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Name:
Name is required.
E-mail:
Email is required.
Please enter a valid email address
Password:
Password length must be greater than or equal to 8
Password is required
Mobile No:
Mobile No is required.
Address
Address is required.
State:
State is required.
City:
City is required.
Pincode:
Pincode is required.
Pincode must be a 6-digit number.
Customer Type:
Medical Industrial
Customer Type is required.