SHORT VISIT REGISTRATION

Covid Jagratha Information Folio

COme VIsit Destination Safely

Issued under Section 2 of the Epidemic Diseases act 1897 & The Disaster Management Act 2005 Inter State
Permit

Registration Number: 307812/2020 Date: 30/09/2020

Applicant Name: Mayank Jain

Address: House No. 30, 3rd D Cross, 21st Main

Government Issued ID Card: Driving License-MP15D20080080615

State and District: Karnataka-Bangalore Urban

Purpose of Visit: Official Visit

Valid From: 02/10/2020

Valid Up To: 04/10/2020

Local contact: 9562205599

Places and Institutions of Visit: Kuruva Island Resort

Fellow Travelers

# Name Sex DOB

1 Sandesh Karkera Male 21-04-1981
2 Dikshita Karkera Female 06-05-1986
3 Gayatri Kuthiala Female 29-11-1989
4 achint Jain Male 07-03-1993
 DISTRICT COLLECTOR & DISTRICT MAGISTRATE
WAYANAD

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