Data Sheet for Repatriation to India

High Commission of India, Dhaka, Bangladesh  

Please go through carefully below before filling up the form:
  • The purpose of this form is only to collect information from Indian citizens who wish to return to India.
  • No decision has been taken with regards to the resumption of flights to India.
  • As and when a decision is taken regarding return of Indians to India, High Commission of India will make an announcement.
  • If you are with your family, this form is to be filled in by head of family. Please take care to add details of each family member who will return to India.
  • If details of family members (name, passport no, etc) are not added, only one person will be considered for return to India.
  • Students may register individually
* Required
Name*
Gender*
 Male  Female
Age (in Years) *
Passport number*
Email*
Purpose of Visit to Bangladesh (Visa Type) *
Do you have a Valid Visa (Yes/No) *
 YES  NO

Visa Validity Date*
Profession *
Are you staying with Family (Yes/No) *
   
Current Address in Bangladesh*
District in Bangladesh*
Nearest land port for leaving Bangladesh*
Contact Number (in Bangladesh)*
Contact Number (in India)*
Nearest International Airport in India *
Home State in India *
Home City in India*
Full Address in India*
Reason for travelling back to India *
Are you Covid Positive?*
 Yes  No  Test not Done

Undertaking

High Commission of India

Dhaka, Bangladesh

Sub: Consent Form for Repatriation from Dhaka , Bangladesh

  1. I hereby confirm my willingness to return to India in accordance with the terms of the High Commission
  2. I confirm my readiness to follow all instructions given by the officials of the Government of India / High Commission of India / Aircraft crew/ medical personnel on arrival.
  3. I agree to undergo a minimum 14 - days mandatory quarantine (quarantine period may be more if decided by local authority) on my arrival in India at my own expense as per the protocols framed by the Government of India.
  4. I am willing to bear the cost of traveling back to India.

  I agree with the above undertaking