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Registration form for people stranded in Chhukha Dzongkhag during 4th lockdown.
This form is NOT for the people stranded in Phuentsholing Thromdey, Sampheling Gewong, Phuentsholing Gewog and Loggchina Gewog.
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* Indicates required question
Name
*
Your answer
CID
*
Your answer
Contact Number
*
Your answer
Vehicle Number (If any)
Your answer
Current Location (Exact Location)
*
Where are you staying and with whom?
Your answer
Destination
*
Where are you going? Enter all the details.
Your answer
Where did you come from?
*
Your answer
Date of travel
*
The day you entered Chhukha Dzongkhag
MM
/
DD
/
YYYY
Reason for coming to Chhukha Dzongkhag
*
Explain why you visited Chhukha
Your answer
Urgency for moving out of Chhukha/Gewog
*
Explain your urgent reasons for moving out of Chhukha
Your answer
Antigen Test
*
Yes
No
Number of other members travelling with you
Your answer
CID numbers of members travelling with you
Please provide the Name and cid number of all members travelling with you.
Your answer
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This form was created inside of Royal Government of Bhutan.
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