Suggestions Form Suggestions Form Name* Family* State*East AzarbaijanWestern AzerbaijanArdabilEsfahanAlborzIlamBushehrTehranChaharmahal and Bakhtiarisouthern KhorasanKhorasan RazaviNorth KhorasanKhuzestanZanjanSemnanSistan and BaluchestanFarsghazvinQomKurdistanKermanKermanshahKohgiloyeh and BoyerahmadGolestanGilanLorestanMazandaranMarkeziHormozganHamedanYazdCity Mobile*Email* Medicine*Syrupeye dropOral dropsCream and gelOintmentsuppositoryMedicine name* Complaints or side effects of the drugCpatchaNameThis field is for validation purposes and should be left unchanged.
