Scribd Logo
Upload

Welcome to Scribd!

  • Self Health Declaration Form: CCU RPR

    Uploaded by

    Madhumita Mudi
    16 views1 page
    This is a self-health declaration form for a passenger traveling from Kolkata to Raipur on February 21st, 2021. The form includes the passenger's name, mobile number, email, age, destination address and pin code. It also requires the passenger to declare that they are not COVID-19 positive, do not reside in a containment zone, are not experiencing any COVID symptoms, are not under quarantine, and will follow all health protocols at their destination.

    Original Description:

    Original Title

    Health & Contact Declaration

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This is a self-health declaration form for a passenger traveling from Kolkata to Raipur on February 21st, 2021. The form includes the passenger's name, mobile number, email, age, destination address and pin code. It also requires the passenger to declare that they are not COVID-19 positive, do not reside in a containment zone, are not experiencing any COVID symptoms, are not under quarantine, and will follow all health protocols at their destination.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    16 views1 page

    Self Health Declaration Form: CCU RPR

    Uploaded by

    Madhumita Mudi
    This is a self-health declaration form for a passenger traveling from Kolkata to Raipur on February 21st, 2021. The form includes the passenger's name, mobile number, email, age, destination address and pin code. It also requires the passenger to declare that they are not COVID-19 positive, do not reside in a containment zone, are not experiencing any COVID symptoms, are not under quarantine, and will follow all health protocols at their destination.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    Please carry the print of this page on the day of Travel

    Self health declaration form


    CCU  RPR
    Kolkata - Raipur 21 Feb 2021, 14:00 - 16:00 6E 171 PNR - JPVK2U

    ARNAB MUDI

    Mobile No 91 7001825833

    Email Id arnabmudi62@gmail.com

    Age 23

    Destination address Lakholi,Arang, Raipur

    Destination Pin code 493441

    COVID Status I am not COVID-19 positive.

    I have declared that:

    I am not residing in any containment zone.

    I am not su ering from any fever, cough, or any respiratory distress.

    I am not under quarantine.

    If I ever develop any of the above mentioned symptoms I will immediately contact the concerned health authorities.

    I have not tested COVID-19 positive in the last three weeks.

    I am eligible to travel as per the extant norms.

    I will make my mobile number/ contact details available to IndiGo, whenever required by them.

    I understand that if I undertake the air journey without meeting the eligibility criteria, I would be liable to penal action.

    I will adhere to the health protocol prescribed by the destination state/ union territory.

    You might also like