User Application Form

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समर्पण लोक कल्याण ट्रस्ट

Samarpan Lok Kalyan Trust

Registration Form

Name * :

Gender * :

Date of Birth * :

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Blood Group *:

State * :

District *:

Mobile No. *:

Aadhar No. *:

Address *:

Pin Code *:

Email:

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सदस्यता शुल्क - 2000/-

बैंक ऑफ बड़ौदा
खाता संख्या - 1527010002636
आईएफएससी कोड - BARB0GODVAR
धारक का नाम - वीरेंद्र पाठक

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