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Full Name
Pushpa Uttam Nikam

Gender
Female Select Gender Male Female Other

Mobile Number
9107815772

Email Address

Date Of Birth
1987-06-22

Marital Status
Married Select Marital Status Married Single Divorced Widowed Separated

State
Maharashtra Select State

District
Mumbai

Taluka
Mumbai

PIN Code
400022

Religion
Hindu Select Religion Hindu Muslim Christian Jain Buddhist Parsi Others

Caste Category
General Select Caste Category General Other backward class (OBC) Scheduled Caste (SC) Scheduled Tribe (ST) Nomadic Tribes (NT) Others

Caste Type
Maratha

Identify Proof
Aadhar Card Select Identify Proof Aadhar Card PAN Card Voters Card Other

Identity Number
7964 0836 2355

Business Name
Maxi Center

Partner
Collective Good Foundation 1 Revolve

Personal Address
Room-44, Jay Bhavani Rahiwashi, Pratiksha Nagar, Sion Room-44, Jay Bhavani Rahiwashi, Pratiksha Nagar, Sion

Business Address
Room-44, Jay Bhavani Rahiwashi, Pratiksha Nagar, Sion Room-44, Jay Bhavani Rahiwashi, Pratiksha Nagar, Sion

Select Home Type
Own Select Home Type Own Rented Others

Select Land Ownership
No Select Land Ownership Own Leased Others

Total Number of family
6 Select Number Of Family

Number of Working People
2 Select Number Of Working People 1 2 3 4 5 6 7 8 9 10+

Monthly household income
25000

Women Monthly Income
8000

Seasonable Income
Yes Select Seasonable Income Yes No

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Type Of Account
Saving Select Type Of Account Current Saving

Bank Account Number
004110110012798

Bank Name
Bank Of India

IFSC Code
BKID0000041