Professional Documents
Culture Documents
( Registration )
140312B634ZF Application ID No. 140312B634ZF Appointment Date FOR OFFICE USE ONLY Reg.No. B 0 0 1 A F G 2 0 1 2 23/03/2012
Personal Details
Surname Given Name MOHAMMADULLAH Sex Male Date of Birth 04/02/1990 Age as on today Year(s) 22 Month(s) Place of Birth KANDAHAR,KANDAHAR,AFGHANISTAN Father's Name OBAIDULLAH Mother's Name Spouse Name Any Identification mark(s) preferably visible NON Present nationality AFGHANISTAN Manner of acquiring present nationality By Birth Date of acquiring present nationality Whether holding dual NO nationality? If yes, Name of the country of second nationality provide the following:- Passport No. of second country Date of Issue Date of Expiry Whether travelled on this passport earlier to India Paste your Recent passport size photograph here
0 10
Previous nationality
NO
Email/Occupation/Profession Details
E-Mail Id MOHAMMADULLAH_OBAIDY@YAHOO.COM Profession/Occupation BUSINESS
Passport Details
Passport No. Date of Issue OR099382 29/07/2007 Place of Issue Expiry Date AFGHANISTAN, KANDAHAR 27/09/2013
Visa Details
Visa Number AP2994512 Date of Issue 05/02/2012 Valid For Single Entry Special endorsement, if any Place of Issue Expiry Date Visa Type VALID FOR 30 DAYS STAY AFGHANISTAN, KANDAHAR 04/05/2012 MEDICAL VISA
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Organization/Company/Institute/Hospital Details
Name MD EYE CARE AND LASER CENTER Address M 165 GREATER KAILASH PART 2 State DELHI Telephone Number
City Email ID
DELHI
Arrival Details
Place of embarkation/boarding for India KABUL,KABUL,AFGHANISTAN Date of arrival in India 11/03/2012 Place of disembarkation/arrival in India DELHI Mode of Journey Air Flight /Ship /Bus /Train No. Purpose of visit to India Medical Treatement of self
Category
Others
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Instruction
Document required for registration
1. 2. 3. 4. 5. Registration form in triplicate. 04 (for adult) and 02 (for minor) recent passport size photographs Copy of passport (photo page, Page indicating validity, page bearing arrival stamp), Copy of Indian Visa and copies of medical papers and test reports. Proof of residential address in India. Copy of valid notarized Lease/Rent agreement or copy of C-form from the Hotel and copy of recent electricity/telephone bills alongwith letter from the landlord. Letter from concerned hospital where treatment is being taken alongwith supportive medical documents/diagnostic test report with tentative period of treatment.Letter from concerned hospital where treatment is being taken alongwith supportive medical documents/diagnostic test report with RECURSIVE tentative period of treatment.
closing time:
18.00
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