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Strict Standards: Declaration of nc_Message::delete_by_id() should be compatible with nc_Essence::delete_by_id($id) in /var/www/contour/contour.org.ua/panel/system/essences/nc_message.class.php on line 184

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Strict Standards: Declaration of nc_cache_browse::nocacheReplace() should be compatible with nc_cache::nocacheReplace($data) in /var/www/contour/contour.org.ua/panel/modules/cache/nc_cache_browse.class.php on line 404

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Strict Standards: Declaration of nc_cache_function::nocacheReplace() should be compatible with nc_cache::nocacheReplace($data) in /var/www/contour/contour.org.ua/panel/modules/cache/nc_cache_function.class.php on line 493

Strict Standards: Declaration of nc_cache_function::nocacheStore() should be compatible with nc_cache::nocacheStore(&$data) in /var/www/contour/contour.org.ua/panel/modules/cache/nc_cache_function.class.php on line 493

Strict Standards: Declaration of nc_cache_calendar::nocacheReplace() should be compatible with nc_cache::nocacheReplace($data) in /var/www/contour/contour.org.ua/panel/modules/cache/modules/nc_cache_calendar.class.php on line 385

Strict Standards: Declaration of nc_cache_calendar::nocacheStore() should be compatible with nc_cache::nocacheStore(&$data) in /var/www/contour/contour.org.ua/panel/modules/cache/modules/nc_cache_calendar.class.php on line 385

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Notice: Use of undefined constant CONTROL_CLASS_CLASS_FORMS_EDITRULES - assumed 'CONTROL_CLASS_CLASS_FORMS_EDITRULES' in /var/www/contour/contour.org.ua/panel/admin/lang/Russian_utf8.php on line 215

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<br /> <b>Notice</b>: Undefined variable: f_seo_name_ukr in <b>/var/www/contour/contour.org.ua/template/template/7/Header.html</b> on line <b>42</b><br />

Реєстрація

Важливо! Щоб зареєструвати покупку пристрої для вимірювання рівня глюкози в крові Contour Plus для обміну протягом терміну служби, заповніть цей талон. Після реєстрації Ви отримаєте можливість обміняти Ваш глюкомерт Contour Plus протязі необмеженого терміну.
Iм`я
Прізвище
По батькові
Дата народження
Стать
Чоловік Жіночий
Країна
Населений пункт
Дата заповнювання анкети
Вулиця
Будинок
Корпус
Квартира
Номер телефону
Email
Пароль
Повтор пароля
Дата придбання приладу
Серійний номер приладу
Кількість вимірювань на тиждень
2 рази в день або частіше
1 раз в день
2-3 рази на тиждень
1 раз в тиждень
2-3 рази на місяць
1 раз на місяць
Чи був у Вас глюкометр раніше?
Якщо так, то який?
нi
так
Тип діабету
I тип (на інсуліні)
II тип (без інсуліну)
II тип (з інсуліном)
Як ви дізналися про глюкометр?
від лікаря
від знайомих
по телевізору
по радіо
Пароль
листівки

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