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..............N.F........... 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 panel charging under extant Railway Rules)

Train No & Name Date of journey 

Class                                                 Number of Berth/Seat  
Station From   To  

Boarding at     Reservation upto  

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


 

 

 

 

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