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26025 - Shehnaaz Gill
25360 - Deepak Sharma




First NameShehnaazfirstname_1632480903127
Last NameGilllastname_1632480921954
GenderFemalegender_1632480960347
Marital StatusSinglemarital_status_1632481010814
Age29age_1632481270095
Height (in CM)148height_in_cm_1632481466855
Past Weight (in KG)75past_weight_in_kg_1632481460597
Current Weight (in KG)65current_weight_in_kg_1632481481649
OccupationTeacheroccupation_1632481512453
Date & Time of Birth27/11/2001,
10,
50,
pm,
date_and_time_of_birth_1632481636928
Place of BirthPatialaplace_of_birth_1632481719810
AddressHMTaddress_1632481784910
CityPinjorecity_1632482124766
StateHaryanastate_1632482194529
Pincode133102pincode_1632482275481
CountryINlistcountry_1632482203427
Phone9817589454phone_1632482611031
Email[email protected]email_1632482615370
Please describe your present health concerns and their duration?I'm suffering from PCODplease_describe_your_present_health_concerns_and_their_duration_1632483008928
How long have you had the chronic conditions about which you are consulting us?6 months to 2 yearshow_long_have_you_had_the_chronic_conditions_about_which_you_are_consulting_us_1632483291659
How has your health problem progressed since it began?Gradually improvinghow_has_your_health_problem_progressed_since_it_began_1632483424318
Please explain the overall intensity of your symptoms?Severeplease_explain_the_overall_intensity_of_your_symptoms_1632483658069
Is your sleep disturbed by the symptoms?Not at allis_your_sleep_disturbed_by_the_symptoms_1632483836947
How often are you having pain or discomfort?Less than once a weekhow_often_are_you_having_pain_or_discomfort_1632484110755
How long does the pain or discomfort last on the average?About one hourhow_long_does_the_pain_or_discomfort_last_on_the_average_1632484324068
Are you currently under the care of a family physician or any other health professional?Noare_you_currently_under_the_care_of_a_family_physician_or_any_other_health_professional_1632484473870
If yes, please mentionif_yes_please_mention_1634559065043
What is their opinion about your health?Did not saywhat_is_their_opinion_about_your_health_1632484659189
Have you undergone any investigations forUltrasound,
have_you_undergone_any_investigations_for_1633593953110
Other Tests:other_tests_1633594057746
Past Prescription Medicinespast_prescription_medicines_1633594583072
Present Prescription Medicinespresent_prescription_medicines_1632486068067
Past Over the counter Medicinespast_over_the_counter_medicines_1632485788149
Present Over the counter Medicinespresent_over_the_counter_medicines_1632486072899
Past Herbs / Vitaminspast_herbs_vitamins_1632485804392
Present Herbs / Vitaminspresent_herbs_vitamins_1632487762903
WinterUnderweight weight loss,
Stomachaches,
Restlessness,
Insomnia,
Anxiety,
winter_1632486754499
SummerIrritability,
Frustration,
Visual problems,
summer_1632486856334
SpringDifficulty paying attention,
Depression,
Oily skin,
Slow digestion,
Possessiveness,
spring_1632486931325
Are you allergic to any substances? Please specify: food, pollen, dust etc., and any other allergic reactions?are_you_allergic_to_any_substances_please_specify_food_pollen_dust_etc_and_any_other_allergic_reactions_1632488989948
Health as a child:Goodhealth_as_a_child_1632489133268
Any Childhood Illness? Please specify.any_childhood_illness_please_specify_1633594885450
Did you had any Immunizations / Vaccinations:? Please specify.did_you_had_any_immunizations_vaccinations_please_specify_1633594973133
Any Vaccination Reaction:any_vaccination_reaction_1632489447679
Do you use any of the following?Hair Dryer,
do_you_use_any_of_the_following_1632489470890
How would you rate your usual energy level?Moderatehow_would_you_rate_your_usual_energy_level_1632489523637
Describe your bowel movements?First thing in the morning,
describe_your_bowel_movements_1632489645684
Please specify other bowel movementsplease_specify_other_bowel_movements_1632489772968
Bowel nature:Mediumbowel_nature_1632489803015
Bowel movement associated with: Other,
bowel_movement_associated_with_1632489843801
Specify if other bowel movement associationspecify_if_other_bowel_movement_association_1633595039610
Do you have any of the following urinary problems?Other discharges,
do_you_have_any_of_the_following_urinary_problems_1632489953159
Specify other urinary problems, if anyspecify_other_urinary_problems_if_any_1633595091008
Do you delay or suppress any of the following?Breathing,
do_you_delay_or_suppress_any_of_the_following_1632490054437
Do you practice any type of meditation? Please explain.do_you_practice_any_type_of_meditation_please_explain_1632490129954
Do you practice any Yoga techniques? Please explain.do_you_practice_any_yoga_techniques_please_explain_1632490142152
What is your present state of mind and emotions?Poorwhat_is_your_present_state_of_mind_and_emotions_1632490158537
Do you often experience any of the following?Anxiety,
Loneliness,
Fear of panic,
Worry,
Lack of energy,
Irritation,
Light-headedness,
do_you_often_experience_any_of_the_following_1632490192444
Do you get up early?Yesdo_you_get_up_early_1632490317555
At what time you wake up?,
06,
15,
am,
at_what_time_you_wake_up_1632490369465
Do you go to bed early?Yesdo_you_go_to_bed_early_1632490390170
At what time you sleep?,
10,
00,
pm,
at_what_time_you_sleep_1632490408843
Do you sleep in the daytime?Nodo_you_sleep_in_the_daytime_1632490436426
How do you generally feel about waking up in the morning?Fresh and restedhow_do_you_generally_feel_about_waking_up_in_the_morning_1632506038742
How is your sleep?Normal durationhow_is_your_sleep_1632506228360
To what direction does your head point during sleep?West,
to_what_direction_does_your_head_point_during_sleep_1632506423272
What is your sleeping position?On tummy,
what_is_your_sleeping_position_1632506568500
How regular is your daily routine (for example, do you go to bed early, eat your meals on time, exercise regularly etc?)Very regularhow_regular_is_your_daily_routine_for_example_do_you_go_to_bed_early_eat_your_meals_on_time_exercise_regularly_etc_1632506634962
What is your body build?Thinwhat_is_your_body_build_1632506679957
Are you overweight?Noare_you_overweight_1632506767736
If so, by how much? (In KG)if_so_by_how_much_in_kg_1633595259407
Do you travel a lot?Nodo_you_travel_a_lot_1632506853154
How often do you exercise? Please specify.how_often_do_you_exercise_please_specify_1633595325166
How long do you exercise?how_long_do_you_exercise_1632506929536
What type of exercise?what_type_of_exercise_1632506945927
Is your exercise: (choose one)is_your_exercise_choose_one_1632507022657
Do you smoke cigarettes or others?Nodo_you_smoke_cigarettes_or_others_1632507068274
If yes, how many per day?if_yes_how_many_per_day_1633595473424
How often do you drink alcohol & How Much?how_often_do_you_drink_alcohol_and_how_much_1633595531513
How often do you drink coffee, tea etc?how_often_do_you_drink_coffee_tea_etc_1633595609026
Which type of weather makes you feel most uncomfortable?Rainwhich_type_of_weather_makes_you_feel_most_uncomfortable_1633595641819
DailyVegetables - Cooked,
Vegetables - Raw Salad,
Other,
daily_1632547529883
WeeklyEggs,
Meat,
Juices,
weekly_1632547523778
MonthlySeafood,
Desserts,
monthly_1632547518283
NeverOther,
never_1632547318159
Breakfast:breakfast_1632547590163
Lunchlunch_1632547627080
Dinnerdinner_1632547638914
Snackssnacks_1632547650740
Do you eat between meals?Yesdo_you_eat_between_meals_1632547695802
Do you eat your meals on time?Yesdo_you_eat_your_meals_on_time_1632547719516
Which is your main meal?Breakfastwhich_is_your_main_meal_1632547738750
Rate your digestionFairrate_your_digestion_1632547795377
How much water do you drink per day?3-4 glasseshow_much_water_do_you_drink_per_day_1632547908945
My eating habits include:Watch television while eating,
my_eating_habits_include_1632547979592
Describe your diet:Lacto-vegetariandescribe_your_diet_1632548223880
Specify other diet, if any.specify_other_diet_if_any_1633595747233
Non-vegetarian:Chicken,
Eggs,
Others,
non-vegetarian_1632548424136
Specify Other Non-vegetarian diet, if any.specify_other_non-vegetarian_diet_if_any_1633595778115
Have you experienced any changes in your sense of taste? (Choose one)Not specifichave_you_experienced_any_changes_in_your_sense_of_taste_choose_one_1632548538090
What taste(s) do you like or crave?Salty,
HotSpicy,
what_taste_s_do_you_like_or_crave_1632548595383
Are there any particular foods that create discomfort when you eat them?Sweet,
Oily or fatty,
Bitter,
are_there_any_particular_foods_that_create_discomfort_when_you_eat_them_1632548654982
How are your family relationships?Goodhow_are_your_family_relationships_1632548738458
How is your social life?Poorhow_is_your_social_life_1632548785864
How is your mental status?Poorhow_is_your_mental_status_1632548803859
How is your career?Can stand ithow_is_your_career_1632548837841
How purposeful is your life?Neutralhow_purposeful_is_your_life_1632548907082
Rate your spiritual life:Neutral emptyrate_your_spiritual_life_1632548997460
As a child, did you experience any abuse or trauma?Other,
None,
as_a_child_did_you_experience_any_abuse_or_trauma_1632549040137
Specify Otherspecify_other_1632549098714
Do you have any problems?do_you_have_any_problems_1632549313946
Age menses began:age_menses_began_1632549536372
Which of the following describes your menstruation? (You may choose more than one)Regular,
which_of_the_following_describes_your_menstruation_you_may_choose_more_than_one_1632549561110
How many days does your menstrual period last?Zero to four days,
how_many_days_does_your_menstrual_period_last_1632549638803
Specify Otherspecify_other_1632549682659
How is your menstrual flow?Normalhow_is_your_menstrual_flow_1632549743376
Associated symptoms (before or during menstruation):Pain,
Frustration,
Nightmares,
Anger,
associated_symptoms_before_or_during_menstruation_1632549820270
Specify Otherspecify_other_1632549928880
Do you have any discharge outside of your menstrual period?Nodo_you_have_any_discharge_outside_of_your_menstrual_period_1632549973021
Do you experience pain during intercourse?Nodo_you_experience_pain_during_intercourse_1632549997783
Do you have any sexual difficulties?Nodo_you_have_any_sexual_difficulties_1632550016852
If yes, please explainif_yes_please_explain_1632550036804
Are you pregnant now?Noare_you_pregnant_now_1632550250829
Do you take contraceptive pills or other devices?Nodo_you_take_contraceptive_pills_or_other_devices_1632550298437
If yes, Please explainif_yes_please_explain_1632550316129
Number of previous pregnancies (choose one) 0 / 1 / 2 / 3 / 4 / 5 / 6 / 7 or morenumber_of_previous_pregnancies_choose_one_0_1_2_3_4_5_6_7_or_more_1632550343493
Do you have any history of abortion, miscarriage, etc? Nodo_you_have_any_history_of_abortion_miscarriage_etc_1632550369499
If yes, Please explain your history of abortion, miscarriage, etc.if_yes_please_explain_your_history_of_abortion_miscarriage_etc_1633595878177
How many children do you have?how_many_children_do_you_have_1632550413346
Children’s ages:children_s_ages_1632550435784
Do you self-exam breasts regularly?do_you_self-exam_breasts_regularly_1632550486495
Do you experience any problems in breasts?Pain or tenderness,
do_you_experience_any_problems_in_breasts_1632550539687
Vata PersonalityI have a thin physique I dont gain weight very easily.,
I have always learned new things very quickly and forget easily. ,
I tend to have cold hands and feet.,
I speak quickly miss words and my friends think that Im talkative.,
I tend to be irregular in my eating and sleeping habits.,
My skin tends to be very dry especially in winter.,
My energy tends to come in bursts.,
My moods change easily and I am somewhat emotional by nature.,
My mind is very active sometimes restless but also very imaginative.,
I tend to have difficulty making decisions.,
I become anxious or worried frequently.,
vata_personality_1632551279599
Pitta PersonalityI become impatient very easily people consider me stubborn.,
I get angry quite easily but then I quickly forget about it.,
One or more of these characteristics describe my hair early graying or balding thin straight,
pitta_personality_1632551297952
Kapha PersonalityI have slow digestion which makes me feel heavy after eating.,
I tend to do things in a slow and relaxed manner.,
I feel comfortable if I sleep at least 8 hours daily. ,
kapha_personality_1632552036884
Total Vata | Pitta | KaphaMy Mind-Body Personality is: VATA - {calc:vata_score} PITTA - {calc:pitta_score} KAPHA - {calc:kapha_score}total_vata_or_pitta_or_kapha_1633668458281
I generally feel constipated.Nonei_generally_feel_constipated_1632553311912
I often get congestion in my head and sinusesNonei_often_get_congestion_in_my_head_and_sinuses_1632553503152
I often get infections.Mildi_often_get_infections_1632553521991
I feel my immune system is weakModeratei_feel_my_immune_system_is_weak_1632553534998
I feel non-clarity of mindSeverei_feel_non-clarity_of_mind_1632553555757
I feel physically exhausted without any reasonSeverei_feel_physically_exhausted_without_any_reason_1632553572092
I feel mentally exhausted easilySeverei_feel_mentally_exhausted_easily_1632553585969
My stress levels areModeratemy_stress_levels_are_1632553598722
I have no desire to eat foodNonei_have_no_desire_to_eat_food_1632553620237
I tend to feel indigestion frequentlyMildi_tend_to_feel_indigestion_frequently_1632553631251
I tend to get lot of salivation in the mouthNonei_tend_to_get_lot_of_salivation_in_the_mouth_1632553642311
I easily get angry and irritated without any real reasonSeverei_easily_get_angry_and_irritated_without_any_real_reason_1632553654853
I feel that my breathing pattern alteredMildi_feel_that_my_breathing_pattern_altered_1632553670338
I frequently get cold throughout the yearMildi_frequently_get_cold_throughout_the_year_1632553682819
I tend to get allergies throughout the yearNonei_tend_to_get_allergies_throughout_the_year_1632553708178
I feel heaviness in the bodyNonei_feel_heaviness_in_the_body_1632553720006
I feel something is not well in my mind-bodyModeratei_feel_something_is_not_well_in_my_mind-body_1632553734372
Body ImpuritiesLevel of Your Mind - Body Impurities: Total: {calc:body_impurities} 1 to 17 = Mild | 17 to 34 = Moderate | 35 to 51 = Severe body_impurities_1633668694737
Abdominal painNoneabdominal_pain_1632555276722
AnorexiaNoneanorexia_1632555370316
Body achesMildbody_aches_1632555381821
FaintingNonefainting_1632555391480
FeverNonefever_1632555401195
FlatulenceNoneflatulence_1632555411714
Giddiness / dizzinessNonegiddiness_dizziness_1632555423107
Gripping pain / colicNonegripping_pain_colic_1632555431775
HeadacheMildheadache_1632555442175
Heaviness in abdomenNoneheaviness_in_abdomen_1632555456173
Improper digestion of foodMildimproper_digestion_of_food_1632555467284
Malaise (Body aches)malaise_body_aches_1632555477827
Slow digestionNoneslow_digestion_1632555495056
Stiffness in back & waistModeratestiffness_in_back_and_waist_1632555511468
ThirstMildthirst_1632555525500
VomitingNonevomiting_1632555541624
Yawningyawning_1632555550703
IndigestionTotal Score: {calc:Indigestion} 1 to 13 = Mild 14 to 26 = Moderate 27 to 39 = Severeindigestion_1633668760493
Feeling tired most the time (Chronic fatigue)Nonefeeling_tired_most_the_time_chronic_fatigue_1632555651334
Digestive problems (gas, bloating, constipation or diarrhea)Nonedigestive_problems_gas_bloating_constipation_or_diarrhea_1632555664605
Gastrointestinal symptoms and bulky stools with excess fat in fecesNonegastrointestinal_symptoms_and_bulky_stools_with_excess_fat_in_feces_1632555677540
Food sensitivities and environmental intoleranceNonefood_sensitivities_and_environmental_intolerance_1632555690211
Allergic-like reactionsNoneallergic-like_reactions_1632555723777
Joint and muscle pains and inflammationMildjoint_and_muscle_pains_and_inflammation_1632555737175
Anemia or iron deficiencyMildanemia_or_iron_deficiency_1632555749782
Hives, rashes, weeping eczema, cutaneous ulcers, swelling, sores, papular lesions, itchy dermatitisNonehives_rashes_weeping_eczema_cutaneous_ulcers_swelling_sores_papular_lesions_itchy_dermatitis_1632555763277
Restlessness and anxietySevererestlessness_and_anxiety_1632555776827
Multiple awakenings during the night and teeth grindingMildmultiple_awakenings_during_the_night_and_teeth_grinding_1632555947540
Excessive amounts of bacterial or viral infectionsMildexcessive_amounts_of_bacterial_or_viral_infections_1632555959537
DepressionMilddepression_1632555973703
Difficulty gaining or losing weightSeveredifficulty_gaining_or_losing_weight_1632555984886
Total Parasites{calc:parasites}total_parasites_1633669821552
First NameDeepakfirstname_1632480903127
Last NameSharmalastname_1632480921954
GenderMalegender_1632480960347
Marital StatusSinglemarital_status_1632481010814
Age24age_1632481270095
Height (in CM)182height_in_cm_1632481466855
Past Weight (in KG)68past_weight_in_kg_1632481460597
Current Weight (in KG)74current_weight_in_kg_1632481481649
OccupationGraphic Designeroccupation_1632481512453
Date & Time of Birth23/07/1997,
09,
50,
am,
date_and_time_of_birth_1632481636928
Place of BirthChandigarhplace_of_birth_1632481719810
Address137 address_1632481784910
CityChandigarhcity_1632482124766
StateUnion Territory state_1632482194529
Pincode160102pincode_1632482275481
CountryINlistcountry_1632482203427
Phone7355407441phone_1632482611031
Email[email protected]email_1632482615370
Please describe your present health concerns and their duration?No issuesplease_describe_your_present_health_concerns_and_their_duration_1632483008928
How long have you had the chronic conditions about which you are consulting us?2 to 5 yearshow_long_have_you_had_the_chronic_conditions_about_which_you_are_consulting_us_1632483291659
How has your health problem progressed since it began?Stablehow_has_your_health_problem_progressed_since_it_began_1632483424318
Please explain the overall intensity of your symptoms?severeplease_explain_the_overall_intensity_of_your_symptoms_1632483658069
Is your sleep disturbed by the symptoms?severelyis_your_sleep_disturbed_by_the_symptoms_1632483836947
How often are you having pain or discomfort?several-times-a-dayhow_often_are_you_having_pain_or_discomfort_1632484110755
How long does the pain or discomfort last on the average?about-30-minuteshow_long_does_the_pain_or_discomfort_last_on_the_average_1632484324068
Are you currently under the care of a family physician or any other health professional?if-yes-mention-detailsare_you_currently_under_the_care_of_a_family_physician_or_any_other_health_professional_1632484473870
What is their opinion about your health?difficult-to-curewhat_is_their_opinion_about_your_health_1632484659189
Have you undergone any investigations forurine-test,
x-ray,
have_you_undergone_any_investigations_for_1633593953110
Other Tests:No other testsother_tests_1633594057746
Past Prescription MedicinesNothingpast_prescription_medicines_1633594583072
Present Prescription MedicinesSomethingpresent_prescription_medicines_1632486068067
Past Over the counter MedicinesFew Thingpast_over_the_counter_medicines_1632485788149
Present Over the counter Medicineslittle thingspresent_over_the_counter_medicines_1632486072899
Past Herbs / Vitaminsbig thingspast_herbs_vitamins_1632485804392
Present Herbs / Vitaminsno thingspresent_herbs_vitamins_1632487762903
Winterdepression,
headache,
insomnia,
worry,
attention-deficit,
constipation,
restlessness,
winter_1632486754499
Summeracne,
anger,
excessive-hunger,
irritability,
burning-in-the-eyes,
hostility,
visual-problems,
summer_1632486856334
Springpossessiveness,
sinus-congestion,
asthma,
apathy,
bronchitis,
difficulty-paying-attention,
neediness,
skin-growths,
slow-digestion,
spring_1632486931325
Are you allergic to any substances? Please specify: food, pollen, dust etc., and any other allergic reactions?No actuallyare_you_allergic_to_any_substances_please_specify_food_pollen_dust_etc_and_any_other_allergic_reactions_1632488989948
Health as a child:poor-childhood-illnesseshealth_as_a_child_1632489133268
Any Childhood Illness? Please specify.No childhood illnessany_childhood_illness_please_specify_1633594885450
Did you had any Immunizations / Vaccinations:? Please specify.Nothingdid_you_had_any_immunizations_vaccinations_please_specify_1633594973133
Any Vaccination Reaction:No reactionany_vaccination_reaction_1632489447679
Do you use any of the following?microwave-cooking,
hair-dye,
do_you_use_any_of_the_following_1632489470890
How would you rate your usual energy level?very-highhow_would_you_rate_your_usual_energy_level_1632489523637
Describe your bowel movements?describe_your_bowel_movements_1632489645684
Please specify other bowel movementsNormalplease_specify_other_bowel_movements_1632489772968
Bowel nature:mediumbowel_nature_1632489803015
Bowel movement associated with: other,
bowel_movement_associated_with_1632489843801
Specify if other bowel movement associationNothingspecify_if_other_bowel_movement_association_1633595039610
Do you have any of the following urinary problems?discoloration,
urination-several-times-during-the-night,
urine-retention,
frequent-urination-during-the-day,
other-discharges,
do_you_have_any_of_the_following_urinary_problems_1632489953159
Specify other urinary problems, if anyNospecify_other_urinary_problems_if_any_1633595091008
Do you delay or suppress any of the following?urination,
breathing,
hunger,
sleep,
tears,
do_you_delay_or_suppress_any_of_the_following_1632490054437
Do you practice any type of meditation? Please explain.Yes, Tai Chido_you_practice_any_type_of_meditation_please_explain_1632490129954
Do you practice any Yoga techniques? Please explain.nodo_you_practice_any_yoga_techniques_please_explain_1632490142152
What is your present state of mind and emotions?fairwhat_is_your_present_state_of_mind_and_emotions_1632490158537
Do you often experience any of the following?loneliness,
depression,
high-stress,
suicidal-tendency,
light-headedness,
worry,
do_you_often_experience_any_of_the_following_1632490192444
Do you get up early?yesdo_you_get_up_early_1632490317555
At what time you wake up?,
12,
00,
am,
at_what_time_you_wake_up_1632490369465
Do you go to bed early?nodo_you_go_to_bed_early_1632490390170
At what time you sleep?,
12,
00,
am,
at_what_time_you_sleep_1632490408843
Do you sleep in the daytime?yesdo_you_sleep_in_the_daytime_1632490436426
How do you generally feel about waking up in the morning?how_do_you_generally_feel_about_waking_up_in_the_morning_1632506038742
How is your sleep?difficulty-falling-asleephow_is_your_sleep_1632506228360
To what direction does your head point during sleep?west,
south,
southeast,
southwest,
to_what_direction_does_your_head_point_during_sleep_1632506423272
What is your sleeping position?on-back,
right-side,
what_is_your_sleeping_position_1632506568500
How regular is your daily routine (for example, do you go to bed early, eat your meals on time, exercise regularly etc?)very-regularhow_regular_is_your_daily_routine_for_example_do_you_go_to_bed_early_eat_your_meals_on_time_exercise_regularly_etc_1632506634962
What is your body build?largewhat_is_your_body_build_1632506679957
Are you overweight?noare_you_overweight_1632506767736
If so, by how much? (In KG)8if_so_by_how_much_in_kg_1633595259407
Do you travel a lot?nodo_you_travel_a_lot_1632506853154
How often do you exercise? Please specify.Normalshow_often_do_you_exercise_please_specify_1633595325166
How long do you exercise?No ideahow_long_do_you_exercise_1632506929536
What type of exercise?Ha ha ha what_type_of_exercise_1632506945927
Is your exercise: (choose one)vigorousis_your_exercise_choose_one_1632507022657
Do you smoke cigarettes or others?nodo_you_smoke_cigarettes_or_others_1632507068274
If yes, how many per day?0if_yes_how_many_per_day_1633595473424
How often do you drink alcohol & How Much?0how_often_do_you_drink_alcohol_and_how_much_1633595531513
How often do you drink coffee, tea etc?Yes a lothow_often_do_you_drink_coffee_tea_etc_1633595609026
Which type of weather makes you feel most uncomfortable?hotwhich_type_of_weather_makes_you_feel_most_uncomfortable_1633595641819
Dailyseafood,
fruits,
desserts,
grains-cereals,
dairy,
poultry,
daily_1632547529883
WeeklyVegetables - Cooked,
juices,
sugar-honey,
eggs,
dairy,
weekly_1632547523778
Monthlyeggs,
seafood,
Vegetables - Cooked,
poultry,
sugar-honey,
other,
monthly_1632547518283
Neverdesserts,
poultry,
seafood,
Vegetables - Cooked,
fruits,
eggs,
never_1632547318159
Breakfast:Nobreakfast_1632547590163
LunchYeslunch_1632547627080
DinnerYesdinner_1632547638914
SnacksYessnacks_1632547650740
Do you eat between meals?yesdo_you_eat_between_meals_1632547695802
Do you eat your meals on time?do_you_eat_your_meals_on_time_1632547719516
Which is your main meal?breakfastwhich_is_your_main_meal_1632547738750
Rate your digestionfairrate_your_digestion_1632547795377
How much water do you drink per day?how_much_water_do_you_drink_per_day_1632547908945
My eating habits include:never-on-time,
eat-very-fast,
talk-or-converse-a-lot-while-eating,
my_eating_habits_include_1632547979592
Describe your diet:vegandescribe_your_diet_1632548223880
Specify other diet, if any.Nospecify_other_diet_if_any_1633595747233
Non-vegetarian:seafood,
non-vegetarian_1632548424136
Specify Other Non-vegetarian diet, if any.No other non vegetarianspecify_other_non-vegetarian_diet_if_any_1633595778115
Have you experienced any changes in your sense of taste? (Choose one)bitter-taste-in-mouthhave_you_experienced_any_changes_in_your_sense_of_taste_choose_one_1632548538090
What taste(s) do you like or crave?sour,
starches,
bitter,
sweet,
what_taste_s_do_you_like_or_crave_1632548595383
Are there any particular foods that create discomfort when you eat them?sour,
oily-or-fatty,
astringent,
dairy-products-including-cheese,
are_there_any_particular_foods_that_create_discomfort_when_you_eat_them_1632548654982
How are your family relationships?excellenthow_are_your_family_relationships_1632548738458
How is your social life?goodhow_is_your_social_life_1632548785864
How is your mental status?excellenthow_is_your_mental_status_1632548803859
How is your career?like-ithow_is_your_career_1632548837841
How purposeful is your life?completelyhow_purposeful_is_your_life_1632548907082
Rate your spiritual life:somewhat-satisfyingrate_your_spiritual_life_1632548997460
As a child, did you experience any abuse or trauma?none,
other,
as_a_child_did_you_experience_any_abuse_or_trauma_1632549040137
Specify OtherNopspecify_other_1632549098714
Do you have any problems?do_you_have_any_problems_1632549313946
Age menses began:age_menses_began_1632549536372
Which of the following describes your menstruation? (You may choose more than one)which_of_the_following_describes_your_menstruation_you_may_choose_more_than_one_1632549561110
How many days does your menstrual period last?how_many_days_does_your_menstrual_period_last_1632549638803
Specify Otherspecify_other_1632549682659
How is your menstrual flow?how_is_your_menstrual_flow_1632549743376
Associated symptoms (before or during menstruation):associated_symptoms_before_or_during_menstruation_1632549820270
Specify Otherspecify_other_1632549928880
Do you have any discharge outside of your menstrual period?do_you_have_any_discharge_outside_of_your_menstrual_period_1632549973021
Do you experience pain during intercourse?do_you_experience_pain_during_intercourse_1632549997783
Do you have any sexual difficulties?do_you_have_any_sexual_difficulties_1632550016852
If yes, please explainif_yes_please_explain_1632550036804
Are you pregnant now?are_you_pregnant_now_1632550250829
Do you take contraceptive pills or other devices?do_you_take_contraceptive_pills_or_other_devices_1632550298437
If yes, Please explainif_yes_please_explain_1632550316129
Number of previous pregnancies (choose one) 0 / 1 / 2 / 3 / 4 / 5 / 6 / 7 or morenumber_of_previous_pregnancies_choose_one_0_1_2_3_4_5_6_7_or_more_1632550343493
Do you have any history of abortion, miscarriage, etc? do_you_have_any_history_of_abortion_miscarriage_etc_1632550369499
If yes, Please explain your history of abortion, miscarriage, etc.if_yes_please_explain_your_history_of_abortion_miscarriage_etc_1633595878177
How many children do you have?how_many_children_do_you_have_1632550413346
Children’s ages:children_s_ages_1632550435784
Do you self-exam breasts regularly?do_you_self-exam_breasts_regularly_1632550486495
Do you experience any problems in breasts?do_you_experience_any_problems_in_breasts_1632550539687
Vata Personalityi-tend-to-have-cold-hands-and-feet,
My mind is very active sometimes restless but also very imaginative.,
i-often-have-difficulty-falling-asleep-or-having-a-sound-night-s-sleep,
i-tend-to-have-difficulty-making-decisions,
i-have-a-thin-physique-i-don-t-gain-weight-very-easily,
i-don-t-tolerate-cold-weather-as-well-as-most-people,
i-tend-to-develop-gas-and-become-constipated-easily,
i-tend-to-be-irregular-in-my-eating-and-sleeping-habits,
my-characteristic-gait-walk-while-walking-is-light-and-quick,
My moods change easily and I am somewhat emotional by nature.,
vata_personality_1632551279599
Pitta Personalityi-consider-myself-to-be-very-effective-in-my-work-and-activities,
In my activities I tend to be extremely precise and orderly.,
i-tend-to-be-quite-critical-of-others-and-also-of-myself,
I have a hot intense sexuality.,
I-am-very-regular-in-my-bowel-habits,
i-tend-to-perspire-easily,
I have a medium proportionate toned body frame.,
I get angry quite easily but then I quickly forget about it.,
I am very fond of cold foods such as ice cream ice cold drinks.,
i-don-t-tolerate-foods-that-are-very-hot-and-spicy,
pitta_personality_1632551297952
Kapha PersonalityI like to sleep more and I feel tired even though I sleep more and am slow to move in my activities in the morning.,
I frequently tend to get excess congestion mucus and sinus problems.,
My body frame is heavy broad evenly proportioned.,
I have slow digestion which makes me feel heavy after eating.,
i-generally-eat-slowly-and-my-activities-are-methodical,
I have warm enduring sexuality,
People like to call me sweet nature peaceful affectionate,
i-tend-to-do-things-in-a-slow-and-relaxed-manner,
I have a large solid body build.,
I dont learn as quickly as some people but I have excellent retention and a long memory.,
kapha_personality_1632552036884
I generally feel constipated.Nonei_generally_feel_constipated_1632553311912
I often get congestion in my head and sinusesMildi_often_get_congestion_in_my_head_and_sinuses_1632553503152
I often get infections.Severei_often_get_infections_1632553521991
I feel my immune system is weakSeverei_feel_my_immune_system_is_weak_1632553534998
I feel non-clarity of mindModeratei_feel_non-clarity_of_mind_1632553555757
I feel physically exhausted without any reasoni_feel_physically_exhausted_without_any_reason_1632553572092
I feel mentally exhausted easilyNonei_feel_mentally_exhausted_easily_1632553585969
My stress levels areModeratemy_stress_levels_are_1632553598722
I have no desire to eat foodi_have_no_desire_to_eat_food_1632553620237
I tend to feel indigestion frequentlyNonei_tend_to_feel_indigestion_frequently_1632553631251
I tend to get lot of salivation in the mouthNonei_tend_to_get_lot_of_salivation_in_the_mouth_1632553642311
I easily get angry and irritated without any real reasonModeratei_easily_get_angry_and_irritated_without_any_real_reason_1632553654853
I feel that my breathing pattern alteredNonei_feel_that_my_breathing_pattern_altered_1632553670338
I frequently get cold throughout the yearModeratei_frequently_get_cold_throughout_the_year_1632553682819
I tend to get allergies throughout the yearMildi_tend_to_get_allergies_throughout_the_year_1632553708178
I feel heaviness in the bodyModeratei_feel_heaviness_in_the_body_1632553720006
I feel something is not well in my mind-bodyNonei_feel_something_is_not_well_in_my_mind-body_1632553734372
Abdominal painNoneabdominal_pain_1632555276722
AnorexiaNoneanorexia_1632555370316
Body achesModeratebody_aches_1632555381821
FaintingMildfainting_1632555391480
FeverMildfever_1632555401195
FlatulenceMildflatulence_1632555411714
Giddiness / dizzinessNonegiddiness_dizziness_1632555423107
Gripping pain / colicgripping_pain_colic_1632555431775
HeadacheNoneheadache_1632555442175
Heaviness in abdomenMildheaviness_in_abdomen_1632555456173
Improper digestion of foodMildimproper_digestion_of_food_1632555467284
Malaise (Body aches)Moderatemalaise_body_aches_1632555477827
Slow digestionMildslow_digestion_1632555495056
Stiffness in back & waistMildstiffness_in_back_and_waist_1632555511468
ThirstMildthirst_1632555525500
VomitingMildvomiting_1632555541624
YawningModerateyawning_1632555550703
Feeling tired most the time (Chronic fatigue)Mildfeeling_tired_most_the_time_chronic_fatigue_1632555651334
Digestive problems (gas, bloating, constipation or diarrhea)Moderatedigestive_problems_gas_bloating_constipation_or_diarrhea_1632555664605
Gastrointestinal symptoms and bulky stools with excess fat in fecesModerategastrointestinal_symptoms_and_bulky_stools_with_excess_fat_in_feces_1632555677540
Food sensitivities and environmental intoleranceModeratefood_sensitivities_and_environmental_intolerance_1632555690211
Allergic-like reactionsMildallergic-like_reactions_1632555723777
Joint and muscle pains and inflammationMildjoint_and_muscle_pains_and_inflammation_1632555737175
Anemia or iron deficiencyModerateanemia_or_iron_deficiency_1632555749782
Hives, rashes, weeping eczema, cutaneous ulcers, swelling, sores, papular lesions, itchy dermatitishives_rashes_weeping_eczema_cutaneous_ulcers_swelling_sores_papular_lesions_itchy_dermatitis_1632555763277
Restlessness and anxietyMildrestlessness_and_anxiety_1632555776827
Multiple awakenings during the night and teeth grindingModeratemultiple_awakenings_during_the_night_and_teeth_grinding_1632555947540
Excessive amounts of bacterial or viral infectionsModerateexcessive_amounts_of_bacterial_or_viral_infections_1632555959537
DepressionModeratedepression_1632555973703
Difficulty gaining or losing weightMilddifficulty_gaining_or_losing_weight_1632555984886





















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First NameDeepak
Last NameSharma
GenderMale
Marital StatusSingle
Age24
Height (in CM)182
Past Weight (in KG)68
Current Weight (in KG)74
OccupationGraphic Designer
Date & Time of Birth23/07/1997, 09, 50, am,
Place of BirthChandigarh
Address137
CityChandigarh
StateUnion Territory
Pincode160102
CountryIN
Phone7355407441
Email[email protected]
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Please describe your present health concerns and their duration?No issues
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How long have you had the chronic conditions about which you are consulting us?2 to 5 years
How has your health problem progressed since it began?Stable
Please explain the overall intensity of your symptoms?severe
Is your sleep disturbed by the symptoms?severely
How often are you having pain or discomfort?several-times-a-day
How long does the pain or discomfort last on the average?about-30-minutes
Are you currently under the care of a family physician or any other health professional?if-yes-mention-details
If yes, please mention
What is their opinion about your health?difficult-to-cure
Diagnostics
Have you undergone any investigations forurine-test, x-ray,
Other Tests:No other tests
Medication
Past Prescription MedicinesNothing
Present Prescription MedicinesSomething
Past Over the counter MedicinesFew Thing
Present Over the counter Medicineslittle things
Past Herbs / Vitaminsbig things
Present Herbs / Vitaminsno things
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Winterdepression, headache, insomnia, worry, attention-deficit, constipation, restlessness,
Summeracne, anger, excessive-hunger, irritability, burning-in-the-eyes, hostility, visual-problems,
Springpossessiveness, sinus-congestion, asthma, apathy, bronchitis, difficulty-paying-attention, neediness, skin-growths, slow-digestion,
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Are you allergic to any substances? Please specify: food, pollen, dust etc., and any other allergic reactions?No actually
Health as a child:poor-childhood-illnesses
Any Childhood Illness? Please specify.No childhood illness
Did you had any Immunizations / Vaccinations:? Please specify.Nothing
Any Vaccination Reaction:No reaction
Do you use any of the following?microwave-cooking, hair-dye,
How would you rate your usual energy level?very-high
Describe your bowel movements?
Please specify other bowel movementsNormal
Bowel nature:medium
Bowel movement associated with: other,
Specify if other bowel movement associationNothing
Do you have any of the following urinary problems?discoloration, urination-several-times-during-the-night, urine-retention, frequent-urination-during-the-day, other-discharges,
Specify other urinary problems, if anyNo
Do you delay or suppress any of the following?urination, breathing, hunger, sleep, tears,
Do you practice any type of meditation? Please explain.Yes, Tai Chi
Do you practice any Yoga techniques? Please explain.no
What is your present state of mind and emotions?fair
Do you often experience any of the following?loneliness, depression, high-stress, suicidal-tendency, light-headedness, worry,
Do you get up early?yes
At what time you wake up?, 12, 00, am,
Do you go to bed early?no
At what time you sleep?, 12, 00, am,
Do you sleep in the daytime?yes
How do you generally feel about waking up in the morning?
How is your sleep?difficulty-falling-asleep
To what direction does your head point during sleep?west, south, southeast, southwest,
What is your sleeping position?on-back, right-side,
How regular is your daily routine (for example, do you go to bed early, eat your meals on time, exercise regularly etc?)very-regular
What is your body build?large
Are you overweight?no
If so, by how much? (In KG)8
Do you travel a lot?no
How often do you exercise? Please specify.Normals
How long do you exercise?No idea
What type of exercise?Ha ha ha
Is your exercise: (choose one)vigorous
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Do you smoke cigarettes or others?no
If yes, how many per day?0
How often do you drink alcohol & How Much?0
How often do you drink coffee, tea etc?Yes a lot
Which type of weather makes you feel most uncomfortable?hot
DO YOU EAT THE FOLLOWING FOOD GROUPS
Dailyseafood, fruits, desserts, grains-cereals, dairy, poultry,
WeeklyVegetables - Cooked, juices, sugar-honey, eggs, dairy,
Monthlyeggs, seafood, Vegetables - Cooked, poultry, sugar-honey, other,
Neverdesserts, poultry, seafood, Vegetables - Cooked, fruits, eggs,
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Please explain your typical food habit?
Breakfast:No
LunchYes
DinnerYes
SnacksYes
Do you eat between meals?yes
Do you eat your meals on time?
Which is your main meal?breakfast
Rate your digestionfair
How much water do you drink per day?
My eating habits include:never-on-time, eat-very-fast, talk-or-converse-a-lot-while-eating,
Describe your diet:vegan
Specify other diet, if any.No
Non-vegetarian:seafood,
Specify Other Non-vegetarian diet, if any.No other non vegetarian
Have you experienced any changes in your sense of taste? (Choose one)bitter-taste-in-mouth
What taste(s) do you like or crave?sour, starches, bitter, sweet,
Are there any particular foods that create discomfort when you eat them?sour, oily-or-fatty, astringent, dairy-products-including-cheese,
How are your family relationships?excellent
How is your social life?good
How is your mental status?excellent
How is your career?like-it
How purposeful is your life?completely
Rate your spiritual life:somewhat-satisfying
As a child, did you experience any abuse or trauma?none, other,
Specify OtherNop
For Men only:
Do you have any problems?
For Women only:
Age menses began:
Which of the following describes your menstruation? (You may choose more than one)
How many days does your menstrual period last?
Specify Other
How is your menstrual flow?
Associated symptoms (before or during menstruation):
Specify Other
Do you have any discharge outside of your menstrual period?
Do you experience pain during intercourse?
Do you have any sexual difficulties?
If yes, please explain
Are you pregnant now?
Do you take contraceptive pills or other devices?
If yes, Please explain
Number of previous pregnancies (choose one) 0 / 1 / 2 / 3 / 4 / 5 / 6 / 7 or more
Do you have any history of abortion, miscarriage, etc?
If yes, Please explain your history of abortion, miscarriage, etc.
How many children do you have?
Children’s ages:
Do you self-exam breasts regularly?
Do you experience any problems in breasts?
Mind Body Self-Evaluation Test
Vata Personalityi-tend-to-have-cold-hands-and-feet, My mind is very active sometimes restless but also very imaginative., i-often-have-difficulty-falling-asleep-or-having-a-sound-night-s-sleep, i-tend-to-have-difficulty-making-decisions, i-have-a-thin-physique-i-don-t-gain-weight-very-easily, i-don-t-tolerate-cold-weather-as-well-as-most-people, i-tend-to-develop-gas-and-become-constipated-easily, i-tend-to-be-irregular-in-my-eating-and-sleeping-habits, my-characteristic-gait-walk-while-walking-is-light-and-quick, My moods change easily and I am somewhat emotional by nature.,
Total Vata Score
Pitta Personalityi-consider-myself-to-be-very-effective-in-my-work-and-activities, In my activities I tend to be extremely precise and orderly., i-tend-to-be-quite-critical-of-others-and-also-of-myself, I have a hot intense sexuality., I-am-very-regular-in-my-bowel-habits, i-tend-to-perspire-easily, I have a medium proportionate toned body frame., I get angry quite easily but then I quickly forget about it., I am very fond of cold foods such as ice cream ice cold drinks., i-don-t-tolerate-foods-that-are-very-hot-and-spicy,
Total Pitta Score
Kapha PersonalityI like to sleep more and I feel tired even though I sleep more and am slow to move in my activities in the morning., I frequently tend to get excess congestion mucus and sinus problems., My body frame is heavy broad evenly proportioned., I have slow digestion which makes me feel heavy after eating., i-generally-eat-slowly-and-my-activities-are-methodical, I have warm enduring sexuality, People like to call me sweet nature peaceful affectionate, i-tend-to-do-things-in-a-slow-and-relaxed-manner, I have a large solid body build., I dont learn as quickly as some people but I have excellent retention and a long memory.,
Total Kapha Score
Total Vata | Pitta | Kapha
Questionnaire Regarding Level of Your Mind - Body Impurities
I generally feel constipated.None
I often get congestion in my head and sinusesMild
I often get infections.Severe
I feel my immune system is weakSevere
I feel non-clarity of mindModerate
I feel physically exhausted without any reason
I feel mentally exhausted easilyNone
My stress levels areModerate
I have no desire to eat food
I tend to feel indigestion frequentlyNone
I tend to get lot of salivation in the mouthNone
I easily get angry and irritated without any real reasonModerate
I feel that my breathing pattern alteredNone
I frequently get cold throughout the yearModerate
I tend to get allergies throughout the yearMild
I feel heaviness in the bodyModerate
I feel something is not well in my mind-bodyNone
Body Impurities
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Abdominal painNone
AnorexiaNone
Body achesModerate
FaintingMild
FeverMild
FlatulenceMild
Giddiness / dizzinessNone
Gripping pain / colic
HeadacheNone
Heaviness in abdomenMild
Improper digestion of foodMild
Malaise (Body aches)Moderate
Slow digestionMild
Stiffness in back & waistMild
ThirstMild
VomitingMild
YawningModerate
Indigestion
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Feeling tired most the time (Chronic fatigue)Mild
Digestive problems (gas, bloating, constipation or diarrhea)Moderate
Gastrointestinal symptoms and bulky stools with excess fat in fecesModerate
Food sensitivities and environmental intoleranceModerate
Allergic-like reactionsMild
Joint and muscle pains and inflammationMild
Anemia or iron deficiencyModerate
Hives, rashes, weeping eczema, cutaneous ulcers, swelling, sores, papular lesions, itchy dermatitis
Restlessness and anxietyMild
Multiple awakenings during the night and teeth grindingModerate
Excessive amounts of bacterial or viral infectionsModerate
DepressionModerate
Difficulty gaining or losing weightMild
Total Parasites
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