Forecast Fetus Sex Application Form

Information

Husband:

Birth place *

Birthday:

*
( If was born abroad, please fill in foreign time )

Wife:

Birth place *

Birthday:

*
( If was born abroad, please fill in foreign time )

Birth place:

Pregnancy:

The Fetus Request *

Remark:

Contact Information

Contact person:

Address:

Mobile:

Remittance:

Bank:

Currency *

Remittance date

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Please carefully check the contents:

Husband:　　
Birth place:
Wife:　　
Birth place:
Birth place:
Pregnancy:　　The Fetus　　Request:　

Remark:

Contact person: Mobile:
Address:
Remittance: Currency: Bank:
Discount amount: RMB

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Confirm password: *

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