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+91 9846101244
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+91 8921705097
narayanaayurvedic@gmail.com
Home
About Us
Legacy
Founder's Message
Milestones
Team
Treatments
Ailments that we Treat
Therapies
Facilities
Accommodation
Suite Rooms
Deluxe Rooms
Standard Rooms
Economy Rooms
Admission
General Enquiry
General Instructions
Daily Routine
Booking
Home
General Enquiry
Enquiry Form
Name
*
Age
*
Gender
*
Male
Female
Mobile No.
*
Email ID
*
Current Problems
*
( Problems for which the patient is seeking treatment from Amrithakripa)
Medical History
*
(History of systemic diseases like Diabetes/Hypertension/Heart Disease/Kidney disease/ Liver disease/ Cancer / Any other medical condition that we should be aware of)
(pdf, png, or jpg)
Is there is any non-healing ulcer/open wound anywhere in the body? :
*
Yes
No
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