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(Kindly fill the relevant information or tick, as appropriate.)
5%-10% 10%-30% >30%
20-30 years 30-40 Years 40-50 Years >50 Years
Tinea cruris Tinea corporis Tinea pedis Onychomycosis Any Other
If any other, please specify
<1 week 1-2 week 2-4 week >4 week
Yes No
Luliconazole Amorolfine Terbinafine Clotrimazole
2 week 2-4 week >4 week