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Name
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Email
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Address
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Phone number
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Whatsapp number
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Age
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Weight
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Height
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Describe your issue
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What measures you have taken to reduce your weight
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dieting
walking and exercising
gym
other measures
Are you concerned about your weight and health and wish to fix it
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yes
no
Which slot would you prefer for joining the free session
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morning 7:30-8:30
evening 7:00-8:00
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