Sections marked with an * are mandatory
                           
REFERRED BY * (Ex: If not Referred make it Self or Internet..)
FIRST NAME *  (max 30 characters a-z and A-Z)
LAST NAME * (max 30 characters a-z and A-Z)
DATE OF BIRTH *

EMAIL ID * (Dont have emailid please click here to create your own  Gmail )
ADDRESS  *
STATE *                            
CITY *
DISTRICT *
VILLAGE
PIN CODE  (6 digit number)
COUNTRY *
LANDLINE NUMBER                
MOBILE NUMBER * (10 digit number)   
ALTERNATE NUMBER (10 digit number)
MARITAL STATUS *
GENDER *
ID CARD TYPE   
PROFILE PHOTO  

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