Every time you eat a meal sit down, chew Slowly and pay attention to flavour and texture Fields marked with * are mandatory Name * Age * Phone Mobile Email * Present Complaints *Kindly mention about your complaints in your own words. Please describe fully the trouble, including its origin, subsequent development and effects or treatments that were received. In this description, please be certain to cover at least the following point: Area of body affected and when Sensations and pain experienced Circumstances (physical & emotional that have brought on the trouble) Conditions that increase the trouble Conditions that reduce the trouble VerificationPlease enter any two digitsExample: 12This box is for spam protection - please leave it blank
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