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FORM FOR CONSULTATION FROM OUR PANEL OF EXPERT DOCTORS.
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Step 1
Medical OPINION Form
Martial Status
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Martial Status
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Hypertenssion
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Diabetes
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PAST HISTORY
Have You Been Suffered From Same Or Other Illness*
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If Any Other Major Illness Or Surgery *
Yes
NO
FAMILY HISTORY
Any family members had similar illness *
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Step 2
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Step 3
DOCTORS & LOCATIONS
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Treatment
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