NH54 Guest House - Room Booking Form

NH54 Guest House

Guest Registration Form
Name*

First NameLast Name
Mobile*
Country code plus mobile number.
E-mail*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Room(s)
State Your Requirement(s)
Number of Guests*
Any children 5-12, state number ?
Accompanying children are at reduced rate.
Status ?
If single, married or unrelated couple or friends.
Arrival Date & Time*

DayMonthYear
DateHourMinutes
Departure Date

MonthDayYear
Taxi Required?

Yes Please! - Pick me up on arrivalNo Thanks - I'll make my own way there
Aadhaar Card
ID Proof 1
Driving Licence No:
ID Proof 2
Voter ID
ID Proof 3
PAN Card
Address Proof Option 1
Utility Bill
Address Proof Option 2 - Electricity Telephone Water Tax
Flight Number
Passport Number
ID Proof 4
Country / Nationality
Purpose of Visit ?
State tourist, business or other etc.
Vehicle / Bike Number
Registered Owner's Name
Travel route here?*
Example: delhi-dabwali-bathinda / uk delhi
Do you have a vaccination cert for each?*
Yes/No - Under curfew or lockdown conditions in the state we are required to request vaccination certs from guest per order of SDMA No: 13180-H111(5)-2022/14. If yes, upload the cert.
Any medication being taken?*
Yes/No. If yes, please state.
Any medical condition last 6 months?*
Declaration of medical fitness. Yes/No - If yes, please state.
Are you declaring any weapons?*
Yes/No - If yes, state knife, sword, gun etc.
Upload One of Each (ID & Address) + Others.

Browse Files
jpg,pdf,txt,docx,xlsx,mkv,avi,wmv Cancelof
Additional Comments*
Should be Empty: