Travel Agent Exchange

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No entries to be made on this page except by authorized

Bank or Travel Agency

Exchange Control

Application Forms Issued

PP

Seal of Bank or

Travel Agent issuing

Foreign Exchange

peril urat aeqafarrr a. car anf wea fife: < e2rt/ Old Travel Document No. with Date and Place of Issue

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INDRA PRASAD POUDEL

freee zafen/ Next of Kin

arai/ Relationship

DPI00038226

FATHER

Surt/ Address

aba 4 / Ref. No.

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