FORMAT "B" 3

(FOR C Category - Home Quorantine Passangers)

CORONA Surveillance - LINELIST FOR REPORTING OF DAILY HEALTH STATUS OF PASSENGERS UNDER OBSERVATION
Kokan Division Date - /03/2020
District / Date of Todays
Country of departure from Date of receipt Observation
Sr No Corporatio Name Age Gender Address Phone District Health comments
visit affected of information started from
n status
country
B/002, Ridhisidhi,
No any sign &
1 Raigad Rani Vijay Peter 45 M pethgaon, 8879742115 Raigad Baharin 19/03/2020 20/03/2020 20/03/2020 Good
symptoms
Palaspephata

Ayurveda village, No any sign &

2 Raigad Deepa Madhavan 55 F 9594935008 Raigad Cannada 19/03/2020 20/03/2020 20/03/2020 Good
Agni symptoms

Ayurveda village, No any sign &

3 Raigad Katima Sarah 52 F 9594935008 Raigad Youganda 19/03/2020 20/03/2020 20/03/2020 Good
Agni symptoms

Ayurveda village, No any sign &

4 Raigad Mutavu Kabenga 60 F 9594935008 Raigad Youganda 19/03/2020 20/03/2020 20/03/2020 Good
Agni symptoms

Ayurveda village, No any sign &

5 Raigad Joimut Avu 48 F 9594935008 Raigad Youganda 19/03/2020 20/03/2020 20/03/2020 Good
Agni symptoms

Room no 105, 4B,

No any sign &
6 Raigad Vikarant G Patil 32 M Radhe Heritage, 95957800906 Raigad Abudhabi 19/03/2020 21/03/2020 21/03/2020 Good
symptoms
Palaspe

B/203, Nbheshwar No any sign &

7 Raigad Suraj Pille 25 M 9822684360 Raigad Sharja Dubai 18/03/2020 21/03/2020 21/03/2020 Good
Angan, Sukapur symptoms

B/203, Nbheshwar No any sign &

8 Raigad Lekha Pille 57 F 9822684360 Raigad Sharja Dubai 18/03/2020 21/03/2020 21/03/2020 Good
Angan, Sukapur symptoms

Milind Jagannath No any sign &

9 Raigad 60 M Sec 4, Karanjade 8692875228 Raigad Singapur 17/03/2020 21/03/2020 21/03/2020 Good
Tatkar symptoms

No any sign &

10 Raigad Praniti Milind Tatkar 55 F Sec 4, Karanjade 8692875228 Raigad Singapur 17/03/2020 21/03/2020 21/03/2020 Good
symptoms
 Pranil Dnyaneshwar No any sign &
11 Raigad 20 M Wadghar 9769532076 Raigad Abudhabi 20/03/2020 21/03/2020 21/03/2020 Good
Kamble symptoms

Rushikesh Ganpat No any sign &

12 Raigad 22 M Karanjade Gaon 9930785529 Raigad Dubai 20/03/2020 21/03/2020 21/03/2020 Good
Jadhav symptoms

Sanket Mahadev No any sign &

13 Raigad 32 M Belpada 8291632933 Raigad Dubai 15/03/2020 16/03/2020 16/03/2020 Good
Koli symptoms

Meghanath No any sign &

14 Raigad 55 M Gulsunde 9960671711 Raigad Abudhabi 13/03/2020 21/03/2020 21/03/2020 Good
Vishwanath Tupe symptoms

Sangita Meghanath No any sign &

15 Raigad 52 F Gulsunde 9960671711 Raigad Abudhabi 13/03/2020 21/03/2020 21/03/2020 Good
Tupe symptoms

Mahesh Balkrushna No any sign &

16 Raigad 36 M Vichumbe 7738526006 Raigad Turki 17/03/2020 19/03/2020 19/03/2020 Good
Sagale symptoms

Nitin Mdhukar No any sign &

17 Raigad 40 M Devad 900435110 Raigad Thiland 18/03/2020 21/03/2020 21/03/2020 Good
Bagade symptoms

Mitesh Suresh No any sign &

18 Raigad 28 M Usarli 9867128191 Raigad Dubai 18/03/2020 21/03/2020 21/03/2020 Good
Kharatmol symptoms

No any sign &

19 Raigad Raja Harindarsing 25 M Vichumbe 7400278177 Raigad Turki 15/03/2020 21/03/2020 21/03/2020 Good
symptoms

Amit Gajanan No any sign &

20 Raigad 36 M Palaspe 9619625616 Raigad Saudi 10/03/2020 21/03/2020 21/03/2020 Good
Deshpande symptoms

No any sign &

21 Raigad Hum Bahadur Thapa 20 M Tara, Barapada 7028110097 Raigad Nepal 06/03/2020 21/03/2020 21/03/2020 Good
symptoms

No any sign &

22 Raigad Chabilal Bisnu Thapa 40 M Tara, Barapada 7028110097 Raigad Nepal 06/03/2020 21/03/2020 21/03/2020 Good
symptoms
 Manisha Chabilal No any sign &
23 Raigad 19 F Tara, Barapada 7028110097 Raigad Nepal 06/03/2020 21/03/2020 21/03/2020 Good
Thapa symptoms

Anushka Chabilal No any sign &

24 Raigad 2 F Tara, Barapada 7028110097 Raigad Nepal 06/03/2020 21/03/2020 21/03/2020 Good
Thapa symptoms

Balaram Tiaram No any sign &

25 Raigad 16 M Tara, Barapada 7028110097 Raigad Nepal 06/03/2020 21/03/2020 21/03/2020 Good
Thapa symptoms

Pushpnarayan Com.
Flat no 203, No any sign &
26 Raigad Anil Kharatmol 37 M 9967447089 Raigad Katar 17/03/2020 22/03/2020 22/03/2020 Good
Devegaon, New symptoms
Panvel
House no 872, No any sign &
27 Raigad Goutam D Mahato 23 M 9619816243 Raigad London 18/03/2020 22/03/2020 22/03/2020 Good
NhavaKhadi, Panvel symptoms

204/7, Vinayak, No any sign &

28 Raigad Smital Vadhavakar 21 F 7977573877 Raigad France 18/03/2020 22/03/2020 22/03/2020 Good
Chipalegaon symptoms

No any sign &

29 Raigad Guddu Hasan Shaikh 41 M Kolakhe 7011344168 Raigad Keneya 22/03/2020 22/03/2020 22/03/2020 Good
symptoms

Siddi Mandar No any sign &

30 Raigad 34 M Usarli 7620378545 Raigad Abudhabi 17/03/2020 23/03/2020 23/03/2020 Good
Khedekar symptoms

Rajendra
No any sign &
31 Raigad Nandkumar 50 M Palaspe 9321566986 Raigad Africa 21/03/2020 23/03/2020 23/03/2020 Good
symptoms
Chachad

No any sign &

32 Raigad Digvijay Nivrutti Patil 25 M Vichumbe 8369813539 Raigad Oman 13/03/2020 23/03/2020 23/03/2020 Good
symptoms

Bharat Ghuleshwar No any sign &

33 Raigad 44 M Vichumbe 9869845011 Raigad Abudhabi 16/03/2020 23/03/2020 23/03/2020 Good
Khandelvar symptoms

Home
34 Raigad Aditya Anil Katkar 19 M Palaspe 9323328383 Raigad Russia 22/03/2020 23/03/2020 23/03/2020 Good
Quorantine
 Home
35 Raigad Subodh Pandit 30 M Waveghar 7758012332 Raigad Dubai 13/03/2020 23/03/2020 23/03/2020 Good
Quorantine

Home
36 Raigad Mukeshkumar 34 M Adai 9892215645 Raigad Youganda 21/03/2020 23/03/2020 23/03/2020 Good
Quorantine

Home
37 Raigad Bhagvan Mokal 50 M Sai 9930834645 Raigad Katar 17/03/2020 23/03/2020 23/03/2020 Good
Quorantine

Sachin Harising Within

38 Raigad 20 M Waveghar 9980651700 Raigad Karnataka 20/03/2020 23/03/2020 23/03/2020 Good
Pawar Country

sec 17, Tejas

No any sign &
39 Raigad Munzir Khanche 31 M heights, 1001, plot 8828191494 Raigad UK 17/03/2020 20/03/2020 20/03/2020 Good
symptoms
no 19, Ulve

1101, B 12x13,
No any sign &
40 Raigad Simran Banerjee 19 F progressive icon 9830348322 Raigad UK 17/03/2020 20/03/2020 20/03/2020 Good
symptoms
soc, sec 8, Ulve

flat no 402, plot no

No any sign &
41 Raigad Shobha Sunil Thakur 35 F 86, sec 12, patel 8080539161 Raigad Shrilanka 18/03/2020 20/03/2020 20/03/2020 Good
symptoms
house, Ulave

Nimbeshwar parvati
No any sign &
42 Raigad Dhiraj Kolage 31 M CHS, C/102, 7575806723 Raigad Australia 16/03/2020 20/03/2020 20/03/2020 Good
symptoms
Palidevad, Sukapur

A 602, Hari hights,

43 Raigad Sagar Bishwas 23 M Room no 23, Sec 9, 8454936537 Raigad Irland 17/03/2020 19/03/2020 19/03/2020 Good Sore Throat
Ulve

Room no 79, Sec6, No any sign &

44 Raigad Nirav Nepali 6 M 9136823148 Raigad Nepal 17/03/2020 18/03/2020 18/03/2020 Good
Karanjade symptoms

Room no 79, Sec6, No any sign &

45 Raigad Balika Nepali 7 F 9136823148 Raigad Nepal 17/03/2020 18/03/2020 18/03/2020 Good
Karanjade symptoms

Room no 79, Sec6, No any sign &

46 Raigad Devbahadur Nepali 40 M 9136823148 Raigad Nepal 17/03/2020 18/03/2020 18/03/2020 Good
Karanjade symptoms
 Room no 79, Sec6, No any sign &
47 Raigad Manisha Nepali 30 F 9136823148 Raigad Nepal 17/03/2020 18/03/2020 18/03/2020 Good
Karanjade symptoms

Room no 79, Sec6, No any sign &

48 Raigad Chetana Nepali 9 F 9136823148 Raigad Nepal 17/03/2020 18/03/2020 18/03/2020 Good
Karanjade symptoms

Agri niwas, house No any sign &

49 Raigad Amit D Thakur 28 M 8080712030 Raigad Sweedon 12/03/2020 18/03/2020 18/03/2020 Good
no 510, Kolakhe symptoms

Manish Devdas 201, Mansi park 2, No any sign &

50 Raigad 22 M 8779488090 Raigad Dubai 15/03/2020 15/03/2020 15/03/2020 Good
Waghmare Devad symptoms

House no 240, uran

Akash Ganpat No any sign &
51 Raigad 32 M road, Hanuman 9930815056 Raigad Dubai 15/03/2020 15/03/2020 15/03/2020 Good
Talekar symptoms
mandir, Pargaon

Vishwajeet Kishor No any sign &

52 Raigad 24 M Dapoli 9322310101 Raigad Dubai 12/03/2020 14/03/2020 14/03/2020 Good
Mhatre symptoms

Prakash Dhau No any sign &

53 Raigad 43 M Padghe 9920661157 Raigad Dubai 12/03/2020 14/03/2020 14/03/2020 Good
Khadekar symptoms

Mahesh Baliram No any sign &

54 Raigad 46 M Owale 9322625218 Raigad Dubai 12/03/2020 14/03/2020 14/03/2020 Good
Mhatre symptoms

Simran No Home
55 Raigad 19 F Ulve 9830348322 Raigad UK 18/03/2020 18/03/2020 18/03/2020
Bandgogdhyay symptoms Quorantine

No Home
56 Raigad Munjir Khanser 30 M Ulve 9326552754 Raigad London 19/03/2020 19/03/2020 19/03/2020
symptoms Quorantine

No Home
57 Raigad Sidhesh Dhokale 33 M Ulve 9664366653 Raigad Singapur 15/03/2020 19/03/2020 19/03/2020
symptoms Quorantine

No Home
58 Raigad Vijay Dhiman 49 M Ulve 7303157351 Raigad Oman 21/03/2020 21/03/2020 21/03/2020
symptoms Quorantine
 Benin (west No Home
59 Raigad Jayesh Sail 46 M Ulve 9833226579 Raigad 18/03/2020 22/03/2020 22/03/2020
africa) symptoms Quorantine

No Daibetic stay
60 Raigad Salim Shaikh 43 M Ulve 9967716597 Raigad Dubai 20/03/2020 22/03/2020 22/03/2020
symptoms with family

No refared to
61 Raigad Asif Shaikh 32 M Ulve 9769313339 Raigad Saudi 12/03/2020 22/03/2020 22/03/2020
symptoms SDH PANVEL

No Home
62 Raigad Prakash Avradhi 39 M Ulve 9004702878 Raigad Sharja Dubai 21/03/2020 22/03/2020 22/03/2020
symptoms Quorantine

14 Days
No
63 Raigad Pranay S Kharkar 24 M Ulve 8424954777 Raigad Dubai 17/02/2020 23/03/2020 23/03/2020 Quarantine
symptoms
already done

14 Days
No
64 Raigad Balvindar Sing 40 M Ulve 7738298081 Raigad Kazakistan 16/02/2020 24/03/2020 24/03/2020 Quarantine
symptoms
already done

14 Days
No
65 Raigad Jyoti Patil 33 F Ulve 8080400200 Raigad UK 05/03/2020 24/03/2020 24/03/2020 Quarantine
symptoms
already done

14 Days
No
66 Raigad Tiana Patil 11 M F Ulve 8080400200 Raigad UK 07/03/2020 23/03/2020 23/03/2020 Quarantine
symptoms
already done

No Home
67 Raigad Abhishekh Nair 28 M Ulve 9167330720 Raigad Shrilanka 17/03/2020 24/03/2020 24/03/2020
symptoms Quorantine

No Home
68 Raigad Omega Nair 27 F Ulve 9082841325 Raigad Shrilanka 17/03/2020 23/03/2020 23/03/2020
symptoms Quorantine

Sadhana Shailesh No Home

69 Raigad 35 F Gavhan 9702730265 Raigad Dubai 17/03/2020 24/03/2020 24/03/2020
Thakur symptoms Quorantine

Rupesh Shantaram No Home

70 Raigad 32 M Deravali 9969801596 Raigad Afganistan 15/02/2020 24/03/2020 24/03/2020
More symptoms Quorantine
 No Home
71 Raigad Sarla Slim Mandal 33 F Kon 9324813195 Raigad Dubai 15/03/2020 24/03/2020 24/03/2020
symptoms Quorantine

No Home
72 Raigad Krishna Nand Sing 38 M Sukapur 9559118501 Raigad UP 23/03/2020 24/03/2020 24/03/2020
symptoms Quorantine

No Home
73 Raigad Vivha Devi 40 F Sukapur 9559118501 Raigad UP 23/03/2020 24/03/2020 24/03/2020
symptoms Quorantine

Shrirang Shrinivas No Home

74 Raigad 37 M Sukapur 9920014582 Raigad America 08/03/2020 23/03/2020 24/03/2020
Kulkarni symptoms Quorantine

No Home
75 Raigad Vaishakh Rai 24 M Nere 9967718940 Raigad Muscut 17/03/2020 23/03/2020 23/03/2020
symptoms Quorantine

No
76 Raigad Sumit Gajanan Patil 30 M Pargaon 8097249797 Raigad Dubai 14/03/2020 14/03/2020 19/03/2020 Kharghar
symptoms

No
77 Raigad Vishal Jitekar 27 M Dapoli Raigad Dubai 14/03/2020 14/03/2020 19/03/2020 Kharghar
symptoms

No
78 Raigad Jinet N Mhatre 30 M Dapoli 9004212821 Raigad Dubai 14/03/2020 14/03/2020 19/03/2020 Kharghar
symptoms

No Home
79 Raigad Satish Chandra Das 54 M Nere 9930593879 Raigad Patna 18/03/2020 18/03/2020 19/03/2020
symptoms Quorantine

No Home
80 Raigad Kishor Kolje 35 M Sukapur 8390288729 Raigad Dubai 15/03/2020 16/03/2020 16/03/2020
symptoms Quorantine

No Home
81 Raigad Sara Pulima 54 F Morbe Raigad Youganda 12/03/2020 20/03/2020 20/03/2020
symptoms Quorantine

No Home
82 Raigad Vahan Mun 45 F Morbe Raigad Youganda 12/03/2020 20/03/2020 20/03/2020
symptoms Quorantine
 No Home
83 Raigad Sunil Bansode 30 M Harigram 8446959528 Raigad Nagpur 20/03/2020 21/03/2020 21/03/2020
symptoms Quorantine

No Home
84 Raigad Indurani Das 40 F Nere 9821453954 Raigad Patna 18/03/2020 21/03/2020 21/03/2020
symptoms Quorantine

No Home
85 Raigad Nitin Patil 35 M Kasalkhand 9833777743 Raigad Dubai 17/03/2020 18/03/2020 18/03/2020
symptoms Quorantine

No Home
86 Raigad Nilesh Gharat 28 M Kasalkhand 9223325961 Raigad Dubai 17/03/2020 18/03/2020 18/03/2020
symptoms Quorantine

No Home
87 Raigad Kalpesh Patil 27 M Kasalkhand 9769084097 Raigad Dubai 17/03/2020 18/03/2020 18/03/2020
symptoms Quorantine

No Home
88 Raigad Sahita Ganesh Beek 27 F Chikhale 7262928029 Raigad Nepal 16/03/2020 16/03/2020 16/03/2020
symptoms Quorantine

No Home
89 Raigad Atish Ganesh Beek 8 M Chikhale 7262928030 Raigad Nepal 16/03/2020 16/03/2020 16/03/2020
symptoms Quorantine

No Home
90 Raigad Paras Dammar Baral 16 M Chikhale 7262928031 Raigad Nepal 16/03/2020 16/03/2020 16/03/2020
symptoms Quorantine

Ashvini Ashok No Home

91 Raigad 50 F Turmale 9820545701 Raigad Dubai 16/03/2020 16/03/2020 16/03/2020
Vajekar symptoms Quorantine

Kiran Dattatre No Home

92 Raigad 25 M Savale 8459002482 Raigad Dubai 14/03/2020 14/03/2020 14/03/2020
Pawar symptoms Quorantine

Mahamad Ayub No Home

93 Raigad 38 M Waveghar 8669798414 Raigad Dubai 21/03/2020 21/03/2020 21/03/2020
Adesanu Had symptoms Quorantine

No Home
94 Raigad Afjal Shaikh 25 M Hedutane 7506553804 Raigad Saudi 13/03/2020 13/03/2020 13/03/2020
symptoms Quorantine
 Nitin Prabhakar No Home
95 Raigad 44 M Sukapur 9699097471 Raigad Abudhabi 11/03/2020 24/03/2020 24/03/2020
Sonar symptoms Quorantine

No Home
96 Raigad Sonu Soman 27 M Sukapur 9715627075 Raigad Dubai 18/03/2020 24/03/2020 24/03/2020
symptoms Quorantine

Nijamuddin Md No Home
97 Raigad 38 M Hedutane 9619992783 Raigad New York 22/03/2020 22/03/2020 22/03/2020
Sharif symptoms Quorantine

Sreya residency,
room no 104, 1st No any sign &
98 Raigad Vikas Balu Thorat 42 M 8652300719 Raigad Mouritious 10/03/2020 24/03/2020 24/03/2020 Good
floor, shri ram symptoms
mandir, Deravali

Salima salam No any sign &

99 Raigad 33 F Kon 9324813195 Raigad Dubai 15/03/2020 24/03/2020 24/03/2020 Good
Maudal symptoms

Shankar palace
Panvel
room no 601, Sec No any sign &
100 Raigad Goutam B Gaikwad 34 M 9967491931 Raigad airport cab 26/03/2020 24/03/2020 24/03/2020 Good
20, plot no 108, symptoms
driver
Ulve

room no 103, F
wing, Haridwar No any sign &
101 Raigad Vishal Vijay Patil 26 M 8149470219 Raigad Saudi 14/03/2020 26/03/2020 26/03/2020 Good
Building no3, Sakshi symptoms
nagar, Devad

Baban Sitaram No Home

102 Raigad 62 M Vichumbe 9702104006 Raigad Dubai 12/03/2020 21/03/2020 22/03/2020
Mohite symptoms Quorantine

No Home
103 Raigad Tone Kanjana 60 F Morbe Raigad Youganda 12/03/2020 20/03/2020 20/03/2020
symptoms Quorantine

B/203, Nabheshwar No No any sign &

104 Raigad Sudhkaran Pille 64 M 9822684360 Raigad Sharja Dubai 18/03/2020 21/03/2020 21/03/2020
Angan, Sukapur symptoms symptoms
 No
105 Raigad Vijay Chanra Das 64 M Nere 9821453954 Raigad Patana 18/03/2020 21/03/2020 21/03/2020
symptoms

Shabbir Husain No Home

106 Raigad 69 M Owegaon Raigad Abudhabi 22/03/2020 22/03/2020 22/03/2020
Sabju symptoms Quorantine

Faridabai Shabbir No Home

107 Raigad 65 F Owe Raigad Abudhabi 22/03/2020 22/03/2020 22/03/2020
Sabju symptoms Quorantine

Anthony Harison No Home

108 Raigad 68 M Sukapur 9892158482 Raigad Goa 19/03/2020 18/03/2020 21/03/2020
Walter symptoms Quorantine