Name ........................................................................................ Sex (Male / Female) .................................
*Father's Name ........................................................ *Mother's Name .........................................................
Date of Birth (dd/mm/yyyy) .................................................. Time of Birth ....................................... AM / PM
Place of Birth ............................... Birth Nearest Town ................................. Country ...................................
Preferred Language (English, Hindi, Gujrati, Marathi, Telugu, Kannada) ................................................................
Purchase Module .................................. Purchase Date ............................. Amount ....................................
* Optional
2. For Possible Date of Marriage:-
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Information is necessary :
Name ........................................................................................ Sex (Male / Female) .................................
Date of Birth (dd/mm/yyyy) .................................................. Time of Birth ....................................... AM / PM
Place of Birth ............................... Birth Nearest Town ................................. Country ...................................
Any two below information is necessary:
(1) Date of Birth of your mother ...............................................................................................................
(2) Date of Birth of your younger brother ...................................................................................................
(3) Date of Birth of your younger sister ......................................................................................................
(4) Any important date ...........................................................................................................................
(Like, Govt. Service Joining, Big Accident, Lottery etc.)
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3. For Have a Question:-
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No. of Question (One / Two / Three) .................................................
Your Question ........................................................................................................................................
..............................................................................................................................................................
Name ........................................................................................ Sex (Male / Female) .................................
Date of Birth (dd/mm/yyyy) .................................................. Time of Birth ....................................... AM / PM
Place of Birth ............................... Birth Nearest Town ................................. Country ...................................
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Send below payment details with above information:-
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Payment Type:
l Paypal (Credit Card):
Paypal ID ....................................................................................... Payment Date .....................................
l Bank Deposit:
Bank Name ..................................................... Branch .................................... Deposit Date .......................
l Demand Draft:
Bank Name ..................................................... Branch .................................... Deposit Date .......................
D.D. No. ......................................................
l Money Order:
Money Order Receipt No. ......................................... Date ................................
All above details with payment details send to [email protected]
Note: Reply Email delivery in 2 days or even earlier.
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