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A specialized edition intended for medical institutions and doctors.
  • Your details

  • Last and first name
  • Age
  • Sex
    • male
    • female
  • Tel
  • Email
  • Information

  • Country where the medicine was purchased
    • Lithuania
    • Moldova
    • Georgia
    • Armenia
    • Azerbaijan
    • Iraq
    • Turkmenistan
    • Afghanistan
    • Uzbekistan
    • Kazakhstan
    • Kirgizstan
    • Tajikistan
    • Belarus
    • Poland
    • Yemen
    • Mongolia
    • Ukraine
  • Trade name of the medicine
  • Serial number
  • Describe the problem
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