Step {{ currentPage }} of 4
Appointment Booking for Mega Healing Camp
{{ errors.fullName }}
{{ errors.phone }}
{{ errors.email }}
Select your state
Select your city in {{ formData.state }}
Select preferred location in {{ formData.city }}
Select preferred date
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Name: {{ formData.fullName }}
Phone: {{ formData.countryCode.flag }} {{ formData.countryCode.dialCode }} {{ formData.phone }}
Email: {{ formData.email }}
Location: {{ formData.area }}, {{ formData.city }}, {{ formData.state }}
Address: {{ selectedLocation.address }}
Date: {{ formData.selectedDate.format("dddd, MMM Do YYYY")}}
{{ errors.consent }}
{{ responseModal.success ? 'Success!' : 'Error' }}
{{ responseModal.message }}
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