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TYPE YOUR ANSWER UNDER EACH QUESTION AND SUBMIT
Date: Time: Names: Location: Phone: For Call / WhatsApp feedback Address: Who is Patient? "YOU, ANOTHER ADULT or CHILD": Emergency - Is the case EMERGENCY, URGENT or NORMAL? Do you need an AMBULANCE, "Yes or No"? Details: Please, explain the situation or symptons in details - confirm if you are already receiving treatment from this Hospital, any other Hospital or if on any medication.