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Home : Consult Our Yoga Experts : Serious or Specific Disorders Ask Our Experts   Name Age (Years.) Sex Male Female Select Marital Status Married UnMarried Divorced Widowed Select e-Mail Type of Solution Select Yoga Nature Care 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 Physical Physcological Emotional Sexual Social Any Other Select 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 High Low Nil Normal Select The nature of your thirst High Low Nil Normal Select The nature of your perspiration High Low Nil Normal Select Your Tongue usually remains Coated Cracked Pink Red Select Your sleeping pattern is Select Normal Disturbed Not Adequate(below 6 hrs) Excessive sleep Your mental state is of type Anxious Depressed Irritable Normal Peaceful Select 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? Select None Smoking Alcohol Drugs Any Other If other, (pls.specify) Are you allergic to anything? Yes No Select     If yes, what? What part of the body gets affected? What foods do you like? Vegetarian Non-Veg A Combination Anything else Select 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 Long Cycle Short Cycle Normal None Any Other Select Duration of a period usually (days) Any pain if suffered Yes No Select     If female and have a child: No. of deliveries Type of deliveries Select Normal Vacumn Forceps Caesarean None 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.           Join us on Facebook!   Follow us on Twitter!

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