Required field are marked with *
Name:- *
Male
Female
Other
Address:-
ID Proof:- * --Select a ID Proof -- Addhar Card PAN Card Passport Driving Lincese
Upload ID Proof:- *
Email:- *
PIN:- *
Payment Available (JUST AN EXAMPLE OF CHECKBOX ELEMENT OF FORM)
Credit Card
Debit Card
Card Type:- * --Select a Card-- VISA RuPay MasterCard
Card Number:- *
Expiry Date:- *
CVV:- *