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  1. What country you are travelling to
  2. What areas of the country you are travelling to 
  3. How many days you will be away for 
  4. The date of arrival and the date of departure



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If yes, please list them


If so, then please list them. This includes over the counter medication, prescription medication, and recreational drugs




If yes, please list them




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The photo will only be used to verify your identity and will not be shared elsewhere. We aim to strictly adhere to data protection legislation and rigorously maintain patient confidentiality.

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