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Ashrafieh - sioufy
nsnlebanon@nsnlebanon.com
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Home
About
Medical Equipment
Services
Medical Tourism
Contact us
Accessories
Oxygen Therapy
Orthopedic Therapy
Pediatric Section
Bathroom
Bedrooms
Clinic Instruments
Ease of access equipment
Machines
Recliners
Walking Aid
WheelChairs
First Aid Kit
Nutrition
Sterilization
Wound Care
APPLICATION
Full Name:
*
Place of birth
Gender
Female
Male
E-mail
*
Date of birth
*
blood type
A+
A-
B+
B-
AB
O+
O-
Adress
Governorate
Street
City / Town
Land Line
Mobile Number
*
Occupation
Employed
Unemployed
Job Title
Treatment
The quality of treatment required
*
Hospital admission
First class
Second Class
Third Class
booking date
Booked in the hotel
Yes
No
Multiple companions
I certify that all of the above information is correct and in the event that it is the contrary, I bear the responsibility of transferring disciplinary penalties by the Company and reserving my entitlements.
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