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Price of the Card: Rs.199 only

* Emai Id
* Name
* Cell No
(Eg: 9849123456)
Home Phone No

      Delivery Address

*Address
*City
*State/Province
*Zip/Postal Code
*Payment Type

      *I here by state that the use of this card would be in compliance with the term & condition said by         Jakas Informatics.