Family Contact Form

ISMRD  –   International Society for Mannosidosis & Related Diseases

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First Parent's Name
Additional Parent's Name (optional)
Name of Affected Family Member
If you have additional affected family members, we will contact you to gather the additional information below.
Address
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  • Pakistan+92
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  • Palestinian Territories+970
  • Panama+507
  • Papua New Guinea+675
  • Paraguay+595
  • Peru+51
  • Philippines+63
  • Poland+48
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  • Sri Lanka+94
  • St. Barthélemy+590
  • St. Helena+290
  • St. Kitts & Nevis+1
  • St. Lucia+1
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  • St. Pierre & Miquelon+508
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  • Sudan+249
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  • Taiwan+886
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Diagnosis of Affected Person
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