Friday, 23 March 2012

Register (Only for Modukuru village people, not for jobs, business...etc)




Name:




S/O, D/O, W/O:




Gender:




Date of Birth:




Blood Group:




Profession:




Educational Qualification:




Email Address:




Contact Number:




Grand Father:




Grand Mother:




Address in Modukuru:




Present Address:




School:




Spouse Name:




Spouse Profession:




Educational Qualifaction:




Blood Group:




Spouse Native Place:




Children's Details
(Please enter name, age, contact, email.... details):




Feedback & Suggestions:






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