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e-Intimation for Prior Vaccination for persons intending to undertake International Travel
New Application
marked fields are mandatory to be filled
New e-Intimation
Check Status
Check Status
Intimation/ ACK ID
Passport No.
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A) Personal Details
Applicant Name
Father/ Spouse Name
Gender
Male
Female
Others
DOB
District
-- Select --
AJMER
ALWAR
BANSWARA
BARAN
BARMER
BHARATPUR
BHILWARA
BIKANER
BUNDI
CHITTORGARH
CHURU
DAUSA
DHOLPUR
DUNGARPUR
HANUMANGARH
JAIPUR 1
JAIPUR 2
JAISALMER
JALORE
JHALAWAR
JHUNJHUNU
JODHPUR
KARAULI
KOTA
NAGAUR
PALI
PRATAPGARH
RAJSAMAND
SAWAI MADHOPUR
SIKAR
SIROHI
SRI GANGANAGAR
TONK
UDAIPUR
Address
Mobile No.
Email ID
Passport No.
B) Other Details
Reason for international Travel
Education
Employment
Sports Event
Medical Treatment
Returning back to Foreign Country
Travel due to Unavoidable circumstances
Travel is essential (VISA + Tickets available)
Intended Date of International Travel
Vaccination Required
Dose-1
Dose-2
C) Upload Supporting Documents (self-attested & readable copy in PDF, JPEG format only upto 1 MB)
Passport Copy (First and Last Page)
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Relevant Document
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D) Self-declaration
I hereby declare that the information provided by me herein is true to the best of my knowledge and am also aware that if found misleading/ false, will be liable to be prosecuted under relevant provisions of IPC and Rajasthan Epidemic Act.
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Mobile Number Validation/ मोबाइल नंबर सत्यापन
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