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Note :
  1. Please Fill All Required Fields .
  2. All Measurements To Be Taken In Centimetres
  3. Means this field is Not Required !!
  4. Please Fill Left or Right or both as per your Requirement
  5. Click on the image to fill the measurements

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Enter the value in specific box

# Measurement Required Cms
1.
Circumference Above Eyebrow
2.
Circumference Below Nose
3.
Circumference Around Head at Chin Angle
4.
Circumference of Neck
5.
Length of Nose
6.
Width of Nose
7.
Width of eyes
8.
Length of Ear
9.
Width of Mouth
10.
Chin To mouth
11.
Chin To Eyes
12.
Length of Buccal Cavity
13.
Length Between Circumference

Note:- All the fields below are required to be filled. order form will not be submitted if left blank

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Select the Thread Colour *

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Silicone Gel Sheet
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Upload Image of the burn/scar area
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