Sign Up Your User Account
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Basic
Personal
Address
Pecuniary
Finish
Basic Information:
Step 1 - 5
Sponsor/Referral Username *
Sponsor/Referral Name *
Group *
Select Group
Full Name *
Email
Mobile Number *
Signup Type
Select Signup Type
Patient
Customer
Direct Seller
Practitioner
Course Applicant
PRO
Personal Information:
Step 2 - 5
Age (Yrs)
Sex
Male
Female
Height (feet)
Weight (kg)
Diseases (if any)
Can we call you to discuss illness related matters?
Yes
No
Address Information:
Step 3 - 5
To
C/O (if any)
House No.
Street Name/No.
Land Mark (if any)
Village/Town
P.S.
District
State
Pincode
Mobile No
Mobile No (2nd)
Pecuniary Information:
Step 4 - 5
Have Laptop/PC
Yes
No
Have Two Wheeler
Yes
No
Have Four Wheeler
Yes
No
Have own House
Yes
No
Have any Office
Yes
No
Have GST Number
Yes
No
Do fill ITR
Yes
No
Finish:
Step 5 - 5
SUCCESS !
Congratulations, You Have Successfully Signed Up
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