### Immunity Booster Program
Kanaka Prashana / Suverna Prashana Program Inquiry Form

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Parent Details*

Child Details*

You want to Consult Dr. Ashish*

Online
In Person at Kanakaveda Clinic - Bandra
In Person at Kanakaveda Clinic - Vasai
Kanakaveda's Referance You Got From*

Kanakaveda's Patient
TV Interview
YouTube
Relative

#### Consultation - Rs. 2000 /-

Please Select A Program from below, according you will get detail information. (Excluding GST)*

#### Courier Charges applicable (Domestic)

3 Months- Rs. 300/- , 6 Months- Rs. 600/-, 12 Months - Rs. 1200/-.

#### Courier Charges for International as per actual.

#### Transactions will be online only

KANAKAVEDAA/c no. : 04087630002016
IFSC code : HDFC0000408
Branch: HDFC BANK, Vasai (W), Ambadi Road,
OR G Pay Number 9820145314

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