Online Consultation FormUncategorized / By neograftchandigarh Please enable JavaScript in your browser to complete this form.name age *sexmalefemale Date / Time *DateTimePhone *Email *MAIN COMPLAINTS/AILMENTS HAIR FALL.HAIR THINNING BUT NO HAIR FALL.HAIR FALL FROM BACK OF HEAD AND FROM BODY.RECEDING HAIR LINE MENRECEDING HAIR LINE WOMENWIDENING PARTITION IN WOMEN.HAIR THINNING WITH HAIR FALLDANDRUFF/SEBORRHEA ON SCALP.SEBORRHEA ON SCALP BEARD AND BODY TOO.ITCHING ON SCALP.HAIR LOSS IN SPOTS ON SCALP.PUS FILLED SRUPTIONS ON SCALP.MORE DETAILS IF YOU WANT TO ADD REGARDING HAIR FALL TELL US ABOUT SEVERITY OF HAIR FALL 10-20 STRANDS/HAIR PER DAY20-30 STRANDS/HAIR PER DAY30-50 STRANDS/HAIR PER DAYMORE THAN 50 STRANDS/HAIR PER DAYMORE THAN 100 STRANDS PER DAY TELL US ABOUT MEDICINES YOU HAVE ALREADY TAKEN SERUM MINOXIDIL 5 %SERUM MINOXIDIL 5 % PLUS FINASTERIDE SERUM PROCAPILSERUM REDENSYLKETOCONAZOLE SHAMPOOKETOCONAZOLE LOTIONCOALTARTABLET FINASTERIDE TABLET DUTASERIDE MULTIVITAMINS TELL US ABOUT ANY OTHER DISEASE WHICH YOU ARE SUFFERING FROM THYROID DISORDERPCODANY OTHER DISEASE ANY OTHER DETAILS FOR CONCURRENT DISEASE FAMILY HISTORY HAIR FALLFATHER, GRAND FATHER HAVE BALDNESSMOTHER, MATERNAL UNCLE, MATERNAL GRAND FATHER HAVE BALDNESSNEITHER HAS BALDNESSPLEASE UPLOAD YOUR PICS FROM FRONT, TOP , SIDES, BACK OF HEAD WET AND DRY CONDITION Click or drag files to this area to upload. You can upload up to 10 files. Submit Related
