RESERVATION / CANCELLATION FORM

........................ RAILWAY                                            CM257 RESERVATION/CANCELLATION REQUISITION FORM   If you are a Medical Practitioner  Please tick ( ) in Box                                                               Dr.   (You could be of help in an emergency) 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 penal charging under extant Railway Rules)   Train No & Name ___________________  Date of journey______________________ Class ____________________________  No of Berth/Seat_______ Station from _______________________  To __________________ Boarding at   ______________________   Reservation upto _____________________ S.No. Name in Block letter(not more than 15 chars) Sex(M/F) Age Concession/TravelAuthority No. Choice if any 1. Lower/Upper berth Veg./Non-veg. Meal for Rajdhani/ Shatabdi Express Only 2. 3. 4. 5. 6. CHILDREN BELOW 5 YEARS (FOR WHOM TICKET IS NOT TO BE  ISSUED) S.No. Name in Block Letters Sex Age                                         ONWARD/RETURN JOURNEY DETAILS  Train No. & Name________________________ Date  ________________________ Class ________ Station from:___________________ To________________________ Name of applicant _______________________________________________________ Full Address ___________________________________________________________ ______________________________________________________________________ ____________________________________________________________________                                            Signature of the Applicant/Representative Telephone No., if any _______________________  Date __________Time __________                                                      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 give 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