notes Name * Sex * Male Female Marital Status SingleMarriedSeparatedDivorcedWidowed Profession * Date of Birth * Day12345678910111213141516171819202122232425262728293031MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberYear202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913191219111910190919081907190619051904190319021901 Time of Birth(24 Hour format or AM, PM) * Place of Birth(City, State, Country) * Longitude and Latitude (Optional) Email Address * Present Location(City, Country) * Contact No.( Optional ) Additional Remarks or Info (Optional) Select Your Service Beneficial Yantra Report by Email Rs. 1000 ($20 USD) Gemstone Analysis by Email Rs. 1500 ($30 USD) Urgent Gemstone Analysis by Email Rs. 3000 ($60 USD) 30 Minute Phone Consultation Rs. 1500 ($30 USD) Urgent Apointment 30 Minute Consultation Rs. 3000 ($60 USD) Match Making on Phone Rs. 3000 ($60 USD) Urgent Apointment Match Making Rs. 6000 ($120 USD) 1 Hour Phone Consultation Rs. 3000 ($60 USD) Urgent Apointment 1 Hour Consultation Rs. 6000 ($120 USD) 2 Hour Phone Consultation Rs. 6000 ($120 USD) Urgent Apointment 2 Hour Consultation Rs. 11000 ($220 USD) Security Code Indian and International Credit Cards, Debit Cards, NetBanking Non-Indian Credit Cards, Debit Cards Accuont to Account Transfer, Cash Deposit, Cheque Deposit * indicates required fields