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Please fill in as much as you are comfortable with.
● Name of the person concerned
● Age of the person concerned
● Your relationship with this person
● Gender of the person concerned
● Physical characteristics of the person (e.g., hairstyle, whether they wear glasses, etc.)
● Place of residence of the person
● What kind of outcome are you hoping for? (What result would you consider ideal?)
● Please tell us the background or reason that led you to request a ritual service.
● Please describe your feelings toward the person concerned.
● If you have any other questions or concerns regarding this request, please write them here.