User Information
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  • * Confirm Password should match with Password
  • * Confirm Email should match with Email
  • * Second Name should contain characters only
  • * The Mobile number should contain 10 to 14 digits. Only numbers are allowed. The format for mobile number can be "9715xxxxxxxx" or "05xxxxxxxx" or "009715xxxxxxxx" or "09715xxxxxxxx"
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  • captcha *