SlideShare a Scribd company logo
1 of 106
Download to read offline
Planet
health(care)
for 7 years on a row, now with all time high, 

the Dutch healthcare system rates best in
European Health Consumer Index (EHCI)
for 7 years on a row, now with all time high, 

the Dutch healthcare system rates best in
European Health Consumer Index (EHCI)
©lucienengelen
Allistair Croll
Scale comes from process, IP, org chart, 

standardization, capitalization.
All of these assume the

future will be like the past, only more so.
time
performance
0
@lucienengelen 2011
time
performance
0
pre-gap
@lucienengelen 2011
time
performance
0
pre-gap
@lucienengelen 2011
Travel
Media
Taxi
Banking
Retail
time
performance
0
pre-gap
post-gap
@lucienengelen 2011
Travel
Media
Taxi
Banking
Retail
time
performance
0
pre-gap
post-gap
@lucienengelen 2011
Travel
Media
Taxi
Banking
Retail
Health(care)
The Innovation Bulb
@lucienengelen 2017
“The end of the beginning”
©lucienengelen 2017 The End of the beginning
The will
The Innovation Bulb
@lucienengelen 2017
“The end of the beginning”
©lucienengelen 2017 The End of the beginning
The need
The will
The Innovation Bulb
@lucienengelen 2017
“The end of the beginning”
©lucienengelen 2017 The End of the beginning
Leadership
The need
The will
The Innovation Bulb
@lucienengelen 2017
“The end of the beginning”
©lucienengelen 2017 The End of the beginning
Strategy
Leadership
The need
The will
The Innovation Bulb
@lucienengelen 2017
“The end of the beginning”
©lucienengelen 2017 The End of the beginning
Processes & Technology
Strategy
Leadership
The need
The will
The Innovation Bulb
@lucienengelen 2017
“The end of the beginning”
©lucienengelen 2017 The End of the beginning
Processes & Technology
Strategy
Culture
Leadership
The need
The will
The Innovation Bulb
@lucienengelen 2017
“The end of the beginning”
©lucienengelen 2017 The End of the beginning
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
Photo courtesy of Christian Lüthen
Radboud University
Medical center
Founding Director
REshape Center
Global Strategist
Digital Health
Deloitte Center
for the Egde
Core Faculty
Exponential Medicine
Singularity University
©lucienengelen
Live vitals in clinical patients
From three times daily to
24/7 continuous monitoring
Lean monitoring
… when they need to be
Continuous & Proactive
Health data now
Live vitals of patients Triple A
Philips
Apple
Ge
Verily (google)
Medtronic
Alibaba
Pharma
©lucienengelen
©lucienengelen
Medical Observational
Year Years to reach 100
Million people
©lucienengelen
Year Years to reach 100
Million people
©lucienengelen
Year Years to reach 100
Million people
Months!Years
©lucienengelen
©lucienengelen
Health(care)
When people talk
about us when
we’re not at the table :
we are on the menu
©lucienengelen
The Healthcare User Experience
(H-UX) is broken



And needs Social RE-calibration
©lucienengelen
The Healthcare User Experience
(H-UX) is broken



And needs Social RE-calibration
©lucienengelen
©lucienengelen
History
proves over
and over
And yet…
We don’t seem
to learn from
it
©lucienengelen
History
proves over
and over
And yet…
We don’t seem
to learn from
it
©lucienengelen
Nicolai
Copernicus
1500
©lucienengelen
Nicolai
Copernicus
1500
©lucienengelen
Health(care)’s Copernican moment
Nicolai
Copernicus
1500
©lucienengelen
Professional
Patient
Health(care)’s Copernican moment
Nicolai
Copernicus
1500
©lucienengelen
Professional
Patient
Patient
Professional
Health(care)’s Copernican moment
Nicolai
Copernicus
1500
Digital strategy is not translating
what you do now,digitally.



It is completely rethinking 

your model grounds-up
©lucienengelen
Digital strategy is not translating
what you do now,digitally.



It is completely rethinking 

your model grounds-up
©lucienengelen
Digital strategy is not translating
what you do now,digitally.



It is completely rethinking 

your model grounds-up
©lucienengelen
#howto?
©lucienengelen
Automating
something digital.
Creating the new
normal. Becoming a
commodity :
calculator
Doing something
digital that was done
analog,
The Digital healthcare Transformation
Digitizing Digital

Transition
Digital

Transformation
©lucienengelen
Automating
something digital.
Creating the new
normal. Becoming a
commodity :
calculator
Doing something
digital that was done
analog,
The Digital healthcare Transformation
Digitizing Digital

Transition
Digital

Transformation
Cahier > App
©lucienengelen
Automating
something digital.
Creating the new
normal. Becoming a
commodity :
calculator
Doing something
digital that was done
analog,
The Digital healthcare Transformation
Digitizing Digital

Transition
Digital

Transformation
Cahier > App App > Smartphone
©lucienengelen
Automating
something digital.
Creating the new
normal. Becoming a
commodity :
calculator
Doing something
digital that was done
analog,
The Digital healthcare Transformation
Digitizing Digital

Transition
Digital

Transformation
Cahier > App App > Smartphone Part of Operating System
©lucienengelen
Automating
something digital.
Creating the new
normal. Becoming a
commodity :
calculator
Doing something
digital that was done
analog,
The Digital healthcare Transformation
Digitizing Digital

Transition
Digital

Transformation
Apps Eco-system Clinics
©lucienengelen
Automating
something digital.
Creating the new
normal. Becoming a
commodity :
calculator
Doing something
digital that was done
analog,
The Digital healthcare Transformation
Digitizing Digital

Transition
Digital

Transformation
Logistics and data center Brick & mortar Healthcaresystem
©lucienengelen
from a caddy
for the few
To a caddy
for all
©lucienengelen
from a caddy
for the few
To a caddy
for all
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
Have a seat lucien,
You’ll run
through
a heart attack
In 15 minutes
from now.
©lucienengelen
Disruptive monitoring with new parameters
Blood glucose HRV
X
Interval X = 30 minutes
5.5 mmol/L
3.9 mmol/L
Early Warning Heart Rate Variability for drop glucose level
©lucienengelen
Digital first, physical next?
©lucienengelen
Digital first, physical next?
©lucienengelen
Healthcare will become a software branch.
©lucienengelen
Healthcare will become a software branch.
©lucienengelen
©lucienengelen
Healthcare will
become a
software branch.
©lucienengelen
Healthcare will
become a
software branch.
©lucienengelen
Healthcare will
become a
software branch.
has
Radboudumc Virtual
Telemedicine & Telehealthcenter
©lucienengelen
Reference Center remote monitoring
NW European region
implementation
order
Radboudumc Virtual
Telemedicine & Telehealthcenter
©lucienengelen
Reference Center remote monitoring
NW European region
implementation
order
Radboudumc Virtual
Telemedicine & Telehealthcenter
©lucienengelen
Reference Center remote monitoring
NW European region
implementation
order
©lucienengelen
Video conferencing reimbursed in the NL
5 % of outpatient
visits
200 parking lots
a day
©lucienengelen
Video conferencing reimbursed in the NL
5 % of outpatient
visits
200 parking lots
a day
Forget ‘uberized’ health(care) will be ‘amazoned’. 

That journey is 80% logistics
©lucienengelen
©lucienengelen
from ‘Hospital’ to ‘Home’
©lucienengelen
from ‘Hospital’ to ‘Home’
from ‘Hospital’ to ‘Phone’
©lucienengelen
©lucienengelen
Innovation comes in flavours
For different phases
Awareness Groundwork Execution
0.0 - 1.0 0.8 - 1.2 1.0 - 100
©lucienengelen
Innovation comes in flavours
For different phases
Awareness Groundwork Execution
0.0 - 1.0 0.8 - 1.2 1.0 - 100
©lucienengelen
Innovation comes in flavours
For different phases
Awareness Groundwork Execution
0.0 - 1.0 0.8 - 1.2 1.0 - 100
©lucienengelen
Innovation comes in flavours
For different phases
Awareness Groundwork Execution
0.0 - 1.0 0.8 - 1.2 1.0 - 100
“The end of the beginning”
©lucienengelen
©lucienengelen
450 Freshmen in new curriculum ‘15
E-health - Social Media - Innovation with patients - Flipped classroom - BYOP
“be curious” ©lucienengelen
Powered by:
©lucienengelen
©lucienengelen
Delocalized
©lucienengelen
Delocalized
Democratized
©lucienengelen
Delocalized
Democratized
Digital
©lucienengelen
Delocalized
Democratized
Digital
Dollars
©lucienengelen
www.lucienengelen.com/book
@lucienengelen
803.214 followers

More Related Content

What's hot

Hartstichting 15 2-2017
Hartstichting 15 2-2017Hartstichting 15 2-2017
Hartstichting 15 2-2017Lucien Engelen
 
Opledingen is vooruit zien (federatie Med. Specialisten
Opledingen is vooruit zien (federatie Med. SpecialistenOpledingen is vooruit zien (federatie Med. Specialisten
Opledingen is vooruit zien (federatie Med. SpecialistenLucien Engelen
 
Stolte Advanced Studiereis 2017
Stolte Advanced Studiereis 2017Stolte Advanced Studiereis 2017
Stolte Advanced Studiereis 2017Lucien Engelen
 
Drechtsteden 17-11-2016
Drechtsteden 17-11-2016Drechtsteden 17-11-2016
Drechtsteden 17-11-2016Lucien Engelen
 
ICT & Health Experience
ICT & Health ExperienceICT & Health Experience
ICT & Health ExperienceLucien Engelen
 
Lucien Engelen Dagens Visit Sweden
Lucien Engelen Dagens Visit Sweden Lucien Engelen Dagens Visit Sweden
Lucien Engelen Dagens Visit Sweden Lucien Engelen
 
Stockholm #ledarskapsdagen2016
Stockholm  #ledarskapsdagen2016Stockholm  #ledarskapsdagen2016
Stockholm #ledarskapsdagen2016Lucien Engelen
 
Smarthealth masterclass e-health
Smarthealth masterclass e-healthSmarthealth masterclass e-health
Smarthealth masterclass e-healthLucien Engelen
 
Slides Lucien Engelen #Ehealthweek 2016
Slides Lucien Engelen #Ehealthweek 2016Slides Lucien Engelen #Ehealthweek 2016
Slides Lucien Engelen #Ehealthweek 2016Lucien Engelen
 
SingularityU Summit 2016 Amsterdam
SingularityU Summit 2016 AmsterdamSingularityU Summit 2016 Amsterdam
SingularityU Summit 2016 AmsterdamLucien Engelen
 

What's hot (20)

Hartstichting 15 2-2017
Hartstichting 15 2-2017Hartstichting 15 2-2017
Hartstichting 15 2-2017
 
Opledingen is vooruit zien (federatie Med. Specialisten
Opledingen is vooruit zien (federatie Med. SpecialistenOpledingen is vooruit zien (federatie Med. Specialisten
Opledingen is vooruit zien (federatie Med. Specialisten
 
#Ehealth2017 Toronto
#Ehealth2017 Toronto#Ehealth2017 Toronto
#Ehealth2017 Toronto
 
Stolte Advanced Studiereis 2017
Stolte Advanced Studiereis 2017Stolte Advanced Studiereis 2017
Stolte Advanced Studiereis 2017
 
Dica 9 juni 2017
Dica 9 juni 2017Dica 9 juni 2017
Dica 9 juni 2017
 
Drechtsteden 17-11-2016
Drechtsteden 17-11-2016Drechtsteden 17-11-2016
Drechtsteden 17-11-2016
 
ICT & Health Experience
ICT & Health ExperienceICT & Health Experience
ICT & Health Experience
 
JnJ bij MeanderMC
JnJ bij MeanderMCJnJ bij MeanderMC
JnJ bij MeanderMC
 
Radiologiedagen 2018
Radiologiedagen 2018Radiologiedagen 2018
Radiologiedagen 2018
 
Apps & Case
Apps & CaseApps & Case
Apps & Case
 
Clustertour Nijmegen
Clustertour NijmegenClustertour Nijmegen
Clustertour Nijmegen
 
Lucien Engelen Dagens Visit Sweden
Lucien Engelen Dagens Visit Sweden Lucien Engelen Dagens Visit Sweden
Lucien Engelen Dagens Visit Sweden
 
Hospitality group
Hospitality group Hospitality group
Hospitality group
 
TMG SUNL 30-11-2016
TMG SUNL 30-11-2016TMG SUNL 30-11-2016
TMG SUNL 30-11-2016
 
Stockholm #ledarskapsdagen2016
Stockholm  #ledarskapsdagen2016Stockholm  #ledarskapsdagen2016
Stockholm #ledarskapsdagen2016
 
Smarthealth masterclass e-health
Smarthealth masterclass e-healthSmarthealth masterclass e-health
Smarthealth masterclass e-health
 
Slides Lucien Engelen #Ehealthweek 2016
Slides Lucien Engelen #Ehealthweek 2016Slides Lucien Engelen #Ehealthweek 2016
Slides Lucien Engelen #Ehealthweek 2016
 
SingularityU Summit 2016 Amsterdam
SingularityU Summit 2016 AmsterdamSingularityU Summit 2016 Amsterdam
SingularityU Summit 2016 Amsterdam
 
Nvlo 2016 congres
Nvlo 2016 congresNvlo 2016 congres
Nvlo 2016 congres
 
Xmed 2016
Xmed 2016Xmed 2016
Xmed 2016
 

Similar to Xmed 2018

Grow with Philips event
Grow with Philips event Grow with Philips event
Grow with Philips event Lucien Engelen
 
Zorginnovatietrip Joris en Christan
Zorginnovatietrip Joris en ChristanZorginnovatietrip Joris en Christan
Zorginnovatietrip Joris en ChristanLucien Engelen
 
Dialyse congres Baxter Ede 30 11-2016
Dialyse congres Baxter Ede 30 11-2016Dialyse congres Baxter Ede 30 11-2016
Dialyse congres Baxter Ede 30 11-2016Lucien Engelen
 
Gyn kwaliteitsmiddag 2018
Gyn kwaliteitsmiddag 2018Gyn kwaliteitsmiddag 2018
Gyn kwaliteitsmiddag 2018Lucien Engelen
 
KNMP congres Patient Power 13 Maart 2018
KNMP congres Patient Power 13 Maart 2018KNMP congres Patient Power 13 Maart 2018
KNMP congres Patient Power 13 Maart 2018Lucien Engelen
 
Oncologie Verpleegkundige Specialisten VSO voorjaarscongres
Oncologie Verpleegkundige Specialisten  VSO voorjaarscongres Oncologie Verpleegkundige Specialisten  VSO voorjaarscongres
Oncologie Verpleegkundige Specialisten VSO voorjaarscongres Lucien Engelen
 
Bravis eHealth avond 17-11-2016
Bravis eHealth avond 17-11-2016Bravis eHealth avond 17-11-2016
Bravis eHealth avond 17-11-2016Lucien Engelen
 
Brazil Health Innovation Show '17
Brazil Health Innovation Show '17Brazil Health Innovation Show '17
Brazil Health Innovation Show '17Lucien Engelen
 
Lucien engelen data driven healthcare 2017 kl
Lucien engelen data driven healthcare 2017 klLucien engelen data driven healthcare 2017 kl
Lucien engelen data driven healthcare 2017 klLucien Engelen
 

Similar to Xmed 2018 (17)

Grow with Philips event
Grow with Philips event Grow with Philips event
Grow with Philips event
 
Dagens Medicine
Dagens MedicineDagens Medicine
Dagens Medicine
 
Venticare 2016
Venticare 2016Venticare 2016
Venticare 2016
 
Zorginnovatietrip Joris en Christan
Zorginnovatietrip Joris en ChristanZorginnovatietrip Joris en Christan
Zorginnovatietrip Joris en Christan
 
SGF dag Putten
SGF dag PuttenSGF dag Putten
SGF dag Putten
 
Dialyse congres Baxter Ede 30 11-2016
Dialyse congres Baxter Ede 30 11-2016Dialyse congres Baxter Ede 30 11-2016
Dialyse congres Baxter Ede 30 11-2016
 
Oost-NL
Oost-NLOost-NL
Oost-NL
 
Gyn kwaliteitsmiddag 2018
Gyn kwaliteitsmiddag 2018Gyn kwaliteitsmiddag 2018
Gyn kwaliteitsmiddag 2018
 
KNMP congres Patient Power 13 Maart 2018
KNMP congres Patient Power 13 Maart 2018KNMP congres Patient Power 13 Maart 2018
KNMP congres Patient Power 13 Maart 2018
 
Oncologie Verpleegkundige Specialisten VSO voorjaarscongres
Oncologie Verpleegkundige Specialisten  VSO voorjaarscongres Oncologie Verpleegkundige Specialisten  VSO voorjaarscongres
Oncologie Verpleegkundige Specialisten VSO voorjaarscongres
 
Zuyderland ehealth
Zuyderland ehealthZuyderland ehealth
Zuyderland ehealth
 
HIS 2de cohort dag 1
HIS 2de cohort dag 1HIS 2de cohort dag 1
HIS 2de cohort dag 1
 
Bravis eHealth avond 17-11-2016
Bravis eHealth avond 17-11-2016Bravis eHealth avond 17-11-2016
Bravis eHealth avond 17-11-2016
 
Denmark 10 11-16
Denmark 10 11-16Denmark 10 11-16
Denmark 10 11-16
 
Masterdialogen AMC
Masterdialogen AMCMasterdialogen AMC
Masterdialogen AMC
 
Brazil Health Innovation Show '17
Brazil Health Innovation Show '17Brazil Health Innovation Show '17
Brazil Health Innovation Show '17
 
Lucien engelen data driven healthcare 2017 kl
Lucien engelen data driven healthcare 2017 klLucien engelen data driven healthcare 2017 kl
Lucien engelen data driven healthcare 2017 kl
 

More from Lucien Engelen

Axira sessie (low res 2)
Axira sessie (low res 2)Axira sessie (low res 2)
Axira sessie (low res 2)Lucien Engelen
 
Healthcare meets retail 8 juni low res.pdf
Healthcare meets retail 8 juni  low res.pdfHealthcare meets retail 8 juni  low res.pdf
Healthcare meets retail 8 juni low res.pdfLucien Engelen
 
Wired Health Italia Lucien Engelen
Wired Health Italia Lucien EngelenWired Health Italia Lucien Engelen
Wired Health Italia Lucien EngelenLucien Engelen
 
Xmed 2019 Lucien Engelen
Xmed 2019 Lucien Engelen Xmed 2019 Lucien Engelen
Xmed 2019 Lucien Engelen Lucien Engelen
 
Book images Augmented Health(care)™
Book images Augmented Health(care)™Book images Augmented Health(care)™
Book images Augmented Health(care)™Lucien Engelen
 
Lucien Engelen ICThealth Conference 2018
Lucien Engelen ICThealth Conference 2018Lucien Engelen ICThealth Conference 2018
Lucien Engelen ICThealth Conference 2018Lucien Engelen
 
#Xmed Lucien Engelen 2017
#Xmed Lucien Engelen 2017#Xmed Lucien Engelen 2017
#Xmed Lucien Engelen 2017Lucien Engelen
 
Navenant Interview Lucien Engelen
Navenant Interview Lucien Engelen Navenant Interview Lucien Engelen
Navenant Interview Lucien Engelen Lucien Engelen
 

More from Lucien Engelen (11)

Axira sessie (low res 2)
Axira sessie (low res 2)Axira sessie (low res 2)
Axira sessie (low res 2)
 
Healthcare meets retail 8 juni low res.pdf
Healthcare meets retail 8 juni  low res.pdfHealthcare meets retail 8 juni  low res.pdf
Healthcare meets retail 8 juni low res.pdf
 
Wired Health Italia Lucien Engelen
Wired Health Italia Lucien EngelenWired Health Italia Lucien Engelen
Wired Health Italia Lucien Engelen
 
DocSF Berlin
DocSF BerlinDocSF Berlin
DocSF Berlin
 
Xmed 2019 Lucien Engelen
Xmed 2019 Lucien Engelen Xmed 2019 Lucien Engelen
Xmed 2019 Lucien Engelen
 
Book images Augmented Health(care)™
Book images Augmented Health(care)™Book images Augmented Health(care)™
Book images Augmented Health(care)™
 
BASIS 2018 Napels
BASIS 2018 Napels BASIS 2018 Napels
BASIS 2018 Napels
 
ROC Almere/Amsterdam
ROC Almere/AmsterdamROC Almere/Amsterdam
ROC Almere/Amsterdam
 
Lucien Engelen ICThealth Conference 2018
Lucien Engelen ICThealth Conference 2018Lucien Engelen ICThealth Conference 2018
Lucien Engelen ICThealth Conference 2018
 
#Xmed Lucien Engelen 2017
#Xmed Lucien Engelen 2017#Xmed Lucien Engelen 2017
#Xmed Lucien Engelen 2017
 
Navenant Interview Lucien Engelen
Navenant Interview Lucien Engelen Navenant Interview Lucien Engelen
Navenant Interview Lucien Engelen
 

Recently uploaded

Difference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac MusclesDifference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac MusclesMedicoseAcademics
 
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptxSwetaba Besh
 
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book nowChennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book nowtanudubay92
 
Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...
Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...
Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...soniyagrag336
 
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Available
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service AvailableLucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Available
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Availablesoniyagrag336
 
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...Dipal Arora
 
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...rajnisinghkjn
 
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana GuptaLifecare Centre
 
Cardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their RegulationCardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their RegulationMedicoseAcademics
 
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableCall Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableJanvi Singh
 
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...Janvi Singh
 
Circulatory Shock, types and stages, compensatory mechanisms
Circulatory Shock, types and stages, compensatory mechanismsCirculatory Shock, types and stages, compensatory mechanisms
Circulatory Shock, types and stages, compensatory mechanismsMedicoseAcademics
 
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...dishamehta3332
 
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...gragneelam30
 
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...Cara Menggugurkan Kandungan 087776558899
 
Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...
Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...
Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...call girls hydrabad
 
Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...
Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...
Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...chanderprakash5506
 
💞 Safe And Secure Call Girls Coimbatore🧿 6378878445 🧿 High Class Coimbatore C...
💞 Safe And Secure Call Girls Coimbatore🧿 6378878445 🧿 High Class Coimbatore C...💞 Safe And Secure Call Girls Coimbatore🧿 6378878445 🧿 High Class Coimbatore C...
💞 Safe And Secure Call Girls Coimbatore🧿 6378878445 🧿 High Class Coimbatore C...dilbirsingh0889
 
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Wayanad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 

Recently uploaded (20)

Difference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac MusclesDifference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac Muscles
 
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
 
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book nowChennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
 
Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...
Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...
Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...
 
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Available
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service AvailableLucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Available
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Available
 
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
 
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
 
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
 
Cardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their RegulationCardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their Regulation
 
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableCall Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
 
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
 
Circulatory Shock, types and stages, compensatory mechanisms
Circulatory Shock, types and stages, compensatory mechanismsCirculatory Shock, types and stages, compensatory mechanisms
Circulatory Shock, types and stages, compensatory mechanisms
 
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
 
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
 
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
 
Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...
Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...
Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...
 
Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...
Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...
Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...
 
💞 Safe And Secure Call Girls Coimbatore🧿 6378878445 🧿 High Class Coimbatore C...
💞 Safe And Secure Call Girls Coimbatore🧿 6378878445 🧿 High Class Coimbatore C...💞 Safe And Secure Call Girls Coimbatore🧿 6378878445 🧿 High Class Coimbatore C...
💞 Safe And Secure Call Girls Coimbatore🧿 6378878445 🧿 High Class Coimbatore C...
 
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Wayanad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service Available
 

Xmed 2018