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Get Tinseltown Farringdon Address Form

: Customer Full address: Telephone No: Email: Post code: ALL PRODUCTS CONSUMED BY CUSTOMER AT RESTAURANT : SYMPTOMS Date Time started Time End Severity Sickness Diarrhoea Abdom pain Headache Fever Nausea Other (Specify) Please list all products consumed 24hrs Prior to being ill. Has the customer visited the doctor or Hospital? Did the customer provide a stool sample? Is a medical certificate available? Have any family members / colleagues / friends sufered with similar symptoms Has t.

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