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 Medical Profile    PHYSICAL DETAILS 
Step 1 of 5   -   Enter Physical Details
 
It is mandatory for you enter Physical details before submitting a Question for consultation. It is not required to fill in the rest of the forms, in order to submit a Question for your consultation. However it is advisable for you to enter maximum details for a more informed and accurate consultation from your consulting MD.
Physical Details
[* Indicates Mandatory Fields]
Age * Gender Male Female*
Height Ft   Inch * Weight   Pounds/LBS Kgs*
Blood Group * Martial Status *
Waist Inches   * Chest  Inches   *
Body Type Slender Average Athletic Few Extra Pounds Overweight*

Physcial Disablity / Deformity

If any physical disablity/deformity please describe above


Please check the conditions that any of your Blood Relatives suffers from [Father/Mother/Brother/Sister]

Allergy


Asthma


Hypertension

Arthritis

Blood Disorder

Cancer

Coronary Heart Disease

Diabetes

Epilepsy

Gout

Mental Disease

Other Heart Disease

Strokes

Thyroid Disease

Tuberculosis
History of Operations Blood Relatives, if any please enter.
[Example: By-Pass Surgery etc.]



 
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