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    International Covid-19 Jagratha Page 1

    Uploaded by

    rahul
    The document is a registration form for Pravasi (Non-resident Keralites) returning to Kerala during the Covid-19 pandemic. It collects personal details like name, passport number, address in Kerala and abroad, contact details, expected travel date, health details and reason for return. The form allows adding family members and saves all entered details.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    International Covid-19 Jagratha Page 1

    Uploaded by

    rahul
    130 views2 pages
    The document is a registration form for Pravasi (Non-resident Keralites) returning to Kerala during the Covid-19 pandemic. It collects personal details like name, passport number, address in Kerala and abroad, contact details, expected travel date, health details and reason for return. The form allows adding family members and saves all entered details.

    Original Description:

    hggkg

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    The document is a registration form for Pravasi (Non-resident Keralites) returning to Kerala during the Covid-19 pandemic. It collects personal details like name, passport number, address in Kerala and abroad, contact details, expected travel date, health details and reason for return. The form allows adding family members and saves all entered details.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    130 views2 pages

    International Covid-19 Jagratha Page 1

    Uploaded by

    rahul
    The document is a registration form for Pravasi (Non-resident Keralites) returning to Kerala during the Covid-19 pandemic. It collects personal details like name, passport number, address in Kerala and abroad, contact details, expected travel date, health details and reason for return. The form allows adding family members and saves all entered details.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    You are on page 1of 2

    Covid-19 Jagratha 28/11/2020, 6:07 PM

    Pravasi Registration

    Click here to check whether you are already


    applied or not.

    Mobile Number In India* Your Email Address

    9892814811 [email protected]

    Passport Number* Name as in Passport *

    H664537 Ralul Ralal

    Age (Completed)* Gender*

    29 Male

    Address Abroad * Address Native*

    House No 988, Way No 418, Mozambique, Africa Kurungattu House, Keezhillam, Perumbavoor, Kerala

    Select District* Select Localbody*

    ERNAKULAM Perumbavoor

    Ward Number Local contact name*

    Ward No Valu

    Land Phone Number (with STD code) Covid Test Done?*

    Land Phone Number Yes

    Covid related health issue* Health remark*

    No Healthy

    Exempted Category* Visa Type*

    No Exemption Visit visa

    Return Reason* Occupation*

    Other Professional

    https://covid19jagratha.kerala.nic.in/home/pravasiEntry Page 1 of 2
    Covid-19 Jagratha 28/11/2020, 6:07 PM

    Other Reason*

    Wedding

    Expected Travel Date* Source Country*

    07-12-2020 Oman

    Details of Other Family Member

    Add Family Member

    Show 5 entries Search:

    # Name Passport Delete

    1 Lalur Lala K43567 !


    Showing 1 to 1 of 1 entries Previous 1 Next

    Save All

    Designed and developed by National Informatics Centre Kerala

    https://covid19jagratha.kerala.nic.in/home/pravasiEntry Page 2 of 2

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