www.starhealth.in
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urlscan Pro
104.126.37.129
Public Scan
Submitted URL: http://klr.pw/xpdx0e
Effective URL: https://www.starhealth.in/buy-now/health/proposer-form/proposerDetails/
Submission: On May 07 via manual from DE — Scanned from DE
Effective URL: https://www.starhealth.in/buy-now/health/proposer-form/proposerDetails/
Submission: On May 07 via manual from DE — Scanned from DE
Form analysis 2 forms found in the DOM
<form id="proposerDetails-form">
<div class="proposer-questions_custom-accordion__GANdc mt-20">
<div class="MuiPaper-root MuiPaper-elevation MuiPaper-rounded MuiPaper-elevation1 MuiAccordion-root MuiAccordion-rounded Mui-expanded MuiAccordion-gutters proposer-questions_accordion-section__jKj8h mb-16 css-1kyh11n">
<div class="MuiButtonBase-root MuiAccordionSummary-root Mui-expanded MuiAccordionSummary-gutters css-1iji0d4" tabindex="0" role="button" aria-expanded="true" aria-controls="address-content" id="address-header">
<div class="MuiAccordionSummary-content Mui-expanded MuiAccordionSummary-contentGutters css-17o5nyn">
<p class="MuiTypography-root MuiTypography-body1 text-blue text-strong css-rvsnqt">Primary Details</p>
</div>
<div class="MuiAccordionSummary-expandIconWrapper Mui-expanded css-1fx8m19"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-vubbuv" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="ExpandMoreIcon">
<path d="M16.59 8.59 12 13.17 7.41 8.59 6 10l6 6 6-6z"></path>
</svg></div>
</div>
<div class="MuiCollapse-root MuiCollapse-vertical MuiCollapse-entered css-c4sutr" style="min-height: 0px;">
<div class="MuiCollapse-wrapper MuiCollapse-vertical css-hboir5">
<div class="MuiCollapse-wrapperInner MuiCollapse-vertical css-8atqhb">
<div aria-labelledby="address-header" id="address-content" role="region" class="MuiAccordion-region">
<div class="MuiAccordionDetails-root mt-20 css-u7qq7e">
<div>
<div class="MuiBox-root css-0">
<div class="MuiContainer-root MuiContainer-maxWidthLg css-1qsxih2">
<div class="MuiGrid-root MuiGrid-container MuiGrid-spacing-xs-2 css-isbt42">
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-1j28t1o"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="true" for="firstName" id="firstName-label">First Name*</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall MuiInputBase-adornedStart css-13xsv1a">
<div class="MuiInputAdornment-root MuiInputAdornment-positionStart MuiInputAdornment-outlined MuiInputAdornment-sizeSmall css-1a6giau"><span class="notranslate"></span>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-sizeSmall demo css-190uj19">
<div tabindex="0" role="button" aria-expanded="false" aria-haspopup="listbox" class="MuiSelect-select MuiSelect-outlined MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-182didf">Mr</div>
<input aria-invalid="false" aria-hidden="true" tabindex="-1" class="MuiSelect-nativeInput css-1k3x8v3" value="mr"><svg
class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium MuiSelect-icon MuiSelect-iconOutlined css-1636szt" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="ArrowDropDownIcon">
<path d="M7 10l5 5 5-5z"></path>
</svg>
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-ihdtdm"><span class="notranslate"></span></legend>
</fieldset>
</div>
</div><input aria-invalid="false" id="firstName" type="text" inputmode="text" maxlength="255" class="MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall MuiInputBase-inputAdornedStart css-162edyi"
value="Kumar N R" style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>First Name*</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-13y6s0b"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-sizeSmall MuiInputLabel-outlined css-17f324k"
for="middleName" id="middleName-label">Middle Name</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall css-5qqdno"><input aria-invalid="false" id="middleName" type="text" inputmode="text"
maxlength="39" class="MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-1o6z5ng" value="" style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-yjsfm1"><span>Middle Name</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-13y6s0b"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="." for="lastName" id="lastName-label">Last Name*</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall css-5qqdno"><input aria-invalid="false" id="lastName" type="text" inputmode="text"
maxlength="39" class="MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-1o6z5ng" value="." style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>Last Name*</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiTextField-root css-higf9k"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-outlined css-hbgfb8"
data-shrink="true" for=":r7:" id=":r7:-label">Date of Birth*</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl Mui-readOnly MuiInputBase-readOnly css-5qqdno"><input aria-invalid="false" id=":r7:" readonly="" type="text"
aria-readonly="true" aria-label="Choose date, selected date is Jan 18, 1995" class="MuiInputBase-input MuiOutlinedInput-input Mui-readOnly MuiInputBase-readOnly css-1x5jdmq" value="18-01-1995">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>Date of Birth*</span></legend>
</fieldset>
</div>
</div>
<div class="pt-8"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-13y6s0b"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary Mui-disabled MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="7338879040" for="mobile" id="mobile-label">Mobile*</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary Mui-disabled MuiInputBase-formControl MuiInputBase-sizeSmall css-5qqdno"><input aria-invalid="false" disabled="" id="mobile" type="text"
inputmode="text" maxlength="255" class="MuiInputBase-input MuiOutlinedInput-input Mui-disabled MuiInputBase-inputSizeSmall css-1o6z5ng" value="7338879040" style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>Mobile*</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-13y6s0b"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="kumarnr18@gmail.com" for="email" id="email-label">Email*</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall css-5qqdno"><input aria-invalid="false" id="email" type="text" inputmode="text" maxlength="254"
class="MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-1o6z5ng" value="kumarnr18@gmail.com" style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>Email*</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiFormControl-fullWidth css-1ujd0rj"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="true" id="occupation">Select occupation*</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall mb-20 w-full mb-10-xs css-10bwxjo">
<div tabindex="0" role="button" aria-expanded="false" aria-haspopup="listbox" aria-labelledby="occupation occupation" id="occupation"
class="MuiSelect-select MuiSelect-outlined MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-182didf">SERVICE</div><input aria-invalid="false" aria-hidden="true" tabindex="-1"
class="MuiSelect-nativeInput css-1k3x8v3" value="OCC15"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium MuiSelect-icon MuiSelect-iconOutlined css-1636szt" focusable="false" aria-hidden="true" viewBox="0 0 24 24"
data-testid="ArrowDropDownIcon">
<path d="M7 10l5 5 5-5z"></path>
</svg>
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>Select occupation*</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-13y6s0b"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="300000" for="annualIncome" id="annualIncome-label">Annual Income*</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall css-5qqdno"><input aria-invalid="false" id="annualIncome" type="text" inputmode="text"
maxlength="255" class="MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-1o6z5ng" value="300000" style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>Annual Income*</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiFormControl-fullWidth css-1ujd0rj"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="true" id="nationality">Nationality</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall mb-20 w-full mb-10-xs css-10bwxjo">
<div tabindex="0" role="button" aria-expanded="false" aria-haspopup="listbox" aria-labelledby="nationality nationality" id="nationality"
class="MuiSelect-select MuiSelect-outlined MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-182didf">Indian citizen</div><input aria-invalid="false" aria-hidden="true" tabindex="-1"
class="MuiSelect-nativeInput css-1k3x8v3" value="Indian citizen"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium MuiSelect-icon MuiSelect-iconOutlined css-1636szt" focusable="false" aria-hidden="true"
viewBox="0 0 24 24" data-testid="ArrowDropDownIcon">
<path d="M7 10l5 5 5-5z"></path>
</svg>
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>Nationality</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-13y6s0b" aria-label="Enter the last 4 digit Aadhaar Card Number"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-sizeSmall MuiInputLabel-outlined css-17f324k"
for="aadharcardNumber" id="aadharcardNumber-label">Aadhaar Card Number</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall css-5qqdno"><input aria-invalid="false" id="aadharcardNumber" type="text" inputmode="text"
maxlength="255" class="MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-1o6z5ng" value="" style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-yjsfm1"><span>Aadhaar Card Number</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="gender">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Select Gender*</h3><label class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="gender" type="radio" value="Male" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Male</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="gender" type="radio" value="Female"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false" aria-hidden="true"
viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Female</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="gender" type="radio" value="Third Gender"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Third Gender</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="panRequired">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Do you have a PAN Card?</h3><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="panRequired" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="panRequired" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
<p class="MuiTypography-root MuiTypography-body1 css-1l5pwci"><svg class="MuiSvgIcon-root MuiSvgIcon-colorPrimary MuiSvgIcon-fontSizeSmall css-1u2ioj0" focusable="false" aria-hidden="true" viewBox="0 0 24 24"
data-testid="InfoOutlinedIcon">
<path d="M11 7h2v2h-2zm0 4h2v6h-2zm1-9C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.41 0-8-3.59-8-8s3.59-8 8-8 8 3.59 8 8-3.59 8-8 8z"></path>
</svg></p>
<div><span class="text-12 font-400 text-secondary"> Note: Please upload form 60 in the upload section, if PAN is not available.
<a rel="noreferrer" target="_blank" href="https://www.starhealth.in/sites/customerapp/Form_60.pdf" class="font-800"> Click here to download </a> </span></div>
<p></p>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-9 css-1hjwhii">
<div class="MuiBox-root css-0">
<p class="MuiTypography-root MuiTypography-body1 mb-20 mt-10 text-strong css-rvsnqt">Form 60</p>
<div class="MuiGrid-root MuiGrid-container css-1xi2gtz">
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-lg-6 css-rpybyc">
<div class="fileupload_file-upload-box-root__dAhXv"><label for="form60proof" class="fileupload_upload-label__MZZ7r relative"><input class="fileupload_upload-input-box___eRz6" type="file" name="form60proof"
id="form60proof">
<div><svg width="65" height="60" viewBox="0 0 65 60" fill="none" xmlns="http://www.w3.org/2000/svg">
<path
d="M30.3803 5.34666L40.4227 6.40889C41.8093 6.55555 43.0521 5.537 43.1986 4.13389C43.3452 2.73078 42.3399 1.47445 40.9534 1.32778L30.911 0.265557C29.5244 0.118894 28.2816 1.13744 28.1351 2.54055C27.9885 3.94366 28.9938 5.2 30.3803 5.34666Z"
fill="#BFCAD9"></path>
<path
d="M59.9787 13.6351L9.7699 8.29433C6.99699 7.99952 4.51289 10.0354 4.22131 12.8417L0.527298 48.4115C0.235993 51.2179 2.24758 53.7319 5.02046 54.027L55.2293 59.3678C58.0022 59.6626 60.4863 57.6268 60.7779 54.8205L64.4719 19.2506C64.7632 16.4443 62.7516 13.9302 59.9787 13.6351Z"
fill="#E5EAF0"></path>
<path
d="M22.5232 19.9239C25.9894 20.2926 28.5039 23.4353 28.1396 26.9433C27.7753 30.4513 24.6701 32.9962 21.2039 32.6275C17.7377 32.2588 15.2231 29.1161 15.5874 25.6081C15.9554 22.1022 19.0582 19.5593 22.5232 19.9239Z"
fill="#BFCAD9"></path>
<path d="M28.67 46.266L11.0969 44.3967L11.2965 42.475C12.1291 37.8629 16.3317 34.6784 20.9389 35.1685C25.5461 35.6586 29.0026 39.6578 28.8696 44.3443L28.67 46.266Z" fill="#BFCAD9"></path>
<path
d="M49.5469 40.7818L39.5052 39.7137C38.1187 39.5662 37.1129 38.3091 37.2586 36.9059C37.4043 35.5027 38.6464 34.4848 40.0329 34.6323L50.0747 35.7004C51.4611 35.8479 52.467 37.105 52.3212 38.5082C52.1755 39.9114 50.9334 40.9293 49.5469 40.7818Z"
fill="#BFCAD9"></path>
<path
d="M50.6036 30.6188L40.5618 29.5506C39.1753 29.4031 38.1695 28.146 38.3152 26.7429C38.461 25.3397 39.7031 24.3217 41.0895 24.4692L51.1313 25.5373C52.5178 25.6848 53.5236 26.9419 53.3779 28.3451C53.2322 29.7483 51.9901 30.7662 50.6036 30.6188Z"
fill="#BFCAD9"></path>
</svg></div>
<div class="fileupload_placeholder-text__NBQ_i pt-24">UPLOAD DOCUMENT</div>
</label></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-lg-6 css-rpybyc">
<div class="w-40 pb-40 pb-0-xs">
<h4 class="text-16 font-600 text-ternary mb-10"><span class="mb-0 inputs text-14 font-300 text-secondary pb-6">(Max File Size - 2Mb)</span></h4>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 css-15j76c0">
<p class="text-12 font-400 text-secondary font-500 flex flex-wrap-xs align-center mb-0 mt-0">ALLOWED DOC TYPE: </p>
<div class="MuiStack-root mt-4-xs css-1yjo05o">
<div class="MuiChip-root MuiChip-filled MuiChip-sizeSmall MuiChip-colorDefault MuiChip-filledDefault css-5rwd7p"><span class="MuiChip-label MuiChip-labelSmall css-1pjtbja">.pdf</span></div>
<div class="MuiChip-root MuiChip-filled MuiChip-sizeSmall MuiChip-colorDefault MuiChip-filledDefault css-5rwd7p"><span class="MuiChip-label MuiChip-labelSmall css-1pjtbja">.jpg</span></div>
</div>
<p></p>
</div>
</div>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="CKYCRequired">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Do you have a CKYC number?</h3><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="CKYCRequired" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="CKYCRequired" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-1j28t1o"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="true" for="customerFirstName" id="customerFirstName-label">First Name*</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall MuiInputBase-adornedStart css-13xsv1a">
<div class="MuiInputAdornment-root MuiInputAdornment-positionStart MuiInputAdornment-outlined MuiInputAdornment-sizeSmall css-1a6giau"><span class="notranslate"></span>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-sizeSmall demo css-190uj19">
<div tabindex="0" role="button" aria-expanded="false" aria-haspopup="listbox" class="MuiSelect-select MuiSelect-outlined MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-182didf">Mr</div>
<input aria-invalid="false" aria-hidden="true" tabindex="-1" class="MuiSelect-nativeInput css-1k3x8v3" value="mr"><svg
class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium MuiSelect-icon MuiSelect-iconOutlined css-1636szt" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="ArrowDropDownIcon">
<path d="M7 10l5 5 5-5z"></path>
</svg>
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-ihdtdm"><span class="notranslate"></span></legend>
</fieldset>
</div>
</div><input aria-invalid="false" id="customerFirstName" type="text" inputmode="text" maxlength="255"
class="MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall MuiInputBase-inputAdornedStart css-162edyi" value="" style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>First Name*</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-13y6s0b"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-sizeSmall MuiInputLabel-outlined css-17f324k"
for="customerMiddleName" id="customerMiddleName-label">Middle Name</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall css-5qqdno"><input aria-invalid="false" id="customerMiddleName" type="text" inputmode="text"
maxlength="39" class="MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-1o6z5ng" value="" style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-yjsfm1"><span>Middle Name</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-13y6s0b"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-sizeSmall MuiInputLabel-outlined css-17f324k"
for="customerLastName" id="customerLastName-label">Last Name*</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall css-5qqdno"><input aria-invalid="false" id="customerLastName" type="text" inputmode="text"
maxlength="39" class="MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-1o6z5ng" value="" style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-yjsfm1"><span>Last Name*</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiFormControl-fullWidth css-1ujd0rj"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="true" id="customerRelation">Relation*</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall mb-20 w-full mb-10-xs css-10bwxjo">
<div tabindex="0" role="button" aria-expanded="false" aria-haspopup="listbox" aria-labelledby="customerRelation customerRelation" id="customerRelation"
class="MuiSelect-select MuiSelect-outlined MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-182didf">Mother</div><input aria-invalid="false" aria-hidden="true" tabindex="-1"
class="MuiSelect-nativeInput css-1k3x8v3" value="Mother"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium MuiSelect-icon MuiSelect-iconOutlined css-1636szt" focusable="false" aria-hidden="true" viewBox="0 0 24 24"
data-testid="ArrowDropDownIcon">
<path d="M7 10l5 5 5-5z"></path>
</svg>
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>Relation*</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiTextField-root css-higf9k"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-outlined css-hbgfb8"
data-shrink="true" for=":rq:" id=":rq:-label">Date of Birth*</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl Mui-readOnly MuiInputBase-readOnly css-5qqdno"><input aria-invalid="false" id=":rq:" readonly="" type="text"
aria-readonly="true" aria-label="Choose date" class="MuiInputBase-input MuiOutlinedInput-input Mui-readOnly MuiInputBase-readOnly css-1x5jdmq" value="">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>Date of Birth*</span></legend>
</fieldset>
</div>
</div>
<div class="pt-8"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="customerGender">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Select Gender*</h3><label class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="customerGender" type="radio" value="Male"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Male</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="customerGender" type="radio" value="Female" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Female</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiFormControl-fullWidth css-1ujd0rj"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="true" id="customerMaritalStatus">Marital Status</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall mb-20 w-full mb-10-xs css-10bwxjo">
<div tabindex="0" role="button" aria-expanded="false" aria-haspopup="listbox" aria-labelledby="customerMaritalStatus customerMaritalStatus" id="customerMaritalStatus"
class="MuiSelect-select MuiSelect-outlined MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-182didf">Married</div><input aria-invalid="false" aria-hidden="true" tabindex="-1"
class="MuiSelect-nativeInput css-1k3x8v3" value="Married"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium MuiSelect-icon MuiSelect-iconOutlined css-1636szt" focusable="false" aria-hidden="true"
viewBox="0 0 24 24" data-testid="ArrowDropDownIcon">
<path d="M7 10l5 5 5-5z"></path>
</svg>
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>Marital Status</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiFormControl-fullWidth css-1ujd0rj"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="true" id="customerResStatus">Residential Status</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall mb-20 w-full mb-10-xs css-10bwxjo">
<div tabindex="0" role="button" aria-expanded="false" aria-haspopup="listbox" aria-labelledby="customerResStatus customerResStatus" id="customerResStatus"
class="MuiSelect-select MuiSelect-outlined MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-182didf">Resident</div><input aria-invalid="false" aria-hidden="true" tabindex="-1"
class="MuiSelect-nativeInput css-1k3x8v3" value="Resident"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium MuiSelect-icon MuiSelect-iconOutlined css-1636szt" focusable="false" aria-hidden="true"
viewBox="0 0 24 24" data-testid="ArrowDropDownIcon">
<path d="M7 10l5 5 5-5z"></path>
</svg>
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>Residential Status</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-9 css-1hjwhii">
<div class="MuiBox-root css-0">
<p class="MuiTypography-root MuiTypography-body1 mb-20 mt-10 text-strong css-rvsnqt">POI/POA*</p>
<div class="MuiGrid-root MuiGrid-container css-1xi2gtz">
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-lg-6 css-rpybyc">
<div class="fileupload_file-upload-box-root__dAhXv"><label for="poidocumentproof" class="fileupload_upload-label__MZZ7r relative"><input class="fileupload_upload-input-box___eRz6" type="file" name="poidocumentproof"
id="poidocumentproof">
<div><svg width="65" height="60" viewBox="0 0 65 60" fill="none" xmlns="http://www.w3.org/2000/svg">
<path
d="M30.3803 5.34666L40.4227 6.40889C41.8093 6.55555 43.0521 5.537 43.1986 4.13389C43.3452 2.73078 42.3399 1.47445 40.9534 1.32778L30.911 0.265557C29.5244 0.118894 28.2816 1.13744 28.1351 2.54055C27.9885 3.94366 28.9938 5.2 30.3803 5.34666Z"
fill="#BFCAD9"></path>
<path
d="M59.9787 13.6351L9.7699 8.29433C6.99699 7.99952 4.51289 10.0354 4.22131 12.8417L0.527298 48.4115C0.235993 51.2179 2.24758 53.7319 5.02046 54.027L55.2293 59.3678C58.0022 59.6626 60.4863 57.6268 60.7779 54.8205L64.4719 19.2506C64.7632 16.4443 62.7516 13.9302 59.9787 13.6351Z"
fill="#E5EAF0"></path>
<path
d="M22.5232 19.9239C25.9894 20.2926 28.5039 23.4353 28.1396 26.9433C27.7753 30.4513 24.6701 32.9962 21.2039 32.6275C17.7377 32.2588 15.2231 29.1161 15.5874 25.6081C15.9554 22.1022 19.0582 19.5593 22.5232 19.9239Z"
fill="#BFCAD9"></path>
<path d="M28.67 46.266L11.0969 44.3967L11.2965 42.475C12.1291 37.8629 16.3317 34.6784 20.9389 35.1685C25.5461 35.6586 29.0026 39.6578 28.8696 44.3443L28.67 46.266Z" fill="#BFCAD9"></path>
<path
d="M49.5469 40.7818L39.5052 39.7137C38.1187 39.5662 37.1129 38.3091 37.2586 36.9059C37.4043 35.5027 38.6464 34.4848 40.0329 34.6323L50.0747 35.7004C51.4611 35.8479 52.467 37.105 52.3212 38.5082C52.1755 39.9114 50.9334 40.9293 49.5469 40.7818Z"
fill="#BFCAD9"></path>
<path
d="M50.6036 30.6188L40.5618 29.5506C39.1753 29.4031 38.1695 28.146 38.3152 26.7429C38.461 25.3397 39.7031 24.3217 41.0895 24.4692L51.1313 25.5373C52.5178 25.6848 53.5236 26.9419 53.3779 28.3451C53.2322 29.7483 51.9901 30.7662 50.6036 30.6188Z"
fill="#BFCAD9"></path>
</svg></div>
<div class="fileupload_placeholder-text__NBQ_i pt-24">UPLOAD DOCUMENT</div>
</label></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-lg-6 css-rpybyc">
<div class="w-40 pb-40 pb-0-xs">
<h4 class="text-16 font-600 text-ternary mb-10"><span class="mb-0 inputs text-14 font-300 text-secondary pb-6">(Max File Size - 2Mb)</span></h4>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 css-15j76c0">
<p class="text-12 font-400 text-secondary font-500 flex flex-wrap-xs align-center mb-0 mt-0">ALLOWED DOC TYPE: </p>
<div class="MuiStack-root mt-4-xs css-1yjo05o">
<div class="MuiChip-root MuiChip-filled MuiChip-sizeSmall MuiChip-colorDefault MuiChip-filledDefault css-5rwd7p"><span class="MuiChip-label MuiChip-labelSmall css-1pjtbja">.pdf</span></div>
<div class="MuiChip-root MuiChip-filled MuiChip-sizeSmall MuiChip-colorDefault MuiChip-filledDefault css-5rwd7p"><span class="MuiChip-label MuiChip-labelSmall css-1pjtbja">.jpg</span></div>
</div>
<p></p>
</div>
</div>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiFormControl-fullWidth css-1ujd0rj"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="true" id="poi">Please Upload Your POI/POA Number</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall mb-20 w-full mb-10-xs css-10bwxjo">
<div tabindex="0" role="button" aria-expanded="false" aria-haspopup="listbox" aria-labelledby="poi poi" id="poi"
class="MuiSelect-select MuiSelect-outlined MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-182didf">Proof of Possession of Aadhaar</div><input aria-invalid="false" aria-hidden="true"
tabindex="-1" class="MuiSelect-nativeInput css-1k3x8v3" value="105"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium MuiSelect-icon MuiSelect-iconOutlined css-1636szt" focusable="false" aria-hidden="true"
viewBox="0 0 24 24" data-testid="ArrowDropDownIcon">
<path d="M7 10l5 5 5-5z"></path>
</svg>
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>Please Upload Your POI/POA Number</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-13y6s0b"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-sizeSmall MuiInputLabel-outlined css-17f324k"
for="poidocumentNumber" id="poidocumentNumber-label">Document Number</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall css-5qqdno"><input aria-invalid="false" id="poidocumentNumber" type="text" inputmode="text"
maxlength="16" class="MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-1o6z5ng" value="" style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-yjsfm1"><span>Document Number</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-9 css-1hjwhii">
<div class="MuiBox-root css-0">
<p class="MuiTypography-root MuiTypography-body1 mb-20 mt-10 text-strong css-rvsnqt">Photograph (Profile Picture)</p>
<div class="MuiGrid-root MuiGrid-container css-1xi2gtz">
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-lg-6 css-rpybyc">
<div class="fileupload_file-upload-box-root__dAhXv"><label for="photograph" class="fileupload_upload-label__MZZ7r relative"><input class="fileupload_upload-input-box___eRz6" type="file" name="photograph"
id="photograph">
<div><svg width="65" height="60" viewBox="0 0 65 60" fill="none" xmlns="http://www.w3.org/2000/svg">
<path
d="M30.3803 5.34666L40.4227 6.40889C41.8093 6.55555 43.0521 5.537 43.1986 4.13389C43.3452 2.73078 42.3399 1.47445 40.9534 1.32778L30.911 0.265557C29.5244 0.118894 28.2816 1.13744 28.1351 2.54055C27.9885 3.94366 28.9938 5.2 30.3803 5.34666Z"
fill="#BFCAD9"></path>
<path
d="M59.9787 13.6351L9.7699 8.29433C6.99699 7.99952 4.51289 10.0354 4.22131 12.8417L0.527298 48.4115C0.235993 51.2179 2.24758 53.7319 5.02046 54.027L55.2293 59.3678C58.0022 59.6626 60.4863 57.6268 60.7779 54.8205L64.4719 19.2506C64.7632 16.4443 62.7516 13.9302 59.9787 13.6351Z"
fill="#E5EAF0"></path>
<path
d="M22.5232 19.9239C25.9894 20.2926 28.5039 23.4353 28.1396 26.9433C27.7753 30.4513 24.6701 32.9962 21.2039 32.6275C17.7377 32.2588 15.2231 29.1161 15.5874 25.6081C15.9554 22.1022 19.0582 19.5593 22.5232 19.9239Z"
fill="#BFCAD9"></path>
<path d="M28.67 46.266L11.0969 44.3967L11.2965 42.475C12.1291 37.8629 16.3317 34.6784 20.9389 35.1685C25.5461 35.6586 29.0026 39.6578 28.8696 44.3443L28.67 46.266Z" fill="#BFCAD9"></path>
<path
d="M49.5469 40.7818L39.5052 39.7137C38.1187 39.5662 37.1129 38.3091 37.2586 36.9059C37.4043 35.5027 38.6464 34.4848 40.0329 34.6323L50.0747 35.7004C51.4611 35.8479 52.467 37.105 52.3212 38.5082C52.1755 39.9114 50.9334 40.9293 49.5469 40.7818Z"
fill="#BFCAD9"></path>
<path
d="M50.6036 30.6188L40.5618 29.5506C39.1753 29.4031 38.1695 28.146 38.3152 26.7429C38.461 25.3397 39.7031 24.3217 41.0895 24.4692L51.1313 25.5373C52.5178 25.6848 53.5236 26.9419 53.3779 28.3451C53.2322 29.7483 51.9901 30.7662 50.6036 30.6188Z"
fill="#BFCAD9"></path>
</svg></div>
<div class="fileupload_placeholder-text__NBQ_i pt-24">UPLOAD DOCUMENT</div>
</label></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-lg-6 css-rpybyc">
<div class="w-40 pb-40 pb-0-xs">
<h4 class="text-16 font-600 text-ternary mb-10"><span class="mb-0 inputs text-14 font-300 text-secondary pb-6">(Max File Size - 2Mb)</span></h4>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 css-15j76c0">
<p class="text-12 font-400 text-secondary font-500 flex flex-wrap-xs align-center mb-0 mt-0">ALLOWED DOC TYPE: </p>
<div class="MuiStack-root mt-4-xs css-1yjo05o">
<div class="MuiChip-root MuiChip-filled MuiChip-sizeSmall MuiChip-colorDefault MuiChip-filledDefault css-5rwd7p"><span class="MuiChip-label MuiChip-labelSmall css-1pjtbja">.pdf</span></div>
<div class="MuiChip-root MuiChip-filled MuiChip-sizeSmall MuiChip-colorDefault MuiChip-filledDefault css-5rwd7p"><span class="MuiChip-label MuiChip-labelSmall css-1pjtbja">.jpg</span></div>
</div>
<p></p>
</div>
</div>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiFormControl-fullWidth css-1ujd0rj"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="true" id="incomesource">Select Income Source*</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall mb-20 w-full mb-10-xs css-10bwxjo">
<div tabindex="0" role="button" aria-expanded="false" aria-haspopup="listbox" aria-labelledby="incomesource incomesource" id="incomesource"
class="MuiSelect-select MuiSelect-outlined MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-182didf">Salaried person</div><input aria-invalid="false" aria-hidden="true" tabindex="-1"
class="MuiSelect-nativeInput css-1k3x8v3" value="salariedperson"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium MuiSelect-icon MuiSelect-iconOutlined css-1636szt" focusable="false" aria-hidden="true"
viewBox="0 0 24 24" data-testid="ArrowDropDownIcon">
<path d="M7 10l5 5 5-5z"></path>
</svg>
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>Select Income Source*</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiFormControl-fullWidth css-1ujd0rj"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="true" id="pep">PEP*</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall mb-20 w-full mb-10-xs css-10bwxjo">
<div tabindex="0" role="button" aria-expanded="false" aria-haspopup="listbox" aria-labelledby="pep pep" id="pep"
class="MuiSelect-select MuiSelect-outlined MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-182didf">No</div><input aria-invalid="false" aria-hidden="true" tabindex="-1"
class="MuiSelect-nativeInput css-1k3x8v3" value="No"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium MuiSelect-icon MuiSelect-iconOutlined css-1636szt" focusable="false" aria-hidden="true" viewBox="0 0 24 24"
data-testid="ArrowDropDownIcon">
<path d="M7 10l5 5 5-5z"></path>
</svg>
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>PEP*</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<p class="MuiTypography-root MuiTypography-body1 css-1l5pwci"><svg class="MuiSvgIcon-root MuiSvgIcon-colorInfo MuiSvgIcon-fontSizeMedium css-1hm3tfm" focusable="false" aria-hidden="true" viewBox="0 0 24 24"
data-testid="InfoIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm1 15h-2v-6h2v6zm0-8h-2V7h2v2z"></path>
</svg></p>
<div>Are you a PEP (Politically Exposed Person), or is any insured member a PEP or related to a PEP? If yes, please share more details.</div>
<p></p>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="gstRequired">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Are you eligible for GST?</h3><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="gstRequired" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="gstRequired" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="eiaRequired">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Do you have an eIA number?*</h3><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="eiaRequired" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="eiaRequired" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
<p class="MuiTypography-root MuiTypography-body1 css-1l5pwci"><svg class="MuiSvgIcon-root MuiSvgIcon-colorPrimary MuiSvgIcon-fontSizeSmall css-1u2ioj0" focusable="false" aria-hidden="true" viewBox="0 0 24 24"
data-testid="InfoOutlinedIcon">
<path d="M11 7h2v2h-2zm0 4h2v6h-2zm1-9C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.41 0-8-3.59-8-8s3.59-8 8-8 8 3.59 8 8-3.59 8-8 8z"></path>
</svg></p>
<div><span class="text-12 font-400 text-secondary"> Please fill up the eInsurance Account Application form after payment completion to create an eIA Account </span></div>
<p></p>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="socialStatus">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Do you belong to any of the following categories? - BPL families, Persons with disabilities or Persons working in the unorganised/informal sector.</h3><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="socialStatus" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="socialStatus" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="proposer-questions_custom-accordion__GANdc mt-20">
<div class="MuiPaper-root MuiPaper-elevation MuiPaper-rounded MuiPaper-elevation1 MuiAccordion-root MuiAccordion-rounded MuiAccordion-gutters proposer-questions_accordion-section__jKj8h mb-16 css-1kyh11n">
<div class="MuiButtonBase-root MuiAccordionSummary-root MuiAccordionSummary-gutters css-1iji0d4" tabindex="0" role="button" aria-expanded="false" aria-controls="address-content" id="address-header">
<div class="MuiAccordionSummary-content MuiAccordionSummary-contentGutters css-17o5nyn">
<p class="MuiTypography-root MuiTypography-body1 text-blue text-strong css-rvsnqt">Address Details</p>
</div>
<div class="MuiAccordionSummary-expandIconWrapper css-1fx8m19"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-vubbuv" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="ExpandMoreIcon">
<path d="M16.59 8.59 12 13.17 7.41 8.59 6 10l6 6 6-6z"></path>
</svg></div>
</div>
<div class="MuiCollapse-root MuiCollapse-vertical MuiCollapse-hidden css-a0y2e3" style="min-height: 0px;">
<div class="MuiCollapse-wrapper MuiCollapse-vertical css-hboir5">
<div class="MuiCollapse-wrapperInner MuiCollapse-vertical css-8atqhb">
<div aria-labelledby="address-header" id="address-content" role="region" class="MuiAccordion-region">
<div class="MuiAccordionDetails-root mt-20 css-u7qq7e">
<div>
<div class="MuiBox-root css-0">
<div class="MuiContainer-root MuiContainer-maxWidthLg css-1qsxih2">
<div class="MuiGrid-root MuiGrid-container MuiGrid-spacing-xs-2 css-isbt42"><input id="address" type="hidden" name="address"
value="{"address1":"560100","category":"Rural","state":"Karnataka","stateCode":"29","tierClassificationCode":"1","zipcode":"560100","district":"Bengaluru Urban","city":"Bengaluru"}">
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<p class="MuiTypography-root MuiTypography-body1 mb-20 mt-10 text-strong css-rvsnqt">Current Address</p>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-lg-3 css-4v9257">
<div>
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-13y6s0b"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="true" for="address1" id="address1-label">Address Line 1*</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall css-5qqdno"><input aria-invalid="false" id="address1" type="text" inputmode="text"
maxlength="225" class="MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-1o6z5ng" value="560100" style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>Address Line 1*</span></legend>
</fieldset>
</div>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-lg-3 css-4v9257">
<div>
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-13y6s0b"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-sizeSmall MuiInputLabel-outlined css-17f324k"
data-shrink="false" for="address2" id="address2-label">Landmark*</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall css-5qqdno"><input aria-invalid="false" id="address2" type="text" inputmode="text"
maxlength="225" class="MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-1o6z5ng" value="" style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-yjsfm1"><span>Landmark*</span></legend>
</fieldset>
</div>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-lg-3 css-4v9257">
<div>
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-13y6s0b"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary Mui-disabled MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="true" for="zipcode" id="zipcode-label">Pincode*</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary Mui-disabled MuiInputBase-formControl MuiInputBase-sizeSmall css-5qqdno"><input aria-invalid="false" disabled="" id="zipcode" type="text"
inputmode="text" maxlength="6" class="MuiInputBase-input MuiOutlinedInput-input Mui-disabled MuiInputBase-inputSizeSmall css-1o6z5ng" value="560100" style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>Pincode*</span></legend>
</fieldset>
</div>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-lg-3 css-4v9257">
<div>
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-13y6s0b"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="true" for="state" id="state-label">State</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall css-5qqdno"><input aria-invalid="false" id="state" type="text"
class="MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-1o6z5ng" value="Karnataka" style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>State</span></legend>
</fieldset>
</div>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiFormControl-fullWidth css-1ujd0rj"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="true" id="district">District</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall mb-20 w-full mb-10-xs css-10bwxjo">
<div tabindex="0" role="button" aria-expanded="false" aria-haspopup="listbox" aria-labelledby="district district" id="district"
class="MuiSelect-select MuiSelect-outlined MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-182didf">Bengaluru Urban</div><input aria-invalid="false" aria-hidden="true" tabindex="-1"
class="MuiSelect-nativeInput css-1k3x8v3" value="Bengaluru Urban"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium MuiSelect-icon MuiSelect-iconOutlined css-1636szt" focusable="false" aria-hidden="true"
viewBox="0 0 24 24" data-testid="ArrowDropDownIcon">
<path d="M7 10l5 5 5-5z"></path>
</svg>
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>District</span></legend>
</fieldset>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiFormControl-fullWidth css-1ujd0rj"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="true" id="city">City</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall mb-20 w-full mb-10-xs css-10bwxjo">
<div tabindex="0" role="button" aria-expanded="false" aria-haspopup="listbox" aria-labelledby="city city" id="city"
class="MuiSelect-select MuiSelect-outlined MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-182didf">Bengaluru</div><input aria-invalid="false" aria-hidden="true" tabindex="-1"
class="MuiSelect-nativeInput css-1k3x8v3" value="Bengaluru"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium MuiSelect-icon MuiSelect-iconOutlined css-1636szt" focusable="false" aria-hidden="true"
viewBox="0 0 24 24" data-testid="ArrowDropDownIcon">
<path d="M7 10l5 5 5-5z"></path>
</svg>
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>City</span></legend>
</fieldset>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-lg-3 css-4v9257"></div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="sameAddress">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Is the Permanent Address the same as the Current Address?</h3><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="sameAddress" type="radio" value="Yes" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="sameAddress" type="radio" value="No"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false" aria-hidden="true"
viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="proposer-questions_custom-accordion__GANdc mt-20">
<div class="MuiPaper-root MuiPaper-elevation MuiPaper-rounded MuiPaper-elevation1 MuiAccordion-root MuiAccordion-rounded MuiAccordion-gutters proposer-questions_accordion-section__jKj8h mb-16 css-1kyh11n">
<div class="MuiButtonBase-root MuiAccordionSummary-root MuiAccordionSummary-gutters css-1iji0d4" tabindex="0" role="button" aria-expanded="false" aria-controls="address-content" id="address-header">
<div class="MuiAccordionSummary-content MuiAccordionSummary-contentGutters css-17o5nyn">
<p class="MuiTypography-root MuiTypography-body1 text-blue text-strong css-rvsnqt">Nominee Details</p>
</div>
<div class="MuiAccordionSummary-expandIconWrapper css-1fx8m19"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-vubbuv" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="ExpandMoreIcon">
<path d="M16.59 8.59 12 13.17 7.41 8.59 6 10l6 6 6-6z"></path>
</svg></div>
</div>
<div class="MuiCollapse-root MuiCollapse-vertical MuiCollapse-hidden css-a0y2e3" style="min-height: 0px;">
<div class="MuiCollapse-wrapper MuiCollapse-vertical css-hboir5">
<div class="MuiCollapse-wrapperInner MuiCollapse-vertical css-8atqhb">
<div aria-labelledby="address-header" id="address-content" role="region" class="MuiAccordion-region">
<div class="MuiAccordionDetails-root mt-20 css-u7qq7e">
<div>
<div class="MuiBox-root css-0">
<div class="MuiContainer-root MuiContainer-maxWidthLg css-1qsxih2">
<div class="MuiGrid-root MuiGrid-container MuiGrid-spacing-xs-2 css-isbt42"><input id="nomineeDetails" type="hidden" name="nomineeDetails"
value="{"nominee1":{"nomineePercent":"100","nomineeRelation":"REL_08"},"nominee2":{"nomineePercent":0}}">
<div class="w-full">
<div class="MuiBox-root css-0">
<div class="MuiContainer-root MuiContainer-maxWidthLg css-1qsxih2">
<p class="MuiTypography-root MuiTypography-body1 mb-20 text-strong css-rvsnqt">Nominee 1</p>
<div class="MuiGrid-root MuiGrid-container MuiGrid-spacing-xs-2 css-3nargb">
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-4 MuiGrid-grid-md-4 MuiGrid-grid-lg-3 css-1hrvdsy">
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-13y6s0b"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-sizeSmall MuiInputLabel-outlined css-17f324k"
data-shrink="" for="nomineeName0" id="nomineeName0-label">Full Name*</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall css-5qqdno"><input aria-invalid="false" id="nomineeName0" type="text" inputmode="text"
maxlength="119" class="MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-1o6z5ng" value="" style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-yjsfm1"><span>Full Name*</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-4 MuiGrid-grid-md-4 MuiGrid-grid-lg-3 css-1hrvdsy">
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-13y6s0b"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-sizeSmall MuiInputLabel-outlined css-17f324k"
data-shrink="" for="nomineeAge0" id="nomineeAge0-label">Nominee Age*</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall css-5qqdno"><input aria-invalid="false" id="nomineeAge0" type="text" inputmode="text"
maxlength="3" class="MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-1o6z5ng" value="" style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-yjsfm1"><span>Nominee Age*</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-4 MuiGrid-grid-md-4 MuiGrid-grid-lg-3 css-1hrvdsy">
<div class="MuiFormControl-root MuiFormControl-fullWidth css-1ujd0rj"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="true" id="nomineeRelation0">Relationship with Nominee*</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall mb-20 w-full mb-10-xs css-10bwxjo">
<div tabindex="0" role="button" aria-expanded="false" aria-haspopup="listbox" aria-labelledby="nomineeRelation0 nomineeRelation0" id="nomineeRelation0"
class="MuiSelect-select MuiSelect-outlined MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-182didf">Spouse</div><input aria-invalid="false" aria-hidden="true" tabindex="-1"
class="MuiSelect-nativeInput css-1k3x8v3" value="REL_08"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium MuiSelect-icon MuiSelect-iconOutlined css-1636szt" focusable="false" aria-hidden="true"
viewBox="0 0 24 24" data-testid="ArrowDropDownIcon">
<path d="M7 10l5 5 5-5z"></path>
</svg>
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>Relationship with Nominee*</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-3 MuiGrid-grid-md-3 MuiGrid-grid-lg-3 css-f9p5hp">
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-13y6s0b"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="true" for="nominee1nomineePercent" id="nominee1nomineePercent-label">Claim Percentage*</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall css-5qqdno"><input aria-invalid="false" id="nominee1nomineePercent" type="text"
inputmode="text" maxlength="3" class="MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-1o6z5ng" value="100" style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>Claim Percentage*</span></legend>
</fieldset>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-lg-3 css-xp45iw"></div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="proposer-questions_custom-accordion__GANdc mt-20">
<div class="MuiPaper-root MuiPaper-elevation MuiPaper-rounded MuiPaper-elevation1 MuiAccordion-root MuiAccordion-rounded MuiAccordion-gutters proposer-questions_accordion-section__jKj8h mb-16 css-1kyh11n">
<div class="MuiButtonBase-root MuiAccordionSummary-root MuiAccordionSummary-gutters css-1iji0d4" tabindex="0" role="button" aria-expanded="false" aria-controls="address-content" id="address-header">
<div class="MuiAccordionSummary-content MuiAccordionSummary-contentGutters css-17o5nyn">
<p class="MuiTypography-root MuiTypography-body1 text-blue text-strong css-rvsnqt">Bank Details of the Proposer</p>
</div>
<div class="MuiAccordionSummary-expandIconWrapper css-1fx8m19"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-vubbuv" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="ExpandMoreIcon">
<path d="M16.59 8.59 12 13.17 7.41 8.59 6 10l6 6 6-6z"></path>
</svg></div>
</div>
<div class="MuiCollapse-root MuiCollapse-vertical MuiCollapse-hidden css-a0y2e3" style="min-height: 0px;">
<div class="MuiCollapse-wrapper MuiCollapse-vertical css-hboir5">
<div class="MuiCollapse-wrapperInner MuiCollapse-vertical css-8atqhb">
<div aria-labelledby="address-header" id="address-content" role="region" class="MuiAccordion-region">
<div class="MuiAccordionDetails-root mt-20 css-u7qq7e">
<div>
<div class="MuiBox-root css-0">
<div class="MuiContainer-root MuiContainer-maxWidthLg css-1qsxih2">
<div class="MuiGrid-root MuiGrid-container MuiGrid-spacing-xs-2 css-isbt42">
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-13y6s0b"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="XXXX0000000" for="ifscCode" id="ifscCode-label">IFSC Code</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall css-5qqdno"><input aria-invalid="false" id="ifscCode" type="text" inputmode="text"
maxlength="11" class="MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-1o6z5ng" value="XXXX0000000" style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>IFSC Code</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-13y6s0b"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="000000000" for="accountNo" id="accountNo-label">Account Number</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall css-5qqdno"><input aria-invalid="false" id="accountNo" type="text" inputmode="text"
maxlength="16" class="MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-1o6z5ng" value="000000000" style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>Account Number</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-13y6s0b"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="XXX" for="bankName" id="bankName-label">Bank Name</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall css-5qqdno"><input aria-invalid="false" id="bankName" type="text" inputmode="text"
maxlength="255" class="MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-1o6z5ng" value="XXX" style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>Bank Name</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full mb-10-xs css-13y6s0b"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="XXX" for="bankBranch" id="bankBranch-label">Bank Branch</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall css-5qqdno"><input aria-invalid="false" id="bankBranch" type="text" inputmode="text"
maxlength="255" class="MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-1o6z5ng" value="XXX" style="width: 100%;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>Bank Branch</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-6 MuiGrid-grid-md-6 MuiGrid-grid-lg-3 css-4v9257">
<div class="MuiFormControl-root MuiFormControl-fullWidth css-1ujd0rj"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiFormLabel-filled MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-shrink MuiInputLabel-sizeSmall MuiInputLabel-outlined css-hbgfb8"
data-shrink="true" id="typeOfAccount">Type of Account</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall mb-20 w-full mb-10-xs css-10bwxjo">
<div tabindex="0" role="button" aria-expanded="false" aria-haspopup="listbox" aria-labelledby="typeOfAccount typeOfAccount" id="typeOfAccount"
class="MuiSelect-select MuiSelect-outlined MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-182didf">Savings Account</div><input aria-invalid="false" aria-hidden="true" tabindex="-1"
class="MuiSelect-nativeInput css-1k3x8v3" value="Savings Account"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium MuiSelect-icon MuiSelect-iconOutlined css-1636szt" focusable="false" aria-hidden="true"
viewBox="0 0 24 24" data-testid="ArrowDropDownIcon">
<path d="M7 10l5 5 5-5z"></path>
</svg>
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-14lo706"><span>Type of Account</span></legend>
</fieldset>
</div>
</div>
<div class="error-position"></div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="proposer-questions_custom-accordion__GANdc mt-20">
<div class="MuiPaper-root MuiPaper-elevation MuiPaper-rounded MuiPaper-elevation1 MuiAccordion-root MuiAccordion-rounded MuiAccordion-gutters proposer-questions_accordion-section__jKj8h mb-16 css-1kyh11n">
<div class="MuiButtonBase-root MuiAccordionSummary-root MuiAccordionSummary-gutters css-1iji0d4" tabindex="0" role="button" aria-expanded="false" aria-controls="address-content" id="address-header">
<div class="MuiAccordionSummary-content MuiAccordionSummary-contentGutters css-17o5nyn">
<p class="MuiTypography-root MuiTypography-body1 text-blue text-strong css-rvsnqt">Medical Condition</p>
</div>
<div class="MuiAccordionSummary-expandIconWrapper css-1fx8m19"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-vubbuv" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="ExpandMoreIcon">
<path d="M16.59 8.59 12 13.17 7.41 8.59 6 10l6 6 6-6z"></path>
</svg></div>
</div>
<div class="MuiCollapse-root MuiCollapse-vertical MuiCollapse-hidden css-a0y2e3" style="min-height: 0px;">
<div class="MuiCollapse-wrapper MuiCollapse-vertical css-hboir5">
<div class="MuiCollapse-wrapperInner MuiCollapse-vertical css-8atqhb">
<div aria-labelledby="address-header" id="address-content" role="region" class="MuiAccordion-region">
<div class="MuiAccordionDetails-root mt-20 css-u7qq7e">
<div>
<div class="MuiBox-root css-0">
<div class="MuiContainer-root MuiContainer-maxWidthLg css-1qsxih2">
<div class="MuiGrid-root MuiGrid-container MuiGrid-spacing-xs-2 css-isbt42">
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="heartDisease">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Heart disease*</h3><label class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="heartDisease" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="heartDisease" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="strokeDisease">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Stroke, epilepsy, fainting attack, chronic head ache, Parkinson’s disease, Alzheimer’s disease*</h3><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="strokeDisease" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="strokeDisease" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="respiratoryInfections">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Tuberculosis, asthma, other respiratory infections</h3><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="respiratoryInfections" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="respiratoryInfections" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68"
focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="injuryLigaments">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Disease of bones/joints, slipped disc, spinal disorder, injury to ligaments*</h3><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="injuryLigaments" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="injuryLigaments" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="cancer">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Cancer, pre cancerous lesions*</h3><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="cancer" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false" aria-hidden="true"
viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="cancer" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="gyncologicalDisorder">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Gynecological disorder such as DUB, fibroid uterus, ovarian cyst- or have undergone caesarian / hysterectomy</h3><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="gyncologicalDisorder" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="gyncologicalDisorder" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68"
focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="fertility">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Treatment for sub fertility or has been advised for? (answer if applicable)*</h3><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="fertility" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false" aria-hidden="true"
viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="fertility" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="stomachCondition">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Disease of stomach, intestine , liver, gall bladder/pancreas, kidney, urinary bladder, urinary tract diseases*</h3><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="stomachCondition" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="stomachCondition" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="genitialCondition">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Disease of prostrate / fistula / piles / genital disease*</h3><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="genitialCondition" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="genitialCondition" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="eyeCondition">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Cataract and other diseases of the eye and ENT disease*</h3><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="eyeCondition" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="eyeCondition" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="otherCondition">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Any other problem please specify*</h3><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="otherCondition" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="otherCondition" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="medicaltest">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Undergone any medical test?*</h3><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="medicaltest" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="medicaltest" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="medicineCondition">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Prescribed any medicines?*</h3><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="medicineCondition" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="medicineCondition" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="surgery">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Been advised for any surgery/treatment?*</h3><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="surgery" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false" aria-hidden="true"
viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="surgery" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="disabilityCondition">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Received/receiving any payment for any disability/injury/illness/diseases*</h3><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="disabilityCondition" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="disabilityCondition" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="tobocco">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Chew Tobacco*</h3><label class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="tobocco" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false" aria-hidden="true"
viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="tobocco" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="smoke">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Smoke*</h3><label class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="smoke" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false" aria-hidden="true"
viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="smoke" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="alcohol">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Consume Alcohol*</h3><label class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="alcohol" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false" aria-hidden="true"
viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="alcohol" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-12 MuiGrid-grid-sm-12 MuiGrid-grid-lg-12 css-15j76c0">
<div class="MuiFormControl-root css-twox94">
<div class="MuiFormGroup-root MuiFormGroup-row css-p58oka" role="radiogroup" aria-labelledby="demo-row-radio-buttons-group-label" id="hivCondition">
<h3 class="proposer-questions_proposer-detail-spouse__uHvYY">Is the person proposed for insurance positive for HIV ?*</h3><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="hivCondition" type="radio" value="Yes"><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1c4tzn" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">Yes</span></label><label
class="MuiFormControlLabel-root MuiFormControlLabel-labelPlacementEnd proposer-questions_proposer-gender__2PnFN css-z7oatq"><span
class="MuiButtonBase-root MuiRadio-root MuiRadio-colorPrimary PrivateSwitchBase-root MuiRadio-root MuiRadio-colorPrimary Mui-checked MuiRadio-root MuiRadio-colorPrimary css-1a5icme"><input
class="PrivateSwitchBase-input css-1m9pwf3" name="hivCondition" type="radio" value="No" checked=""><span class="css-hyxlzm"><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-q8lw68" focusable="false"
aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonUncheckedIcon">
<path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm0 18c-4.42 0-8-3.58-8-8s3.58-8 8-8 8 3.58 8 8-3.58 8-8 8z"></path>
</svg><svg class="MuiSvgIcon-root MuiSvgIcon-fontSizeMedium css-1u5ei5s" focusable="false" aria-hidden="true" viewBox="0 0 24 24" data-testid="RadioButtonCheckedIcon">
<path d="M8.465 8.465C9.37 7.56 10.62 7 12 7C14.76 7 17 9.24 17 12C17 13.38 16.44 14.63 15.535 15.535C14.63 16.44 13.38 17 12 17C9.24 17 7 14.76 7 12C7 10.62 7.56 9.37 8.465 8.465Z"></path>
</svg></span><span class="MuiTouchRipple-root css-w0pj6f"></span></span><span class="MuiTypography-root MuiTypography-body1 MuiFormControlLabel-label css-rvsnqt">No</span></label>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="mt-30 text-right">
<div class="proposer-details_button-section-static__h7c4I mt-20 pb-40">
<div class="text-center"><button
class="MuiButtonBase-root MuiButton-root MuiButton-contained MuiButton-containedPrimary MuiButton-sizeMedium MuiButton-containedSizeMedium MuiButton-root MuiButton-contained MuiButton-containedPrimary MuiButton-sizeMedium MuiButton-containedSizeMedium btn-orange pl-26 pr-26 pt-10 pb-10 font-700 text-18 css-117v3kn"
tabindex="0" type="submit" inputref="[object Object]">Next<span class="MuiTouchRipple-root css-w0pj6f"></span></button></div>
</div>
</div>
</form><form id="otp-form">
<div class="otp_contact-form__bXiD8">
<div class="MuiContainer-root MuiContainer-maxWidthLg MuiContainer-fixed css-x3h831">
<div class="mb-30">
<div class="MuiFormControl-root MuiTextField-root mb-20 w-full css-13y6s0b"><label
class="MuiFormLabel-root MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-sizeSmall MuiInputLabel-outlined MuiFormLabel-colorPrimary MuiInputLabel-root MuiInputLabel-formControl MuiInputLabel-animated MuiInputLabel-sizeSmall MuiInputLabel-outlined css-17f324k"
data-shrink="false" for="otp" id="otp-label">Enter Otp</label>
<div class="MuiInputBase-root MuiOutlinedInput-root MuiInputBase-colorPrimary MuiInputBase-formControl MuiInputBase-sizeSmall css-5qqdno"><input aria-invalid="false" id="otp" type="text" inputmode="numeric" maxlength="5"
class="MuiInputBase-input MuiOutlinedInput-input MuiInputBase-inputSizeSmall css-1o6z5ng" value="" style="padding: 10px;">
<fieldset aria-hidden="true" class="MuiOutlinedInput-notchedOutline css-igs3ac">
<legend class="css-yjsfm1"><span>Enter Otp</span></legend>
</fieldset>
</div>
</div>
</div>
<div class="mt-30 mb-30"><button
class="MuiButtonBase-root MuiButton-root MuiButton-contained MuiButton-containedPrimary MuiButton-sizeMedium MuiButton-containedSizeMedium MuiButton-root MuiButton-contained MuiButton-containedPrimary MuiButton-sizeMedium MuiButton-containedSizeMedium btn-orange pl-26 pr-26 pt-10 pb-10 font-700 text-18 css-jdhbb"
tabindex="0" type="submit">Verify Otp<span class="MuiTouchRipple-root css-w0pj6f"></span></button>
<div class="flex align-center mt-10 justify-center">
<p class="MuiTypography-root MuiTypography-body1 text-14 css-rvsnqt"><span>Resend OTP in <span>01:26 </span></span></p>
</div>
</div>
</div>
</div>
</form>Text Content
Members to be insured (2) 1Proposer Details 2Insured Details 3eNACH CLICK HERE TO VERIFY CKYC Primary Details First Name* Mr First Name* Middle Name Middle Name Last Name* Last Name* Date of Birth* Date of Birth* Mobile* Mobile* Email* Email* Select occupation* SERVICE Select occupation* Annual Income* Annual Income* Nationality Indian citizen Nationality Aadhaar Card Number Aadhaar Card Number SELECT GENDER* MaleFemaleThird Gender DO YOU HAVE A PAN CARD? YesNo Note: Please upload form 60 in the upload section, if PAN is not available. Click here to download Form 60 UPLOAD DOCUMENT (MAX FILE SIZE - 2MB) ALLOWED DOC TYPE: .pdf .jpg DO YOU HAVE A CKYC NUMBER? YesNo First Name* Mr First Name* Middle Name Middle Name Last Name* Last Name* Relation* Mother Relation* Date of Birth* Date of Birth* SELECT GENDER* MaleFemale Marital Status Married Marital Status Residential Status Resident Residential Status POI/POA* UPLOAD DOCUMENT (MAX FILE SIZE - 2MB) ALLOWED DOC TYPE: .pdf .jpg Please Upload Your POI/POA Number Proof of Possession of Aadhaar Please Upload Your POI/POA Number Document Number Document Number Photograph (Profile Picture) UPLOAD DOCUMENT (MAX FILE SIZE - 2MB) ALLOWED DOC TYPE: .pdf .jpg Select Income Source* Salaried person Select Income Source* PEP* No PEP* Are you a PEP (Politically Exposed Person), or is any insured member a PEP or related to a PEP? If yes, please share more details. ARE YOU ELIGIBLE FOR GST? YesNo DO YOU HAVE AN EIA NUMBER?* YesNo Please fill up the eInsurance Account Application form after payment completion to create an eIA Account DO YOU BELONG TO ANY OF THE FOLLOWING CATEGORIES? - BPL FAMILIES, PERSONS WITH DISABILITIES OR PERSONS WORKING IN THE UNORGANISED/INFORMAL SECTOR. YesNo Address Details Current Address Address Line 1* Address Line 1* Landmark* Landmark* Pincode* Pincode* State State District Bengaluru Urban District City Bengaluru City IS THE PERMANENT ADDRESS THE SAME AS THE CURRENT ADDRESS? YesNo Nominee Details Nominee 1 Full Name* Full Name* Nominee Age* Nominee Age* Relationship with Nominee* Spouse Relationship with Nominee* Claim Percentage* Claim Percentage* Bank Details of the Proposer IFSC Code IFSC Code Account Number Account Number Bank Name Bank Name Bank Branch Bank Branch Type of Account Savings Account Type of Account Medical Condition HEART DISEASE* YesNo STROKE, EPILEPSY, FAINTING ATTACK, CHRONIC HEAD ACHE, PARKINSON’S DISEASE, ALZHEIMER’S DISEASE* YesNo TUBERCULOSIS, ASTHMA, OTHER RESPIRATORY INFECTIONS YesNo DISEASE OF BONES/JOINTS, SLIPPED DISC, SPINAL DISORDER, INJURY TO LIGAMENTS* YesNo CANCER, PRE CANCEROUS LESIONS* YesNo GYNECOLOGICAL DISORDER SUCH AS DUB, FIBROID UTERUS, OVARIAN CYST- OR HAVE UNDERGONE CAESARIAN / HYSTERECTOMY YesNo TREATMENT FOR SUB FERTILITY OR HAS BEEN ADVISED FOR? (ANSWER IF APPLICABLE)* YesNo DISEASE OF STOMACH, INTESTINE , LIVER, GALL BLADDER/PANCREAS, KIDNEY, URINARY BLADDER, URINARY TRACT DISEASES* YesNo DISEASE OF PROSTRATE / FISTULA / PILES / GENITAL DISEASE* YesNo CATARACT AND OTHER DISEASES OF THE EYE AND ENT DISEASE* YesNo ANY OTHER PROBLEM PLEASE SPECIFY* YesNo UNDERGONE ANY MEDICAL TEST?* YesNo PRESCRIBED ANY MEDICINES?* YesNo BEEN ADVISED FOR ANY SURGERY/TREATMENT?* YesNo RECEIVED/RECEIVING ANY PAYMENT FOR ANY DISABILITY/INJURY/ILLNESS/DISEASES* YesNo CHEW TOBACCO* YesNo SMOKE* YesNo CONSUME ALCOHOL* YesNo IS THE PERSON PROPOSED FOR INSURANCE POSITIVE FOR HIV ?* YesNo Next Verify OTP Enter Otp Enter Otp Verify Otp Resend OTP in 01:26