- Physical Generals
- Mental Generals
Phone Number (Include Country Code)
Address Include Nationality
Height (Ft.) & Weight (Kg)
Urine Color (Pale, Yellow, Clear, Mixed with blood, Foamy etc..)
Thermals (Which weather affects you more)
Describe Yourself, Your Strength, Ambition and Weakness Your Nature
Are you Anxious ? About What ?What makes you angry ?
Do you like to be in company or like to be alone ?- Do you weep easily? If someone console you when you are upset, does it help or worsen the situation ?
How is your memory ? (Hint – Good, Poor, Forgetful, etc..) – Do you have fear of anything ?
Main Complaint Location, Sensation when does it increase and decrease
Past History Any other major illness in past and its treatment
Family History Mention Diseases that happen to occur in your blood relations (Example – BP, Thyroid, Sugar, Asthma, etc..)
Medicinal History Taking medicines, if any ? Please mention disease and name of medicine
Latest Medical Reports, if any ?
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