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 Hair sample by Post

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First Name:   Surname:

Address:

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Any Organs Removed? If Yes, which?:

Major Medications?

The Health Test Session for 1 Patient is 85.00 Euro.

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Turner Clinic of Alternative Medicine,
13 Cunningham Park,
Cornelscourt,
Foxrock,
Dublin 18,
Ireland.

Please make Bank Draft payable to Ronnie Turner.

Please note: your Health Test will not be processed until payment is received and will subsequently take longer if paid by Bank Draft.

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