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Passport Name *

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Date of birth(dd/mm/yy) *
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Surgery History *

Please include Surgical History and Allergy (be as specific as possible). *
Date of Surgery(dd/mm/yy) *

Promotion Info

THE TIME Plastic Surgery & Dermatology
Liposuction Revision
¥25,514 ¥38,270

Final Settlement Info

Price
38,270
Discout price
12,757
VATPrice
0 USD

The amount due
25,514