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Basic & Personal Info
FULL NAME (As in Passport/UID): *
Email Address : *
Mobile Number : *
Password : *
Profile Created By: *
--Please Select--
Parents
Self
Brother
Sister
Guardian
Relatives
Friends
How do you Know us? *
--Please Select--
TV Add
News Paper
Google Search
Hoardings
Pamphlet
Friend
Relatives
Email
Others
Gender: *
--Please Select--
Male
Female
MARITAL STATUS: *
--Please Select--
DATE OF BIRTH: *
Year of Married *
Year
Month of Married *
Month
Year of Divorce: *
Year
Month Of Divorced: *
Month
Year of Qula: *
Year
Month of Qula: *
Month
Year of widow: *
Year
Month of widow: *
Month
DO YOU HAVE CHILDREN? *
--Please Select--
Yes
No
TOTAL NO. OF CHILDREN: *
--Please Select--
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
TOTAL NO. OF MALE CHILDREN: *
--Please Select--
0
TOTAL NO. OF FEMALE CHILDREN: *
CHILDREN LIVING WITH: *
--Please Select--
With me
Not with me
REASON FOR ANOTHER MARRIAGE:
*
REASON FOR DIVORCED: *
REASON FOR QULA:
*
HEIGHT (in feets): *
--Please Select--
3
3.1
3.2
3.3
3.4
3.5
3.6
3.7
3.8
3.9
4
4.1
4.2
4.3
4.4
4.5
4.6
4.7
4.8
4.9
5
5.1
5.2
5.3
5.4
5.5
5.6
5.7
5.8
5.9
6
6.1
6.2
6.3
6.4
6.5
6.6
6.7
6.8
6.9
7
7.1
7.2
7.3
7.4
7.5
7.6
7.7
7.8
7.9
8
8.1
8.2
8.3
8.4
8.5
8.6
8.7
8.8
8.9
9
9.1
9.2
9.3
9.4
9.5
9.6
9.7
9.8
9.9
10
BODY WEIGHT (in Kgs): *
--Please Select--
less than 50
50 to 55
56 to 60
61 to 65
66 to 70
71 to 75
76 to 80
80 to 85
86 to 90
91 to 95
96 to 100
105 to 110
111 to 115
116 to 120
121 to 125
126 to 130
131 to 135
135 to 140
141 to 145
146 to 150
More than 150
COMPLEXION: *
--Please Select--
Fair
Very Fair
Whitish
Dark
BODY TYPE: *
--Please Select--
Slim
Average
Athletics
Fat
Physically Challenged
PLEASE SPECIFY *
--Please Select--
By Birth
Acquired
TYPE OF PHYSICALLY CHALLENGED: *
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