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Nome da pessoa precisando de cura
Person needing cure
Nome da mãe da pessoa (se não souber deixe em branco) - para diferenciar
Person's mother's name (if you don't know, keep blank) - to diferentiate
Qual doença neurológica?
What neurological disease?
Seu email (opcional) - enviaremos notícias posteriormente
Your email (optional) - we will send news later
OBRIGADO / THANK YOU
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