Tell us about your problem

1. Are you suffering from any disease? And have you taken any treatment for that

2. How is your appetite? a) Normal b) Less c) More

3. what is the color of your tounge in the morning?

4. Is there any black spot on your tongue ?

5. Is there any cuts on your left or right side of the tounge ?

6. Is their any white coating/ excessive saliva on your tounge in the morning

7. What is the color of your urine in the morning? a) Yellow b) dark yellow c) petrol color d) sandy color e) haldi color

8. Is there any kind of frofth(foam) in your urine

9. Is their any burning sensation in your urine ?

10. Do you suffer from chronic constipation and is their any gap(1,2,5,7 days) for stool

11. What is the color of your stool ?

12. Is their any hard stool/ semi solid stool or goat like stool?

13. Do You feel Pulsating sound while pressing the belly button?

14. Is there any pain while pressing the navel? If yes in which direction

15. Have You ever suffered form typhoid? If yes how many times

16. Attach scan copy Your previous report