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| The nature and purpose of the operation, the risk involved, and the possibility of complocations have been explained |
| to me. I acknowledge that no guarantee to assurance has been made as to the result that may be obtained.
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| I aslo understand, and give permission to the doctor, when necessary involved under underseen events during |
| operation, to alter anesthesia, administer blood transfusion. And or provide surgical procedure in addition |
| to ablove stated operation(s),accerding to standard of good medical practice. I also consent to the disposal by |
| authroties of the above and Delight Fertility Clinic. Of any tissues of parts for which removed may be necessary. |
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