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Home : Consult Our Yoga Experts : Serious or Specific Disorders Bookmark and Share
Ask Our Experts
 
Name Age (Years.)
Sex Marital Status
e-Mail Type of Solution
Past Complaints and Treatments Taken
(This not only includes ailments but past diseases, accidents, operations, etc. or anything that you have suffered for more than 15-30 days):
Problem #1 Treatment/ Medication Taken Since no. of Days

Maximum of 500 Words

Maximum of 500 Words
Problem #2 Treatment/ Medication Taken Since no. of Days
Maximum of 500 Words Maximum of 500 Words  
Problem #3 Treatment/ Medication Taken Since no. of Days
Maximum of 500 Words Maximum of 500 Words  
Present Complaints If other, (pls.specify)
Name Of Disease
(If Diagnosed)
   
Symptoms Experienced
Maximum of 500 Words
Investigation
(Any type of tests and their report, if any)

Maximum of 500 Words
Heriditary/ Genetical Diseases Your appetite is
The nature of your thirst The nature of your perspiration
Your Tongue usually remains Your sleeping pattern is
Your mental state is of type How many times usually do you pass bowels?
What is the color of your stool? Your height
Your weight Any form of exercise that you practice?
Any addiction? If other, (pls.specify)
Are you allergic to anything?    
If yes, what? What part of the body gets affected?
What foods do you like? If other, (pls.specify)
Is their any strong dislike regarding your food habit?    
If female, then please provide details regarding your periods/menstruation cycle:
Gap between periods Duration of a period usually (days)
Any pain if suffered    
If female and have a child:
No. of deliveries Type of deliveries
Abortion (if any), give reasons
Maximum of 500 words
Pulse rate B.P.
    (if you know how to take or have the necessary device to measure)
Present Dietary details :    
Routine Time Details (What do you usually consume?)
Breakfast
Mid-Morning
Lunch
Tea
Dinner
Snacks(if any)
Bed time
Any past diet (in short) if different from present
Maximum of 500 words
I understand that this advise is only of an advisory nature and not prescriptive.It is not meant as a substitute to a doctor's advise.Health and Yoga undertake no responsibility for the advise mentioned.
   

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