First name:*

Middle name:*

Last name:*

Gender:* --Select Gender-- Male Female

Email:*

Phone number:*

Region:* --Select Region-- Arusha Region Dar es Salaam Region Dodoma Region Geita Region Iringa Region Kagera Region Katavi Region Kigoma Region Kilimanjaro Region Lindi Region Manyara Region Mara Region Mbeya Region Morogoro Region Mtwara Region Mwanza Region Njombe Region Pwani Region Rukwa region Ruvuma Region Shinyanga Region Simiyu Region Singida Region Songwe Region Tabora region Tanga Region Zanzibar

District:* --Select District--

A PHP Error was encountered

Severity: Notice

Message: Undefined variable: districts

Filename: account/account.php

Line Number: 98

Backtrace:

File: C:\rsmis\htdocs\rsmis.moha.go.tz\application\views\account\account.php
Line: 98
Function: _error_handler

File: C:\rsmis\htdocs\rsmis.moha.go.tz\application\controllers\Account.php
Line: 263
Function: view

File: C:\rsmis\htdocs\rsmis.moha.go.tz\index.php
Line: 342
Function: require_once

A PHP Error was encountered

Severity: Warning

Message: Invalid argument supplied for foreach()

Filename: account/account.php

Line Number: 98

Backtrace:

File: C:\rsmis\htdocs\rsmis.moha.go.tz\application\views\account\account.php
Line: 98
Function: _error_handler

File: C:\rsmis\htdocs\rsmis.moha.go.tz\application\controllers\Account.php
Line: 263
Function: view

File: C:\rsmis\htdocs\rsmis.moha.go.tz\index.php
Line: 342
Function: require_once

Identity Type:* --Select Identity Type-- Nida Passport Permit

Identity Number:*

Generate/Enter Control Number:

Generate

   Verify NIN

Password:[example: Aaaaa@2023]*

Confirm Password:*

Photo:[Format JPEG,JPG,PNG Size 2MB]