Enter Your Full Name
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Date of Birth
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Enter Your Mobile No.
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Enter Your Email ID
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Enter Your Aadhar No.
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Gender
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Travel Plan |
Mode of Journey
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Flight No./Train No./Vehicle No.
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Date of Journey
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Date of Arrival at the Academy
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Arrival Time at Dehradun Airport/Railway Station
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Health/COVID Report |
Any Chronic Medical Disease | : | |
Are you vaccinated for COVID-19?
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Any medication that you are currently on (kindly specify dosage): |
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Food Allergies (if any)
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Any other relevant medical information that you would like to share
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Medical Policy (if any)
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Details of Spouse (if accompanying) |
Is your spouse also accompanying you?
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Please enter spouse name (if yes)
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Any Chronic Medical Disease (for spouse):
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Is your spouse vaccinated for COVID-19?
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Any medication that your spouse is currently on (kindly specify dosage): |
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Medical Policy of spouse(if any)
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Emergency Contact details |
Person to be contacted in case of any Emergency
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Contact details of Family Doctor (if any)
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