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お問い合わせ contact forms
オンラインメディカルクリニックへのお問い合わせはこちら
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Email
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お名前 / Your name
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ご連絡可能な電話番号 / phone number
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会社名・ 医療機関名・所属 / affiliation
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お問い合わせ種別 / type of inquiry
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一般診療 / medical consultation
パーソナル漢方 / traditional chinese medicine (Kampo medicine)
CT/MRI等の放射線診断（遠隔診断）/ tele radiology
パーソナルメディカルパートナー（2ndオピニオンサービス）/ 2nd opinion
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お問い合わせ内容 / details of your inquiry
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