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Reservation/Cancellation Requisition Form: .......................... RAILWAY CM257

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RAILWAY CM257

Reservation/Cancellation Requisition Form

If you are a Medical Practitioner

Please tick ( ) in Box


(You could be of help in an emergency) Dr.

If you want Sr. Citizen Concession, please write Yes/No in Box

(if yes, please carry a proof of age during the journey to avoid inconvenience of panel charging under extant Railway Rules)

Do you want to be upgraded without any extra charge?


Write

Yes/NO in the box.


(if this option is not exercised, full fare paying passengers may be upgraded automatically)

Train No & Name Date of journey

Number of
Class
3A Berth/Seat

Station From To

Boarding at Reservation upto

Choice Meals for


Name in Block Letters
S.No. Sex(M/F) Age Concession/Travel Authority No. (Lower/Upper Rajdhani/Shatabdi
(not more than 15 letters)
Berth) Express

1.
-- --

2.
-- --

3.
-- --

4.
-- --
5.
-- --

6.
-- --

CHILDREN BELOW 5 YEARS (FOR WHOM TICKET IS NOT TO BE ISSUED)

S.No. Name in Block Letters (not more than 15 letters) Sex Age

1.
--

2.
--

ONWARD/RETURN JOURNEY DETAILS

Train No & Name Date of journey Class


1A

Station From To

Name of applicant Full Address

Signature of the Applicant/Representative ______________________

Telephone No., if : :
Date Time
any

FOR OFFICE USE ONLY

S.No. of Requistion_______________________ PNR No._______________________

Berth/Seat No._______________ Amount collected ________________

______________________ Signature of Reservation Clerk

NOTE : 1.Maximum permissible passengers is 6 per requisition.


2. One person can giFve one requisition form at a time.
3. Please check your ticket and balance amount before leaving the window.
4. Forms not properly filled or in illegible forms shall not be entertained.
5. Choice is subject to availability

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