Personal Details
                                Agency Name
                                
                            
                            
                                Mobile Number
                                
                            
                            
                                Aadhaar Number
                                
                            
                            
                                Name(as on Aadhar Card)
                                
                            
                            
                                Address(line1)
                                
                            
                            
                                Address(line2)
                                
                            
                            
                                Email Id
                                
                            
                            
                                State
                                
                            
                            
                                City
                                
                            
                            
                                Postal code
                                
                            
                        
        