NIFTY pro survey | Test NIFTY pro Przeskocz do treści
Autoryzowane placówki i wizyty domowe w całej Polsce
Autoryzowane placówki i wizyty domowe w całej Polsce
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Ponad 200 punktów pobrań i wizyty w całej polsce
badanienifty.pl NIFTY pro survey

NIFTY pro survey

IMPORTANT: If on the day of sample collection the data provided in the survey changes, be sure to contact us to update the data.

    1. Name and surname*:  






    7. Weight and height*:





    Date of last dose:

    Transplant date:

    Term of therapy completion:

    Questions regarding the last 12 months
    (in case of a situation older than 12 months, please tick NO)

    Term of therapy completion:

    Term of therapy completion:

    Term of therapy completion:

    Term of therapy completion:

    Term of therapy completion:

    Term of therapy completion:

    Questions about the current pregnancy

    Date:


    *mandatory fields

    IMPORTANT: If on the day of sample collection the data provided in the survey changes, be sure to contact us to update the data.

    Zrób test NIFTY pro w domu z wynikiem ONLINE

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