Member Registration
* Username
Usernames must be at least 4 characters long
* Password
Passwords must be at least 5 characters long
* Confirm Password
* Screen Name
If you leave this field blank, your screen name will be the same as your username
* Email Address
* Confirm Email Address
* Full name
Please enter your full name
* Tel
e.g home or office telephone number
* Mobile No
Your contact number
* Address
Your current address
* Town
e.g. Petaling Jaya
* State
* Postcode
Identity Card No. e.g. 800123105189
Please tell us about yourself
e.g. are you pregnant ?
If pregnant, when is your pregnancy due date?
tarikh bersalin...please fill in if you are pregnant thank you.
If pregnant, where (name of hospital) will you del
Please fill in full name of hospital (including town)
I delivered my baby in a
If mother, how old are your kids ?
e.g. 1 month, 2 years old, 6 years and 7 years
No. of children ?
how many kids do you have
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