• Fields in red color are mandatory.
  • After submitting the form, a System Generated Bar Code is displayed, please take a screenshot or print it and keep it safely. The form will be downloaded automatically in your device.
  • This form is prepared for the details of Passenger Locator and Health Declaration of the passengers.
  • For latest travel advisory please visit www.immigration.gov.np

1. Personal Details

2. Travel History (Past 30 Days)

From To Mode of Travel Flight/ Vehicle No. Date Add/ Remove

3. Country of Present Residence

4. Health Information

Please show your vaccination certificate to respective authority upon arrival.


  • The above information is correct and I am subject to legal consequences if found otherwise.
  • I will abide by the health directives issued by the Government of Nepal during my stay .
  • I will take utmost care to abide by the health directives of the Government of Nepal to contain the possible spread of COVID 19 from me to my community.