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Full Name

Please provide your full name.

Gender

Please select your gender.

Date of Birth

Please provide your date of birth.

Email Address

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Password

Password must be at least 6 characters and include uppercase, lowercase, number, and special characters.

Confirm Password

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ID Number

Please provide your ID or Passport number.

Phone Number

Phone number must start with 01 or 07 and be 10 digits long.

Role

Role is required.

Next of Kin Details (Optional)

Next of Kin Name

Next of Kin Phone

Invalid Next of Kin phone number format.

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