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Pay online: Medical & Welfare Complex

Online Donations Page «

Amount
Rs.  *
* Medical & Welfare Complex = approx. Rs. 1,036.06 (per Unit). But you are welcome to pay any amount.

Extra Information
(Optional)



Customer Information (All fields are required)

Title
First Name« Please enter your
name as it appears
on your Debit/Credit Card.
Middle Initial
Last Name
Phone
Email
Street Address« Please enter your
Debit/Credit Card billing address
City
State
Zip
Country