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Order Form

Click here for Match Making Order Form

Fields marked with * are essential

*FULL NAME:
*SEX: MALE FEMALE
*DATE OF BIRTH:
*TIME OF BIRTH: (24-hr Format)
*PLACE OF BIRTH:
STATE:
*COUNTRY:
*ORDER FOR :-
Type of Horoscope :-

With Life Reading :- YesNo

No. of years for Predictions :-

US $ for all the other countries.

Rs. for Indian Residents only.

LANGUAGE:
*DELIVERY BY: E-MAIL (English only)POST
*E-MAIL:
REFERRED BY:
OTHERS (Specify):
Complete Mailing Address
NAME:
ADDRESS:
*COUNTRY:
PINCODE (ZIP):
Form will not get submitted unless all *essential fields are filled.

E-mail :- comphoroscope@hotmail.com


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