PROBLEM SOLVING  FORM

   Name     
   Address     
   Email     
   Gender       Male         Female 
   Marital Status     Married   Unmarried 
   
Divorced  Widowed
   Date of Birth                                            
   Time of Birth                                          
   Country of Birth     
   City of Birth     
   State of Birth     
   Country presently living in      
   City presently living in      
   Profession     
   Mother's Name    
   Father's Name    
   Sisters    
   Brothers    
   Spouse's Name    
   Spouse's Date of Birth                                           
   Spouse's Time of Birth                                         
   Spouse's Country of Birth    
   Spouse's City of Birth    
   Spouse's State of Birth    
   Some Important Event    
   Date of this Event    
   Specific Problem/Problems 
   for which Solution is reqd.
   
   Birth Signs on the Body
  
(if any)
   
 
                                                        

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