DOMESTIC RETURNEES REGISTRATION

Covid Jagratha Information Folio

COme VIsit Destination Safely

Issued under Section 2 of the Epidemic Diseases act 1897 & The Disaster Management Act 2005 Inter State
(Outside State) Permit

Registration Number: 1614550 Date: 02-10-2020

Applicant Name: SYAMKUMAR AK

SRUTHI NIVAS (H), ASARIKANDI, CHELEMBARA VILLAGE,
Address: THENHIPALAM, MALAPPURAM, CALICUT UNIVERSITY, KERALA,
PIN : 673635
Government
699874470526
Issued ID Card:
Starting Place: Perungudi
District: MALAPPURAM
Localbody: CHELAMBRA
Name Date Slot
Checkpost:
Manjeshwaram 03-10-2020 10 am to 1 pm
Purpose of Travel: Join With Family
Vehicle Type: Two Wheeler(Pillion Driver Spouse Only)
Vehicle No: KL 65 M 5740

Fellow Travelers

# Name Sex DOB

1 MITHUN V S Male 28-10-1993

DISTRICT COLLECTOR & DISTRICT MAGISTRATE

MALAPPURAM
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