Please fill the details to get more information

• Write a small brief about your requirement for Medical assistance.
• Give all possible details, if possible attach pictures or scan files.
• Give a brief case history, existing condition, treatment taken.
• Medical urgency - how soon you need the procedure to done.
• How many people would travel and kind of accomodation needed.
• Give correct contact information, so that we can communicate with you.
• If additional tourism service needed please mention that too.

First Name
Last Name
Email Address
Mobile Number
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