female Consultation

  • Marital Status
  • How is your physique ?
  • How is your appetite ?
  • Do you have constipation ?
  • Type of food that you eat.
  • Do you feel any burning sensation in chest / abdomen ?
  • Do you consume alcohol and wine ?
  • Are you addicted to any other intoxicant (e.g. liquor/wine etc.)?
  • Do you take excessive quantity of tea or coffee?
  • Do you suffer from sleeplessness ?
  • Do you suffer from excessive urination ?
  • Do you feel any irritation or burning sensation while passing urine ?
  • How is the flow of urine ?
  • Do you suffer from Involuntary Urination ?
  • Do you suffer, or have you ever suffered from any venereal disease (Syphilis / Gonorrhoea) ?
  • Does any mucous (pus / fluid) pass out with urine ?
  • Are you having problem of white discharge (particularly leucorrhoea) ?
  • Is your husband suffering or has ever suffered from any venereal disease (Syphilis, Gonorrhoea) ?
  • Do you feel pain in the back ?
  • Do you have complaints of nausea or vomiting in the morning ?
  • Are the menstrual periods regular ?*
  • Are the menstrual periods painful ?
  • Are you presently pregnant?
  • Has there been any miscarriage ?
  • Any child born after miscarriage ?
  • Have you ever suffered from fainting or convulsive fits ?
  • Do you still get such fits ?
  • Do you suffer from High Blood Pressure ?*
  • Do you feel pain below the naval ?
  • Are you suffering from Diabetes ?*
  • Have you suffered from any disease earlier ?
  • Is there any history of hereditary diseases in the family
  • "All fields marked with (*) are mandatory before submission."
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