Patient Information Form First - Middle - Last Name مکمل نام Date Of Birth تاریخ پیدائش Gender صنف MaleFemale Height قد Weight وزن Marital Status ازدواجی حیثیت SingleMarriedWidowedDivorced Occupation پیشہ Contact Number رابطہ نمبر WhatsApp Number واٹس ایپ نمبر Email ای میل Blood Group خون کا گروپ —Please choose an option—A+A-B+B-AB+AB-O+O- Body Frame Type جسمانی ساخت Large frame, more musclesLarge frame, more fatsMedium frame, leanThin/bony frame (Short/tall) Skin Touch & Texture جلد کا لمس اور حالت Moderate in Softness and dryness. Warm to the touchSoft, Moist and ColdDry and WarmDry, rough and Cold Skin Complexion جلد کی رنگت Reddish, glowingPale/WhiteYellowishGrayish Hair بال Thick, Oily, Wavy/StraightThin, Oil, StraightModerate in thickness and softness, straight, LongDry, tends to curl Physical Activity جسمانی حرکات Moderate to active, Good stamina and physical enduranceLethargic, slow and poor staminaVery active, enthusiastic, precise and orderlyActive, disorganized and erratic Diet غذا Cold and DryHot and DryCold and MoistHot and Moist Climatic Preference موسمی ترجیحات Intolerance to hot & humid conditions, summer & rainy weatherIntolerance to cold & moist conditions, winter & rainy weatherIntolerance to dry conditions, summer & springIntolerance to cold & dry conditions, late winter & autumn Excretion اخراج Regular, Soft stool, Golden yellow urine with occasional burning, tends to perspire easilyThe sticky unstable stool, occasional diarrhea, tends to pass excessive, transparent, light yellow urine, low perspirationSoft, Loose stool, occasional dysentery, tends to pass dark yellow urine, low in quantity with occasional burnnig & tends to perspire easiltyHard, dark stool towards constipation tends to pass moderate to excessive urine, low perspiration Sleep pattern نیند کی ترتیب Moderate to deep 6-8 hours adequateHeavy, prolonged, excessive 8 hours plus tendency to oversleepLow but sounds 5-6 hours adequate tendency to insomniainterrupted, irregular, tendency towards insomnia Emotional traits Personality Traits Mental activity جذباتی خصلتیں شخصیت کی خصوصیات ذہنی سرگرمی Worry, cheerful, Excited, Bold, persuasive, Sociable, outgoing, talkative, Moderate to active intelligenceFearful, Shy, Self-Content. Calm, accomodating, patient, good listener, slow receptove, cool mindedaggressive, anger irritable, impatient,resourceful, outspoken, dominant, may be short tempered. Aggressive itelligent, sharp mindedFearful, insecure suspicious, anxious, thoughtful, logical, analytical, tend to be perfectionist restlessness, enquiring, philosophical, imaginative Subject Your message (optional)
