אבחון מקוון , טופס השתלת שיער
אִשָׁה
זָכָר
פָּנִים
אף אחד
אוֹר
אור בינוני
בינוני
נִרחָב
לַחֲלוּטִין
תצוגה מקדימה
בחר את נשירת השיער שלך באזור הקדמי.
אף אחד
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אף אחד
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חום
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פחות משנה
יותר מ-10 שנים
לא
כן
בְּהֶקְדֵם הַאֶפְשַׁרִי
תוך 3 חודשים
בעוד שנה
עוד לא תכננתי את זה.
תרופות
מחלות כרוניות
שם ושם משפחה
כתובת דוא"ל
מספר הטלפון שלך
I have read and approved
Privacy Policy
.
I have read, understood and approved the
Potential Patient Explicit Consent Text
, the
Potential Patient Disclosure Text
.
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