Welcome to Cure on Door - Free Consultation and Remedies

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Personal Details
Title:
Your First Name:
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Date of Birth:
Gender:
Marital Status:
If yes, then how long since married?	years
Any kids?
Medical History:
Tell us about your illness: Tell us how do you feel? When do you feel? If you could think of a reason for this? If you have any previous consultations or medicines, or have run some tests. Try to give as much detail as possible.
After how many days/hours/weeks does your problem appear?
How many days/hours does the pain/symptoms/sickness stay?
How many days/weeks/years you have the problem or suffering from it?
Do you feel that your symptoms or problem increases or decreases with certain food, or climate or temperature or time of day? When?
Father alive Mother alive
Tell us about sickness history in your family like your parents', grand parents' sickness or illness? Give as much detail as possible.

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