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Member Registration
* Full name
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* Tel
e.g home or office telephone number
* Mobile No
Your contact number
* Address
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* Town
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* State
* Postcode
NRIC No.
Identity Card No. e.g. 800123105189
Please tell us about yourself
e.g. are you pregnant ?
If pregnant, when is your pregnancy due date?
tarikh bersalin...please fill in if you are pregnant thank you.
If pregnant, where will you deliver your baby?
Please fill in full name of hospital (including town)
I delivered my baby in a
If mother, how old are your kids ?
e.g. 1 month, 2 years old, 6 years and 7 years
No. of children ?
how many kids do you have
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* Password Confirm
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