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Full Name
Suhasini Kiran Dengale

Gender
Female Select Gender Male Female Other

Mobile Number
9763336823

Email Address

Date Of Birth
1975-01-28

Marital Status
Married Select Marital Status Married Single Divorced Widowed Separated

State
Maharashtra Select State

District
Satara

Taluka
Khatav

PIN Code
415505

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
7808 0193 4549

Business Name
Potter Work

Partner
Collective Good Foundation 2 Revolve

Personal Address
Ap Khatav Tal Khatav Dist Satara Ap Khatav Tal Khatav Dist Satara

Business Address
Ap Khatav Tal Khatav Dist Satara Ap Khatav Tal Khatav Dist Satara

Select Home Type
Own Select Home Type Own Rented Others

Select Land Ownership
Own Select Land Ownership Own Leased Others

Total Number of family
4 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
12000

Women Monthly Income
5000

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
000410139001069

Bank Name
Manndeshi Mahila Bank

IFSC Code
YESB0MAN001