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First Name (ስም) *
Last Name (የአባት ስም) *
Phone Number (ስልክ ቁጥር) *
E-mail (የኢሜል አድራሻ) *
Password (የሚስጥር ቁጥር) *
Confirm Password (ሚስጥር ቁጥሮትን ያረጋግጡ) *