ACCOMMODATION DEPARTMENT REQUEST FOR ACCOMMODATION (oantenrs fet Prtacr a7) (lowe Fniu i Brock Lerma) ‘To: THE ACCOMMODATION DEPARTMENT (arafsteer, PRI) arses RADIA SOAMI SATSANG Beas (Ture Bern are) Complete Cancellation Via -SMS. Dera Bawa JAIMal Since (Ber aren dare ftiz). Prone No TORTOLENOO Type Als erp. fas. Punias PIN CODE-145 20 (em, Ho-143 204) TELEPHONE (ST > os3.388200 AspuaarNo: 7014 648% SYR __ Visrror 1D (ore (ng #4) (Mr/Mrs./Ms yatta ae): IC Sy ne Teesans Genper (in)_Y (Citas (1a ENaC Rane) O) FuLty Vacewarep: vesD4%0 VACCINATION BENEFICIARY ID. TS 6M, > (qhawed teeter am tang, (arract cenrinicare pHorocory ae eee sy Famuen’s name: TEC be Cpe preety ___ snouse'swawe:___Lfseey (Fert er arr) (orf /creft est 7) Dare or BiRTH/AGtGaRa sy: OF] 19) 19. 9 intmaten Greer fret # ar ath: Yes! RESIDENTIAL ADDRESS(H =r OT: dob. WExTRos Souery i eeuen se fried Ru Distaicritaen: Puweé State (ry Mana acn7an Pinte ais UIP OU S Mon, No(Stt.) (an ty, 81078 COUPE rau, 1D:_lebas tan PROFESSION/Work(@ramay: RET) Re feo ory PRerrte DESIGNATION(aHfK ines Bn aGeR DISABILITY, IF ANY (Pem@varmmnter nf sig & a PARTICULARS OF ACCOMPANYING PERSONS ~ ONLY DEPENDENT FAMILY MEMBERS STAYING AT SAME ADDRESS. (eee 8 ary ara 7 Peer — fer fee A ager at ae ae Pe tle wrod amr zed) [SNo. NAME GT PEO | eee | eoneeeeney |e oct a) em) ean orem Li. | Lasengy Tuccare [2¥ [oP] 17h /B487 L846 HoI29 Yori Wi FE 2 442 a ti BI rae ae ate 6. ArRIVAL Date: | 0% Doin DEPARTURE DATE: 14 eg Dore tt Gat aR) are (ar = fats (UCONFIRM THAT ALL. THE ABOVE MEMBERS, ELIGIBLE FOR VACCINATION AS PER THE AGE CRITERIA DEFINED BY GOVT. OF INDIA, ARE FULLY VACCINATED thar arear/ wt fae Rca if weet a er re rer Ps er eee A eT stgtt O4}®2) 901% ee Date Ae SIGNATURE. OF APPLICANT (atta WaT) FoR OFFICE Use ONLY Frovt: To: NUMBER oF PEOPLE: ACCOMMODATION ALLOTTED: BooKING No. REMARKS: ACCOMIRE/2021/01