31/08/20, 6*40 PM

NOTE:Please follow the below safety rules when at RTA Office

1. Please sanitize your hands.
2. Please wear a mask.
3. Please maintain Physical Distancing
4. Please follow the COVID-19 guidelines issued by Government of India.
5. Please Visit the RTA Office in the Time Slot booked.

TELANGANA TRANSPORT DEPARTMENT

Provisional Slot Booking Slip

Booking Date : 31/08/2020

Dear RAMAKANTHA SARMA PANTANGI,

Thanks for using Online Services of Transport Department, Government of Telangana.

Provisional booking subject to confirmation only on payment of requisite fee within 24 hours
at any eseva/meseva center or you can pay online.
Failure in payment of fee with-in 24 hours, your booked slot will be cancelled.

Your slot for Renewal is successfully filed for License number 10854HS1993OD with Application Numer
TS007/18541/2020/OL.
Your slot has been booked for 02/09/2020 between 12:00 PM -- 12:10 PM.
Please report RTA RANGAREDDY.
Failing which your slot will be cancelled.

Please bring Valid Medical Certificate if age is more than 50 years & for Transport License., Original Driving
License.

Fee Details OFFICE ADDRESS

1. Application Fee Rs. 300 NEAR PILLAR NO 175 176 ,

2. Test Fee Rs. 0 RAJENDRANAGAR COURT ROAD ,
3. Smart Card Fee Rs. 200 YADAVAREDDY NAGAR .
4. Service Charge Rs. 300
5. Postal Charge Rs. 35
6. Late Fee Rs. 0

Total Rs. 835

Licencing Authority,
RTA RANGAREDDY
RANGA REDDY.

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 31/08/20, 6*40 PM

Form No. 9
(see Rule 81(1))
Form of Application for Renewal of Driving License

Application Number : TS007/18541/2020/OL Application Date: 31/08/2020

I Sri/Smt./Kum RAMAKANTHA SARMA PANTANGI Son/Wife/Daughter/ of VENKATESHWARA SASTRY P
hereby apply for renewal of my driving license which is attached and particulars of which are as follows.
a) Surname : RAMAKANTHA SARMA PANTANGI
b) Date of Birth : 12/04/1964
c) Blood Group :
d) Mandal : RAJENDRANAGAR
e) Pin Code : 500030
f) Mobile No : 9849804463
g) Educational Qualification :
h) Number : 10854HS1993OD
i) Date of issue : 05/08/1991
Licensing Authority by which
j) : RTA-HYDERABAD-NZ - TS010
license was issued
Licensed Authority by which
: RTA RANGAREDDY
k) the license was last renewed
: 23/04/2015
No. & Date of renewal
Class of vehicle authorised to
l) : Light Motor Vehicle Non Transport, Motor Cycle With Gear
be driven
m) Date of expiry of license to drive :
i. Transport Vehicle :
ii. Vehicles other than Transport Vehicles :16/04/2020
My present address is :

If this address is not entered on the license I do/do not wish that if should be so entered.

If the license not attached, reasons why it is not available?

If the license was not renewed within 30 days of the date of expiry,reasons for delay

.......

The renewal of license has not been refused by any Licensing Authority.

I have not been disqualified for holding or obtaining a driving license.My license has not been revoked.

I enclose a medical fitness certificate in Form 1 A

I have paid the fee of Rs 835.00

I hereby declare that to the best of my knowledge and belief the particulars given above are true.

Signature or thumb impression

Date:
of the applicant

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 31/08/20, 6*40 PM

Form 1A

Medical Certificate
[Rule 5(1), (3), 7, 10(a), 14(d) and 18(d)]

(to be filled in by a registered medical practitioner appointed by the State Government or authorized in this
behalf by the State Government referred to under sub-sec(3) of Sec.(8) )

1. Name of the applicant RAMAKANTHA SARMA PANTANGI

2. Identification Marks 1.
2.

a) Does the applicant to the best of your judgement suffer from any
Yes / No
defect of vision ? If so ,has it been corrected by suitable spectacles?
b) Can the applicant to the best of your judgement readily distinguish
Yes / No
the pigmentary colors ,Red and Green?
c) In your opinion is he able to distinguish with his eye sight of a distance
Yes / No
of 25 meters in good day light a motor car Number plates?
d) In your opinion does the applicant suffer from a degree of deafness
Yes / No
that would prevent his hearing the ordinary sound signals?
e) In your opinion does the applicant suffer from night blindness? Yes / No
f) Has the applicant any defect or deformity or loss of member which
interfere with the efficient performance of his duties as a driver? If so Yes / No
give your reasons in details.
g) .........................................................................................

OPTIONAL

a) Blood Group of the applicant (if the applicant so desires that the
information may be noted his driving license)
b) RH factor of the applicant (if the applicant so desires that the information
may be noted his driving license)
Declaration made by the applicant in Form 1 as to physical fitness is attached.
I certify that I have personally examined the applicant /I have directed special Test of the Distant vision
and hearing ability, the condition of arms, legs hand and joints of both extremities of the candidate and to the best
of my judgment he is medically fit/not fit to hold a driving License.

The applicant is not medically fit to hold a license for the following reasons:

Signature Name and designation of the

medical Officer/Practitioner
Photo Seal

Regn.No. of the medical Officer

Signature/Thumb impression of
the applicant

NB : The Medical Officer shall affix his signature party on the photo and partly on certificate.

Form 1

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 31/08/20, 6*40 PM

(See Rule 5(2))

Application cum declaration as to the fitness

1. Name of the Applicant RAMAKANTHA SARMA PANTANGI

2. Son/Wife/Daughter of VENKATESHWARA SASTRY P
3. Permanent Address
4. Temporary/Official Address
5. a) Date of Birth (DD/MM/YYYY) 12/04/1964
b) Age on date of application 56 Year(s), 4 Month(s)
6. Identification Marks 1.
2.

Declaration :

a) Do you suffer from epilepsy or from sudden attacks of consciousness or

Yes No
Giddiness from any cause?

b) Are you able to distiguish with each eye (or if you have a driving license to
drive motor vehicle for a period of not less than five years and if you have
lost the sight of one eye after said period of five years and it the applicant is
driving a light motor vehicle other than a transport vehiclefitted with an Yes No
outside mirror on the steering wheel side) or with one eye at a distance of
25 meters in good day light(with glasses if whom) a motorcar number
plate?

c) Have you lost either hand or foot or are you suffering from any defect or
Yes No
muscular pain of either arm or leg?

d) Can you readily distinguish the pigmentary colors red and green? Yes No

e) Do you suffer from night blindness Yes No

f) Are you so deaf as be unable to hear (and if application is for driving of a

Yes No
light motor vehicle with or without hearing aid )the ordinary sound?

g) Do you suffer any other disease or disability likely to cause you a driving of a
Yes No
motor vehicle to be a source of danger to the public ?if so give details.

I here by declare that the best of my knowledge and belief the particulars
given above and the declaration made herein are true.

Signature or thumb impression

of the applicant

Note :An applicant who answer yes to any of the question(a),(c),(f),and(g)and No to either.Of the
question (b) and (d) should amplify his answer with ful particularsand may be required.To give further
information relating thereto

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