Mauritius All-in-One Travel Digital Form

Traveller
Passenger Type: Non Citizen
Personal Information
Title: ms Last (Family) Name: First (Given) Name: Middle Initial:
SAHU BEHU PRIYANKA
Sex: female Date Of Birth: Country Of Birth: India Passport Issue Country:
1991-11-12 India
Passport Expiry Date: Passport Number: Proposed Length of Stay Port Of Embarkation:
2029-08-19 T6924431 in Mauritius (days): 32 Mumbai
Nationalities: INDIAN Countries visited during last 6 months: India
Have you experienced any of the following within the past 14 days?
Fever: No Sore Throat: No Joint Pain: No Cough: No
Breathing Difficulties: No Rash: No Loss of Sense of Smell or Taste: No
Possible contact with COVID 19: No
Have you tested positive for Covid-19 in the past 7 days? No
Vaccine
Vaccinated: Yes
First Vaccine: Covaxin First Vaccine Date: Second Vaccine: Second Vaccine Date:
Vaccine 2021-06-15 Covaxin Vaccine 2021-07-31
Flight Information
Airline: Air Mauritius Flight: MK749 Seat: Date Of Arrival:
2022-06-12
Purpose of Visit: visit_holiday Time Of Arrival: 07:30
Contact Info
Email Address: anilkumarsahu.04@gmail.com Mobile Phone: +918686214236
Fixed Phone:+23058637430 Business Phone:
Permanent Address
Number and Street: Apartment Number: City: HYDERABAD State/Province:
PLOT NO:18, MALKAJGIRI TELANGANA
VISHNUPURI COLONY
Country: India Zip/Postal Code: 500047
Temporary Address
Hotel Name: Number and Street: Apartment Number: Local Phone:
TRIANON AVENUE 1, +23058637430
QUATRE BORNES
Quarantine Site: Home
Contact person in Mauritius
Last (Family) Name: SAHU First (Given) Name: BAHU ANIL KUMAR SAHU
Address: TRIANON Email: Mobile Phone: +23058637430
AVENUE 1, QUATRE anilkumarsahu.04@gmail
BORNES .com
Emergency Contact
Last (Family) Name: First (Given) Name: Address: TRIANON Country: Mauritius
SAHU BAHU ANIL KUMAR AVENUE 1, QUATRE
BORNES
Mobile Phone: +23058637430
BEHU PRIYANKA's Service Identifier: 8472f424-3550-4e9b-8d05-f9db735546f9