Register | Pharmacy | Swasthye

Pharmacy Details

Pharmacy Name

Registration No.

PAN/VAT No.

Owner Photo

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Basic Details

First Name

Middle Name

Last Name

Sex

Male
Female
Others

DOB (In A.D.)

DOB (In B.S.)

Email Address

Phone No.

Password

Confirm Password

Address Details

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Choose City

Choose Municipality

Ward No.

Street