Welcome to
"Ayush Ayur Life Council of India (AALCI) Family"

Application Form for Wellwisher Membership with AALCI

Once your membership is approved, you will receive an Authorized ID Number from the Ayush Ayur Life Council of India.

This will entitle you to access our "AYUSH Care Plus Clinics," "Homely Clinics," and Our Other Authorized Partners.

Please fill in all fields of the application form. Our representative will contact you shortly.

AALCI Wellwisher
Application Form

Please take a moment to fill out the form.

First Name

Last Name

Email

Phone

House Name / H.No

Land Mark / Street Addres

City / Town

Region/State/Province

Postal / Zip code

Panchayat / Municipality / Corporation

Age & Date of Birth

WhatsApp Number

Passport / Aadhaar/ Driving / Voter ID Number

Introducer Name / ID Number

Upload Your Passport Size Photo

Upload Your Photo

Upload supported file (Max 15MB)

Upload Your ID Copy

Upload Your Aadhaar / Passport / Driving Licence / Voter Card.

Upload supported file (Max 15MB)

Enter Your Bank Account Details.: (Your Name, Bank Name, Acc.No, Branch, IFSC, Gpay, Paytm / UPI)

Thanks for Submitting!

Our Representative will Contact You Shortly.

+91 813 9090 813

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