D_Upload Clinical Case (p-2-x-2 NN)

Submission of Clinical Cases

1. Case Provider Information

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Name *

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Member Number *

Email *

Phone Number *

2. Case Information

Disease *

Treatment Method *

DAte of Case *

Subject *

Select Platform for Collaboration *

Case Summary Description *

Please note that the clinical case submitted is for discussion among Doctors and CMP only in a way to facilitate collaboration among Chinese-Western medicine professionals. Information leading to identification of the patients should be not be used. Therefore ................

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p-2-X-2 NN