Mauritius All-in-One Travel Digital Form

Traveller
Passenger Type: Non Citizen
Personal Information
Title: mr Last (Family) Name: First (Given) Name: Middle Initial: SP
PICHOT STEPHEN
Sex: male Date Of Birth: Country Of Birth: France Passport Issue Country:
1972-01-28 Reunion
Passport Expiry Date: Passport Number: Proposed Length of Stay Port Of Embarkation:
2024-11-19 14DI43403 in Mauritius (days): 10
Nationalities: FRANCE, METROPOLITAN Countries visited during last 6 months:
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: Pfizer First Vaccine Date: Second Vaccine: Pfizer Second Vaccine Date:
Vacine 2021-07-21 Vacine 2021-09-22
Flight Information
Airline: Air Austral Flight: UU108 Seat: Date Of Arrival:
2022-08-01
Purpose of Visit: visit_holiday Time Of Arrival: 17:35
Contact Info
Email Address: steven.pichot@icloud.com Mobile Phone: +262692305753
Fixed Phone: Business Phone:
Permanent Address
Number and Street: 4 Apartment Number: City: La Rivière St Louis State/Province:
allée des lianes aurore
Country: Reunion Zip/Postal Code: 97422
Temporary Address
Hotel Name: T Number and Street: Apartment Number: Local Phone:
+2304515979
Quarantine Site: Not Applicable
Contact person in Mauritius
Last (Family) Name: TATTEA First (Given) Name: Anjanee
Address: Rue des Email: Mobile Phone: +23058179379
pâquerettes, Le Morne angietattea@gmail.com
Emergency Contact
Last (Family) Name: First (Given) Name: Address: 16 avenue de la Country: France
Pichot Rodolphe libération 60400 NOYON
Mobile Phone: +33686245913
STEPHEN 's Service Identifier: f149bd71-c635-4c61-8329-bf469e65181f