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かかりつけ患者 登録フォーム
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登録が完了しますと、ご記入いただいたメールアドレスに、かかりつけ患者さん専用の電話番号を通知します(通知がこなかった場合は、お手数ですが診療時間内にお電話ください)。
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年齢は6歳未満(5歳まで)ですか?
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