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Endoscopia y Colonoscopia/Endoscopy and Colonoscopy
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Ciudad/City
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Puerto Vallarta
Guadalajara
Chapala
CDMX
Nombre del paciente/Patient name
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Your answer
Fecha de nacimiento/ Date of birth
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Your answer
Tipo de estudio/Type of study
*
Endoscopia/Endoscopy
Colonoscopia/Colonoscopy
Other:
Numero/Number WhatsApp
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