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C Ije64— 12pced <br /> TANTRA INK <br /> HOUSE OF PERMANENT MAKEUP <br /> CC1 .11=.1 IT TIT VT\ IH IT 111 . \1 <br /> QEyebrows <br /> ,OEyes <br /> O Li ps <br /> Client Name Date Time <br /> Treatment/s carried out <br /> Pigment.colors used Technique used <br /> Brand Blade/Needle(s) used Pain level/Bleeding <br /> Procedure notes <br /> TECHNICIAN SIGNATURE: <br /> Agreed Fee Deposit Paid Retouch Fee <br /> RETOUCH TREATMENT <br /> I can confirm there have been no change to my medical history since the last treatment. <br /> CLIENT NAME (PRINTED): CLIENT NAME (SIGNATURE): DATE: <br /> Date Time <br /> Treatment/s carried out <br /> Pigment colors used Technique used <br /> Brand Blade/Needle(s) used Pain level/Bleeding <br /> Procedure notes <br /> TECHNICIAN SIGNATURE: <br /> N209-601-1326 TANTRAINK dYAHOO.COM `1TANTRAINK.HPM <br />