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Basic Information
Shop Name
*
:
Email:
Phone
*
:
+88
Note!
Phone number format: 01XXXXXXXXX
Type
*
:
--- Select Type ---
Retailer
Distributor
Address
*
:
Division
*
:
--- Select Division ---
Barishal
Chattogram
Dhaka
Khulna
Mymensingh
Rajshahi
Rangpur
Sylhet
District
*
:
--- Select District ---
Thana
*
:
--- Select Thana ---
Cluster:
--Select Cluster--
Chittagong
Khulna
Dhaka
Zone:
--Select Zone--
Additional Information
Owner Name:
NID/Passport No:
Infrastructure Type:
--- Select Infrastructure ---
Permanent
Temporary
Avg.Transaction:
Tk.
Note!
Average monthly transaction value
Login Information
Username
*
:
Password
*
:
Note!
Password must be a combination of at least one lower case, one upper case, one number & one special character, at least 8 character
Confirm Password:
*
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