Franchisee Form

Institute Information

Name of Organisation/Institute/Trust*

State

District

City

Permanent Address

Present Address*

Contact Person

Contact No.

Whatsapp No

Institute Facility Details

ESTD Date

Location

Documents: (Any one document must)*

Trade License/ Institute Front Image/ Office-room Image/ Lab-Room Image/ Theory Room Image

Information About Centre Head

Name of the Centre Head

Parents / Guardian Name

Designation / Position

Village/ Town

Post Office Name

Postal Code

Contact No.

DOB

Nationality

Gender

Religion

Qualification

Partner Name (Mandatory if partnership firm)

Designation/ Position

Reference Name ( Though whom/which you came to know about RVSP)

Institute Head Image

Aadhar Card Front

Aadhar Card Back

Voter Card Front

Voter Card Back

PAN Card

Aadhar Card Front

Aadhar Card Back

PAN Card

AIPRC

Aarogya Institute Physiotherapy & Research Centre focuses on physiotherapy treatments and research