Consultation

Request for Consultation
Present Complaints
Personal History
Milestones of Life
Past / Childhood History
Family History
Appetite & Thirst
Bowel Habits
Urination & Urine
Sweat
Miscellaneous
Additional Queries for Female Patients

What about salivation?

Normal

Excessive

Dry

How is the quality of your sleep most of the time?

Rested and refreshed

Feel tired most mornings

Do you dream at all? If you do, do you remember them, What is the content?

Yes

In general, do you like being out in the open air or do you feel more comfortable in closed rooms?

Out in the open

More comfortable in closed rooms

How would you describe yourself?

Amiable

Loner

Quite social

Very picky

Particular about cleanliness and keeping appointments

Things to be done in a certain way or at a particular time

How do you react to stress and tension?

Tend to be verbally expressive

Tend to keep things to self and brood about them

Additional Information, if any?

Consultation

Request for Consultation

Present Complaints

Personal History

Milestones of Life

Past / Childhood History

Family History

Appetite & Thirst

Bowel Habits

Urination & Urine

Sweat

Miscellaneous

Additional Queries for Female Patients

Request for Consultation

Present Complaints

Personal History (Habits)

Milestones of Life

History of Trauma

Past / Childhood History

Family History

Appetite & Thirst

Bowel Habits

Urination & Urine

Cold / Cough

Sexual Sphere

Sweat

Miscellaneous

Additional Queries for Female Patients

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Consultation

Request for Consultation

Present Complaints

Personal History

Milestones of Life

Past / Childhood History

Family History

Appetite & Thirst

Bowel Habits

Urination & Urine

Sweat

Miscellaneous

Additional Queries for Female Patients

Request for Consultation

Present Complaints

Personal History (Habits)

Milestones of Life

History of Trauma

Past / Childhood History

Family History

Appetite & Thirst

Bowel Habits

Urination & Urine

Cold / Cough

Sexual Sphere

Sweat

Miscellaneous

Additional Queries for Female Patients

Thank You! We have received your mail. Our Team member will contact you soon.

Sorry, Please try again!

Thank You! We have received your mail.
Our Team member will contact you soon.