Registration of Indian Nationals

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First Name*
 Location*
Last Name*
 State*
Father Name*
 Phone Number (Sri Lankan)*
Mother Name*
 Mobile Number (Sri Lankan)*
Gender*
Male
Female

Profession*
Doctor
Engineer
Business
Indian Workers
Others
Date of Birth*
 Email Id*
Marital Status (if married, spouse’s name and passport details)*
 Passport Number*
Address in Sri Lanka Address in India
Address Line 1*
 Address Line 1*
Address Line 2*
 Address Line 2*
District / Province*
 District / State*
Phone Number*
 Phone Number*
Contact Person In Sri Lanka Contact Person In India
Name*
 Name*
Address*
 Address*
Mobile Number*
 Mobile Number*
Phone Number*
 Phone Number*
Email Id*
 Email Id*
Date of Arrival in Sri Lanka/ Type of Visa Category*
 Purpose of Visit*
Expected duration of stay (in Days in numbers)*

 Current Location/City/Town*
Details of Institution/Organisation where Working*
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