Consult Dr Rajan TD, MD(Skin & VD)

हिंदी भाषा के लिए ऊपर क्लिक करें

Consult Dr Rajan TD

www.drrajantd.com

Email: docrajantd@gmail.com
Name*

First NameLast Name
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Phone Number*

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Occupation
Where do you live*
Married?*
Married

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Have you consulted Dr Rajan TD before ?*

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Date of last consultation
Do you have*

High BPDiabetesAsthmaHeart diseasePregnancyThyroid medicationLiver diseaseKidney diseaseAcidityOther
Present complaint; give details of how it began, what increases it and which part of the body*
Duration of present complaint in days, months, years*
Is it itchy or paining*

mild itchingsevere itchingburningpainingnot itchy or painful
Details of earlier treatment of Dr Rajan TD
Are you allergic to any medication. If yes, give details*
Other remarks if any
Send
1. Dr Rajan's prescription
2. Other doctors prescription
3. 3 Photos of present condition
4. For video consultation attach Aadhar Card
Write your name in Subject

to

docrajantd@gmail.com
I will email the above photos and prescription NOW*
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