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Please email the treatment papers of the patient undergoing chemotherapy along with her photograph at email@example.com
After scrutiny, a free synthetic hair wig will be couriered at your address.
I understand that by filling up the form for a free wig donated by Madat Trust, I'm giving consent for the use of my photograph by Madat Trust in any form or medium for the purpose of creating awareness about their activities and for their records. l'll email my photograph with and without the wig.
|Thanks & regards
|Dr Anand Parihar