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We need you to confirm a few details, so that we can correctly process your order.
Would you like to be contacted by these details?
Full Name
CHANGE
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Let's get some of your clinical details
When did you start noticing symptoms?
Today
Yesterday
This week
Last week
Two weeks ago
Three weeks ago
This month
Last month
Enter some of the symptoms you are feeling. (seperated by comma ,)
Description of the illness
Please indicate the level of discomfort or pain
1 (mild pain)
2
3
4
5
6
7
8
9
10 (unbearable)
How would you like attend the session?
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Total amount due:
1,500
NGN
CHAT WITH DOCTOR
1,500
NGN
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