+(503) 2338-5345 / +(503) 7190-3298

4th East Street #2-3, In Front of the Green Cross, Lourdes, Colón, La Libertad, El Salvador, C.A

hospital@hlourdes.com

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Contact us about anything related to our company or services.
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PATIENT INFORMATION

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Suffering

Phone Number

Email *

Subject / Treatment to be quoted *

Question *

Address

PATIENT'S RESPONSIBLE INFORMATION

Full name *

Kinship *

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Phone *

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My Company
3575 Fake Buena Vista Avenue
+1 (650) 555-0111
info@yourcompany.example.com

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