Dear User,

We are happy that you have visited our site to become aware of diabetes and footcare. We strongly appreciate your decision of registering with us. On registering with us you would have the following benefits:

  • You can send it your queries and get clarification for the same.
  • You will be sent regular New letters.
  • You can also fix prior appointment with us through email appointments@mvdiabetes.com

Personal Details
   
Name (in full)
Gender
Age
Nationality
Address
City
State
Country
Pincode
Telephone-1
Telephone-2
Mobile
Fax
Email
 
Diabetic History
   
Duration of Diabetes Years 
Height cms 
Weight kgs 
Treatment type : (insulin / drugs / diet)
Alcohol
Smoking
History of previous foot complication/Allergy
How many times?
Specific foot problems
Name of your family Doctor

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