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Indian Mission*
 
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 Applicant Details
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Surname
 Surname/Family Name (As in Passport)
Given Name*
 Given Name (As in Passport)
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Sex *
  
Date of Birth *
    (DD/MM/YYYY) Date of Birth as in Passport in DD/MM/YYYY format
Town/City of birth *
 Province/Town/City of birth
Country of birth *
  
Citizenship/National Id No. *
 If not applicable Please Type NA
Religion *
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Visible identification marks *
Educational Qualification *
  
Nationality *
  
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Prev. Nationality

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Passport Details    
Passport No. *
 Applicant's Passport Number
Place of Issue *
  
Date of Issue *
    (DD/MM/YYYY) In DD/MM/YYYY format
Date of Expiry *
    (DD/MM/YYYY) In DD/MM/YYYY format.Minimum Six Month Validity is Required.
     
Any other valid Passport/Identity Certificate(IC) held ,Yes / No If Yes Please give Details
Country of Issue
  
Passport/IC No.
  
Date of Issue
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Place of Issue
  
Nationality described therein
  
     
 
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