1. Registration No.(to be filled by the office)_______________________________

Space for Photo

2. Name_________________________________Age________Sex (M/F) ________

3. Father's Name/Spouse's Name_________________________________________

4. Permanent Address__________________________________________________
                             __________________________________________________
                             __________________________________________________

State_____________________District_________________Tehsil______________

Post Office_______________________Pin______________Police Station______________________
Fax No.(if any)_________________________Telephone No.(if any) ____________________________
5. Route Option: i) Pahalgam |        |  ii) Baltal |        |    (Please _/ the option )
6. Preffered Date for Darshan_____________________________________________________________
7. Whether travelling in a group ?  If yes, mention the number & particulars of members. (Use a separate sheet for details, if required) .
Note : The strength of the group shall in no case exceed 6 (six) members. However, each pilgrim will be given a separate Registration - cum - Identity Slip.

Signature/Thumb Impression of applicant

Medical Fitness Certificate

Certified that the applicant is fit to undertake the Yatra at the height of 14,500 feet above mean sea level.

Name of Doctor _______________________________________________________________

Address _____________________________________________________________________

_____________________________________________________________________________
 

Seal & Signature of Certifying Doctor

Note : Please enclose an additional passort - size photograph for the Registration - cum Identity Slip.