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Q1.
Firstame
Q2.
Lastname
Q3.
Email Address
Q4.
Age range
Below 12 years
12 - 18 years
19 - 35 years
35 - 50 years
50 - 60 years
Above 60 years
Q5.
Nationality
Q6.
Phone Number
Q7.
Employment Status
Student
Self Employed
Employed
Unemployed
Retired
Q8.
Organization or School name
Q9.
Marital Status
Select
Single
Married
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