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Ayur Sutra – payment form

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Donation Total: $560.00

Chinese translation map:

Last name: 姓
Frist name: 名
Email: 邮箱
Phone number: 联系电话
Card number: 信用卡号码
Mm/yy: 月份／年份
Cvc: 信用卡验证码
Donate now: 现在就捐款