：：：The diagnosis for odontopathy patients by correspondence：：：
Name：
Sex：
Age：
Tel.：
Add：
P.C.：
Attack time：
Diagnosis：
Treated in which hospital：
Drugs used：
How the stomach and intestinal feel：
Sensitive to what drugs：
Symptoms and location：
 bleeding or not? swelling? shrinking? loose? deformation? pain degree? and dental caries?
left upper teeth left lower teeth upper incisor lower incisor right upper teeth right lower teeth

Remarks

If you have anything unclear about the products and information provided by our web-site, please contact us as soon as possible. Thanks a lot for your support.


　　　　　　　　　　
 
：：：The diagnosis for trigeminal neuralgia patients by correspondence：：：
Name：
Fax：
Age：
Profession：
Unit：
Tel.：
Detailed Add：
P.C.：
The earliest attack time:
Pain symptom：
Focus area
Right eye（the first one）
Right forehead（the second one）
Right low jaw（the third one）
Left eye（the first one）
Left forehead（the second one）
Left low jaw（the third one）
Basic situation
 Diagnosis in which hospital?
Received what treatment?
Allergic history?
Chronic disease history
Intestines and stomach?
Like cool food or hot food?
Constipation? （others）

Remarks

If you have anything unclear about the products and information provided by our web-site, please contact us as soon as possible. Thanks a lot for your support.


　　　　　　　　　　
 
 
 
Unit：Taiyuan Chinese Medicine Clinic for Trigeminal Neuralgia and Toothache
Tel.：0351—4176630 4191190
P.C.：030001 Add：No.8, Qingnianludong Street, Taiyuan, Shanxi
Bus Line：Bus No.11 from the Railway Station; Bus No.103 from the square and get off at Binxi Building
E-mail：zkmz@trigeminalnerve.com
　　　　like6630@public.ty.sx.cn