Details of Participants

Enter Your Full Name
:
Date of Birth
:
Enter Your Mobile No.
:
Enter Your Email ID
:
Enter Your Aadhar No.
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Gender
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Travel Plan
Mode of Journey
:
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):
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?
:
Please enter spouse name (if yes)
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Any Chronic Medical Disease (for spouse):
:
Is your spouse vaccinated for COVID-19?
:
Any medication that your spouse is currently on (kindly specify dosage):
Medical Policy of spouse(if any)
:
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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