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Not to be sold to minors. For sale ONLY in Delhi, West Bengal, Assam, Andhra Pradesh & Telangana.

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80 YEARS OF HERITAGE

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I am at least 18 yrs old.

I Accept all Terms & Conditions to become a Modicare Consultant.

First Name:

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DOB:

Co-Applicant:

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You will be deemed as a Preferred customer till your KYC is Approved and Terms and Conditions of joining is accepted by you. Please click on NEXT to complete your registration.

Timeline for OTP Linked Aadhaar verification – 1 working day

Timeline for other documents or Non-OTP linked Aadhaar verification - 5 working days

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I/We hereby confirm that the above information and details entered by me/us are accurate and correct and all the documents uploaded by me/us are in my/our name and Modicare Limited (“Modicare”) would not be liable under any circumstances if any particulars or information provided by me/us is found incorrect.

I/we hereby understand and acknowledge that in the event that any information furnished by me/us is found to be false/ incorrect/inappropriate then the Company shall have the right to terminate any contract arising out of this application immediately without notice.

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