DHEERGAYU INSTITUTE OF YOGA
REGISTRATION FORM
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NAME *
EMAIL ID *
CONTACT *
DOB *
MM
/
DD
/
YYYY
GENDER *
ADDRESS *
ANY PREVIOUS HEALTH ISSUES ? *
PRESENT WEIGHT *
BATCH *
MODE OF ATTENDING THE CLASS *
                        SCAN TO PAY THE ADMISSION FEES AND MONTHLY FEES
ENTER THE AMOUNT PAID *
ENTER THE TRANSACTION ID HERE ( IF FEES NOT PAID ENTER "NA") *
WALLET USED *
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