Online Cosmetic Consultation Cosmetic consultation with Dr RajeevConsultation fee ₹ 500Please enable JavaScript in your browser to complete this form.Name *Mobile Number for digital consultation *Age *GenderFemaleMaleOtherEmailYour Concern on faceWrinkles ( Frown lines / Forehead lines / Crow's feet )Cheek SaggingLoose SkinUnder Eye HollownessDark CirclesFolds around LipThin LipsJawlineChinNose BumpScarsOthersDescribe your concern on faceConcern on NeckLoose Skin on neckNeck BandNeckless linesWrinkles on neckOthersDescribe your concern on neckOther Cosmetic ConcernStretch MarksDark SpotsDouble ChinWrinkled HandsLoose ArmsLoose TummyUpper Chest WrinklesSmall BreastHairExcessive sweatingOthersDescribe your concernHow long have you had this Condition *Few DaysFew WeeksFew MonthsFew YearsMode of Payment *PaytmQR Code ScanOnline Bank TransferNoneTransaction ID of PaymentCheck below *I consent for cosmetic tele-consultation with Dr RajeevNameSubmit Payment mode detailsConsultation fee ₹ 500 QR Code Scan Paytm9810521212 Online Bank TransferRajeev R SrivastavHDFC Bank Current A/C 50200028100250 IFSC: HDFC0001662
