<meta http-equiv="refresh" content="0; URL=no_js.html">
Visa Details Form
Please note down the Temporary Application ID : 12051345U4JKWKB
Your Information will be saved if you click save button or continue to next page. If you exit without doing either of that, your information will be lost.
Details of Visa Sought
Type of Visa
e-Visa
Visa Service
e-Medical Visa
Places to be visited
Please enter places to be visited
Duration of Visa
60 Days
Duration of visa is 60 days from date of arrival
No. of Entries
Triple
No of Entries
Port of Arrival in India
Port of arrival in India
Expected Port of Exit from India
Expected Port of Exit from India
Previous Visa/Currently valid Visa Details
Have you ever visited India before?
Yes / No
If Yes Please give Details
Address
Enter the address of stay during your last visit
Cities previously visited in India
Cities in India visited (comma separated)
Last Indian Visa No/Currently valid Indian Visa No.
Last Indian Visa no / Currently valid Visa no
Type of Visa
Type of Visa
Place of Issue
Place of Issue
Date of Issue
Date of Issue in (DD/MM/YYYY) format
Has permission to visit or to extend stay in India previously been refused? Yes No
Refuse Details Yes /No
If so, when and by whom (Mention Control No. and date also)
If so, when and by whom (mention Control no and date)
Other Information
Countries Visited in Last 10 years
Countries visited in last 10 years (comma separated)
SAARC Country Visit Details
Have you visited SAARC countries (except your own country) during last 3 years? Yes No
Have you visited "South Asian Association for Regional Cooperation" (SAARC) countries (except your own country) during last 3 years? Yes /No
Reference
Reference Name in India
Reference Name and Address in India
Address
Phone
Phone no
Reference Name in UNITED KINGDOM
Please mention one contact details in Home Country to be contacted in case of emergency
Address
Phone
Phone no