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  • Permit To Travel

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    Sadhish Kumar
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    This document provides a health declaration and screening summary for an individual named Sundaram Sadhish kumar arriving in Nigeria from India on October 18th, 2022. It includes their personal details like name, passport number, gender, date of birth, as well as travel details like flight number and addresses. It screens for COVID-19 symptoms, contact with sick individuals, and medications in recent time periods. It confirms the individual is fully vaccinated.

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    2. Permit To Travel

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    This document provides a health declaration and screening summary for an individual named Sundaram Sadhish kumar arriving in Nigeria from India on October 18th, 2022. It includes their personal details like name, passport number, gender, date of birth, as well as travel details like flight number and addresses. It screens for COVID-19 symptoms, contact with sick individuals, and medications in recent time periods. It confirms the individual is fully vaccinated.

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

    Permit To Travel

    Uploaded by

    Sadhish Kumar
    This document provides a health declaration and screening summary for an individual named Sundaram Sadhish kumar arriving in Nigeria from India on October 18th, 2022. It includes their personal details like name, passport number, gender, date of birth, as well as travel details like flight number and addresses. It screens for COVID-19 symptoms, contact with sick individuals, and medications in recent time periods. It confirms the individual is fully vaccinated.

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    © All Rights Reserved
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    of 1

    YOUR HEALTH DECLARATION & SCREENING SUMMARY

    Fully Vaccinated

    PERMIT TO
    TRAVEL

    Phone Number Passport Number


    08182729574 Z3628110

    Gender Nationality
    Male India

    Date of Birth Country of Residence


    10/05/1979 Nigeria

    Travel
    Details

    Flight Number Departure Airport Arrival Airport


    QR1433 Chennai International Airport Port Harcourt
    Seat Number

    COUNTRIES VISITED
    IN THE LAST 21 DAYS

    India,

    DESTINATION IN NIGERIA
    FOR THE LAST 21 DAYS

    Address 1 City, State Duration of stay


    R8A-16, Heliconia Park, Eastern Bypass road Port Harcourt, Rivers 56 day(s)

    EMERGENCY CONTACT OR NEXT OF KIN


    IN NIGERIA

    Address
    Name Phone Number
    Plot10, JC International street, Trans Amadi Ind
    Beatrice Mark 08118837563
    Layout, PHC,

    HEALTH DETAILS

    SYMPTOMS SICK PERSON CONTACT MEDICATION


    IN THE LAST 21 DAYS IN THE LAST 21 DAYS IN THE LAST 24 HOURS

    LAB

    Passenger Name Arrival Date Vaccination Status


    Signature
    Sundaram Sadhish kumar 18/10/2022 Fully Vaccinated

    Fully Vaccinated (NO PAYMENT)

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