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WFH
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Registration Form
I hereby give my consent for the use of jan aadhar and aadhar information for registration purpose. I have read all the
terms and conditions.
Jan Aadhaar Number
Aadhaar Number
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Jan Aadhaar Member ID
Name (Full Name)
Father's Name
Mother's Name
Date of Birth
Mobile Number
Email ID
Special Category
Not Applicable
Widow
Divorcee
Specially abled
Victim of violence
Attach Special Category Document
Address
District
Block/City
Pin Code
SSOID (optional)
User Name
Password
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