Vitiligo Online Consultation Free - vitiligo specialist at Ayurhealthline

Name*

Age

Sex *

Body Weight (KG/LB)*

Address/City *

Ph./Mob. *

e-mail *

Confirm e-mail *

Country*

Parental History/ Family History of Vitiligo (if any)...

Month/Year of onset of first spot...

Mostly affected Areas (in detail)...

Patches colour...

Spreading rate of patches...

Percentage of affected Skin (approx)

Colour of hairs on patches

Skin type over patches

Dietary Habits...

Your Digestion...

Any Important Medical History ( related to autoimmunity ) i.e. Alopecia/Thyroid

Any Important Medical History related to jaundice/Malaria/Typhoid

Treatment Taken Before

Result Shown (if any)...

Psycosomatic condition ...

Present Treatment Details...

Result shown if you have started treatment from Ayurhealthline. (Details)...

Comments

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Disclaimer *Please note that we do not claim to cure each and every case, nor do we guarantee any magical cure*