Patient Consultation form


  • Please co-operate with us and fill necessary columns. It will help us to understand Case history for advice and prescription. We will respond you                  within 48 hours
  • We ensure that your identity will be kept confidential. Your data will not be transmitted, resold or shared with third parties without your permission.
  • Persons who are over 18 years old only eligible for consultation. In case of children consultation, Parents need to be filling up this form.
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