Nume:____________________________ ; Prenume:________________________________ Nr. de telefon:______________________; E-mail:___________________________________ Varsta:________; Mediul de lucru:_______________________________________________
II. Examen vizual:
Tipul morfologic al fetei:______________________________________________________ Coloratia pielii:______________________________________________________________ Aspectul pielii: ______________________________________________________________ Aspectul porilor:_____________________________________________________________ Imperfectiuni inestetice:______________________________________________________ Riduri (relief si tipuri):________________________________________________________