คลินิกเวชกรรม สวท Basic Information Name(Required) Surname(Required) Age(Required) Province(Required)BangkokswordKanchanaburiKalasinKamphaeng PhetKhon KaenChanthaburiChachoengsaochon buriChai NatChaiyaphumChumphonchiang raiChiang MaiTrangTratTakNakhon NayokNakornpathomNakhon PhanomNakhonratchasimaNakhon Si ThammaratNakornsawanNonthaburiNarathiwatNanBueng Kanburi ramPathum ThaniPrachuap Khiri KhanPrachin BuriPattaniAyutthayaPhang NgaPhatthalungPhichitPhitsanulokPhetchaburiPhetchabunspreadPhayaoPhuketMahasarakhampearlmae hong sonYasothonYalaroi etRanongRayongRatchaburiLop BuriLampangLamphunfurtherSisaketSakon NakhonSongkhlaSatunSamut PrakanSamut SongkhramSamut SakhonSa KaeoSaraburising buriSukhothaiSuphan BuriSuratthaniSurinNong KhaiNong Bua LamphuAng ThongUdon ThaniUttaraditUthai ThaniUbon RatchathaniAmnatcharoenMedical History/Personal Illness Birth History(Required)nevernatural birthCaesarean section
