Online Treatment

* Name
Age
Sex
Occupation
Address
* E-Mail
Present complaints and duration
History of the present illness
History of any major diseases before

Personal History
Appetite
Sleep
Bowel Movements
Urine
In abnormal case please specify
Sexual Drive
Height
Weight
Blood Pressure
Habit
Menstrual History

Mental Functions
Pleasure
Sadness
Fear
Anger
Depression
Treatment history, Medical reports  
& Lab investigations

Family History
Parents
If dead, due to
Marital Status
Children
History of any specific disease in the family
Other specifications related to the disease
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