Astro Bhrigu Vision
REGISTRATION FORM – NADI READING
Instructions for completing and sending the Form :
1. Read the complete Form Carefully.
2. Complete the Questionnaire using CAPITAL LETTERS.
3. Affix your Thumb Impre ssion. (Neatly and clearly).
4. Send the completed Form to the followi ng address by Registered A/D or by some
reliable couriers / By Hand.
5. If you have not paid online , please send the Demand Draft Drawn in favor of
“Astro Bhrigu Vision”, Payable at Delhi for the amount suggested on
the site .
Astro Bhrigu Vision
ER- 13, Inderpuri
New Delhi – 100 012.
PERSONAL DETAILS
Name: _____________________________________________________
Address:___________________________________________________
__________________________________________________________
__________________________________________________________
City : ________________________State: _________________________
Pin Code :_____________________
Phone : (Day) (______) __________________Phone: (Eve) (______) ________________
Fax Number: (______) ________________e- mail: _______________________________
Date of Birth (use format DD/MM/YYYY) : _______________________________________
(for example, 31/12/1970)
Also, please write date of birth in words : ____________________________________
(for example, December 31, 1970):
Time of birth (_______________________) AM/ (______________________) PM
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Place of birth : ______________________________________________________
please include city or town, state, country: ____________________________________
Note : Please be informed that prior to Na di Reading the “The NADI LEAF” is to
be identified. There are rare chances of “Leaf” may not found at a particular
point of time. If no “LEAF” is found, we w ill be refunding the paid amount after
deducting Rs.100/- as administrative Charges.
Please check the appropriate areas below :
Yes, I am requesting Shiva Nadi - Chapter 1
(Conversation between Lord Shiva & Goddess Parvathi) Rs. 3500/-
Delivery Options:
The Above prices are for in-person readings only.
Other delivery options are as follows. The prices are per chapter:
Audio Tape translation in Tamil - Rs. 500/-
Audio Tape in language other than Tamil- Rs.2000/-
(you will be contacted to confirm the language)
Written translation into English- Rs.2000/-
Release Form
I fully understand that a Nadi As trology record does not exist for every person. I take full
responsibility for monies paid.
I further understand that Nadi astrology is a divine science. The letters appear and
disappear on the leaves, so the words cannot be re-traced to the leaf at a later date.
Date : ____________________ Signature: ________________________________
www.astrobhriguvision.com P age 2 of 2
Instructions for Completing the questionnaire
Please give single word answers to the questions. Do not volunteer information.
1. For question requiring “YES” or “NO” as an answer.
2. If the question is relevant to you or applicable in your life, answer “YES”.
3. If a question is not relevant to you or not applicable in your life, answer “NO”.
4. If you are undecided about the answer to a particular question, then please write
“NOT SURE” as the answer.
5. For the questions that refer to your relationships, just answer as “GOOD” or
“BAD” or “NEUTRAL”.
6. For questions that pertain to health conditions, please write as “GOOD HEALTH”
or “UNHEALTHY”. Don’t specify diseases.
7. For questions where you may not be able to give single word answers, please be
very brief in your answers and do not elaborate on the answers.
Nadi Astrology Questionnaire
1. Name (in full): _______________________________________________________
Sex (Male / Female) : ________________________________
Date of Birth : (DD / MM / YYYY/): ______________________________________
Date of Birth in words ( 31st December 2004) : _____________________________
Time of Birth (24 hours Time. Ie 20.30 hours for 8.30 PM) :____________________
Place of Birth (exact) : _______________________________________________
Town, City, State, Country : ____________________________________________
Are you adopted? (YES/NO) : _________________
2. Your educational qualifications:
__________________________________________________________________
_________________________________________________________________
Do you have any idea to pursue higher studies? : __________________________
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3. Mother’s name (in full) : _______________________________________________
Is she alive? : _________________
Please describe health problems, occupation / business : _____________________
___________________________________________________________________
Details of properties : _________________________________________________
__________________________________________________________________
4. Details of patrimony –
Father’s Name (in full) : _______________________________________________
Is he alive? : __________________________
Please describe health problems and occupation / business : _________________
__________________________________________________________________
How many times has your father been married? : ___________________________
Through which wife were you born? : _____________________________________
5. Number of brothers and sisters (currently living): _______________________
What is your position among your siblings? : ______________________________
List the marital status of your brothers and sisters
__________________________________________________________________
__________________________________________________________________
6. If Married Name of wife/husband (in full) : ______________________________
Is he/she alive? : ___________________
His/her job or business details : _________________________________________
Does he/she have any health problems? : _________________________________
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How many times have you been married? : _____________________________
7. Children (Total Number) : _______________________
Number of male and female : ___________________________________________
Their educational status (Specify grades) : ________________________________
___________________________________________________________________
Their job/business details : _____________________________________________
Marital status details : _________________________________________________
Nature of relationship between self And children : ___________________________
8. If unmarried Are you in relationship? : __________________________________
Are you planning on marrying this person? : ______________________________
Details of surgical treatments you have already undergone :__________________
___________________________________________________________________
9. Nature of business or job : ___________________________________________
If business - with partners or without partners? : ____________________________
10. Details of debts : ___________________________________________________
Is there any litigation? : _______________________________________________
Do you have any health problems : _______________________________________
AFFIX A CLEAR THUMBPRINT USING AN INK PAD
FEMALE – LEFT HAND MALE – RIGHT HAND
www.astrobhriguvision.com P age 5 of 5
