Application for * ---Mega StorePatanjali ChikitsalayaPatanjali Aarogya kendraGramin Aarogya kendra

Name Of the Applicant *

Father/Husband’s Name *

E-Mail*

Mobile No*

Does Applicant have any other business, if yes then please provide detail*

Proposed area*

Expected Investment*

If Associated with any Political/Social/Religious Institution then give Detail

Number of Patanjali Centers in the Name of Applicant or his family/Relatives

I Agree with Term and Conditions

Note: नशीले पदार्थो का व्यापार करने वाले व्यक्ति आवेदन-पत्र न भरें कयोंकि हमारी संस्था एक सामाजिक और आध्यात्मिक संस्था है|