ServicePlus- ePass for Movement amid COVID-19 Pandemic

Applicant Details

Applicant's Name *

Gender *

Male

Female

Transgender

Mobile Number *

E-Mail

Identity Proof *

Identity Card Number *

Category of Travelers *

Student

Migrant Worker

Tourist

Pilgrim

Medical

Applicant's Photograph *

Details of moving during Lockdown *

Traveling within Tripura

Traveling out of Tripura

Traveling to Tripura from outside

Present Address

Flat No. /Street No. *

Area/ Locality *

Town/ Village/ Ward No.

State

District

Postal / Zip Code

Country

Destination Address

Flat No. / Street No. *

Area / Locality *

Town / Village

State

District

Postal / Zip Code

Country

Travel Details

Type of Travel *

Reason for Travel *

Date & Time of Travel *

Estimated Date of Arrival on Destination Address *

Date & Time of Return Travel *

Estimated Date of Arrival on Return Address *

Travel Arrangement *

Type of Vehicle *

Vehicle Number *

Traveling as *

Seating Arrangement *

Traveller(s) Details

Name *

Gender *

Mobile Number

Identity Proof

Id Proof Number

Is there any cold/cough or fever or related symptoms? *

Ever been quarantined by authorities in the recent past? *

Name *

Gender *

Mobile Number

Identity Proof

Id Proof Number

Is there any cold/cough or fever or related symptoms? *

Ever been quarantined by authorities in the recent past? *

Declaration

I hereby declare that above details are true and correct to the best of my knowledge. Also, I undertake that if anything is found untrue I shall be liable for punishment/penalty as per law.

I hereby declare that I have downloaded Aarogya Setu App and have done Self Assessment on Aarogya Setu App.

I Agree *

Additional Details

Applied to the Office*

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