Modak Matrimony

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Registration Form

Patri or Patra:

Name:

Photo Upload:

Phone Number:

Password:

Age (Only Numbers):

D.O.B:

Birth Time:

Birth Day:

Birth Place:

Height (Ex: 5ft 3in):

Weight:

Gotra:

Gon:

Complexion:

Blood Group:

Education:

Occupation:

Father's Name:

Father's Occupation:

Mother's Name:

Mother's Occupation:

Total Family Members:

Number of Brothers:

Number of Sisters:

Village/Town:

Post Office:

District:

PIN Code:

State:

Requirements: