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NPCIL Pariwar Connexion Web Portal

USER REGISTRATION

* Indicates mandatory fields
User Name * : (5-20 Chars)
Employee No * :
First Name * :
Last Name :
Mobile No. * : (Enter 10 digit Mobile Number)
Alternate Mobile No. : (Enter 10 digit Mobile Number)
Gender * :
Email * :
Address * :
City :
State * :
Retired From Site * :
CHSS No. * :
Dispensary Location * :
Enter characters shown in image*

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