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Type of help *:

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Information about the project

Project name *:

Name(who needs help) *:

Date of birth *:


Region *:

City оf residence *:

Project description *:

Required amount *:

Where will the treatment be? *:

Attach documents of pictures

Pictures of the project *:

Application by parents *:

Passport(1st and 2nd page) *:

Birth certificate *:

Additional information :

Treatment indications *:

Bank account of the hospital *:


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