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Brief History of Dental Problem :*
History of any other ailment: :
Do you want a dental tourism program :*
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Accomodation required :*
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Transfer arrangements required
(from Airport to location)
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Appointment for

:  
   
Checkup & Consultation  
Silver Filling  
Tooth Coloured filling (Cosmetic Filling)  
Root canal treatment (RCT)  
Cap(Full Jacket Crown)  
Replacement of missing teeth (Fixed Dentures)
 
Replacement of missing teeth (Removable Dentures)  
Crown and bridge work  
Complete dentures  
Cleaning & Polishing  
Bleaching (Whitening)  
Gum Treatment  
Splinting of Mobile Teeth  
Extraction of teeth(Simple)  
Extraction (Impacted teeth)  
Correction of Fractured Jaw  
Braces for malposed teeth  
Implants  
Any Onther
 
     
     
   
 
     
 
     
 
 
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