Rail Travel Concession Form for the Mentally Retarded

{See Rule 101, Serial No.29(1)}
CONCESSION CERTIFICATE

Paste passport size photograph Duly signed and stamped by the Issuing Doctor Form the purpose of grant of rail concession to orthopedically handicapped/paraplegic persons/ patients to be used by the Govt. Doctor
This is to certify that Km./ Shri./ Smt. .................................................., whose particulars are furnished below, is a bonafide deaf and dumb person/patient and CANNOT TRAVEL WITHOUT THE ASSISTANCE OF AN ESCORT.
Particulars of the Orthopaedically handicapped/ Paraplegic person/ patient :
  1. Address : _________________________________________________________________
  2. Father's/ Husband's Name : ___________________________________________________
  3. Age : ____________________________________________________________________
  4. Sex : _____________________________________________________________________
  5. Signature of Left Hand Thumb Impression of Mentally Retarded person : __________________
    _________________________________________________________________________
Place : _________
Date : __________

Signature of Govt. Doctor

____________________________________
Clear Seal of Govt. Hospital/ Clinic 		______________________________________
Seal Containing full name and Regd. No. of Doctor
* Strike out where not applicable Note:
  1. Certificate should be issued only to those Mentally Retarded persons WHO CANNOT TRAVEL WITHOUT AN ESCORT. The photo must be signed and stamped in such a way that Doctor's signature and stamp appears partly on the photo and partly on the certificate.
  2. The certificate is valid for five years from the date of issue. After expiry of the period of validity of the certificate, the person is required to obtain a fresh certificate. A Photostat copy of this certificate is accepted for the purpose of grant of concession. The original certificate will have to be produced for inspection at the time of purchase of concessional ticket and during the journey, if demanded.
  3. No alteration in the form is permitted.

(Note : Mentally Retarded person is permitted to travel by 2-tier A.C.Sleeper on payment of concessional fare for first class and surcharge for 2-tier A.C.Sleeper)

Facility of issue of concessional return ticket will also be available in one month from the date of commencement of outward journey. M.R. person should be given preference in allotment of coupe on reservation in first class, if required. Free ticket for one escort is available for every two persons in the same class of carriage whether they hold adult ticket or half ticket.

All the concessional fares shall be calculated on the basic railway fare for the journey. No person/party will be allowed more than one concession at one time.

The holder of a concession ticket will not permitted to change the ticket to a higher class by paying the difference except in the case of T.B. and Cancer patient, leprosy patient etc., The break up journey shall not be allowed on a concession ticket for a specific journey for example students traveling for an examination center, patient traveling to/from a hospital, professor traveling from/to a conference etc. The break journey will be allowed only if it is a natural event. During break journey, the passenger has to endorse the ticket alongwith Station Master's initial, date and station code. Refund of the untravelled person on such tickets will not be allowed.