Of This Form. Please Turn Over (P.T.O.)

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    Vijay Lad
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    Passengers undergoing COVID-19 RT-PCR testing at Chhatrapati Shivaji Maharaj International Airport in Mumbai must fill out a form acknowledging that they will quarantine at home after arriving at their destination until they receive their test results from the laboratory or government authorities. They also must agree to report to the nearest government health center if they develop any COVID symptoms.

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    Revised_Undertaking_Form_for_International_Arrival_Passengers_10.12.2020

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    Passengers undergoing COVID-19 RT-PCR testing at Chhatrapati Shivaji Maharaj International Airport in Mumbai must fill out a form acknowledging that they will quarantine at home after arriving at their destination until they receive their test results from the laboratory or government authorities. They also must agree to report to the nearest government health center if they develop any COVID symptoms.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    22 views2 pages

    Of This Form. Please Turn Over (P.T.O.)

    Uploaded by

    Vijay Lad
    Passengers undergoing COVID-19 RT-PCR testing at Chhatrapati Shivaji Maharaj International Airport in Mumbai must fill out a form acknowledging that they will quarantine at home after arriving at their destination until they receive their test results from the laboratory or government authorities. They also must agree to report to the nearest government health center if they develop any COVID symptoms.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    Note: Passengers undergoing RT-PCR test at CSMI Airport, Mumbai, need to mandatorily fill up the form given on backside

    of this form. Please Turn Over (P.T.O.)


    Page 1 of 2
    UNDERTAKING FOR PASSENGERS UNDERGOING COVID19 RT-PCR TEST AT CSMIA, MUMBAI

    I, Mr / Mrs / Ms........................................................................................................................, Age: ....... yrs,

    Male / Female, hereby undertake to home quarantine myself, after reaching my destination, at following

    address: …………………………………………………………………………………………………………………

    ..........................................................................................................................................................................

    ..........................................................................................................................................................................,

    till I have been communicated my COVID19 RT-PCR report by the laboratory / Govt authorities.

    I also undertake to report to the nearest Government Heath Center in case I develop any COVID symptoms.

    Signature :..........................................................Date: ……………………………..Time : ……………………

    Name : ................................................

    Mobile no : .............................................

    Page 2 of 2

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