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

Self health declaration form

RPR  DEL
Raipur - Delhi 01 Jan 2022, 11:30 - 13:20 6E 374 PNR - PIKYFV

Keshav Gupta

Mobile No 91 9826446405

Email Id keshav21@mit.edu

Destination address New Delhi Airport

Destination Pin code 110037

COVID Status I am not COVID-19 positive.

I have declared that:

I am not residing in any containment zone.

I am not suffering 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.