अनुसूची – ६

(नियम १५ को उपनियम (९) सँग सम्बन्धित)

यात्रा अनुमतिपत्रको नमूना

Government of Nepal

EMBASSY/PERMANENT MISSION/ CONSULATE

GENERAL/CONSULATE OF NEPAL

…………………………………..

TD No.:                                                                                                                       DATE:

ONE WAY TRAVEL DOCUMENT

THE EMBASSY / PERMANENT MISSION / CONSULATE GENERAL / CONSULATE OF NEPAL AT REQUEST AND REQUIRES ALL THOSE WHOM IT MAY CONCERN TO ALLOW MR./MS. ……………………………… WITH THE FOLLOWING DESCRIPTION, TO PASS FREELY, WITHOUT LET OR HINDRANCE, AND TO AFFORD HIM/HER ALL NECESSARY HELP AND COOPERATION HE/SHE MAY STAND IN NEED OF.

THIS TRAVEL DOCUMENT IS VALID TILL ……………………… FOR ONE WAY TRAVEL TO NEPAL AND COUNTRIES EN ROUTE.

DESCRIPTION

NAME                           :

ADDRESS                     :

SEX                               :

DATE OF BIRTH          :

OLD PASSPORT NO.    :

PHOTOGRAPH

ISSUING AUTHORITY:

NAME:

SIGNATURE: