Describe your problem in detail in the form below to enable us to understand it correctly & completely:
Please describe yourself
Please describe in detail the nature of your problem
Since when did this problem start?
Have you treated this problem before? If yes state where & when
Do you have any past investigative reports ? If yes please write the report in brief
How would you rate your general health?
Do you have any common minor illnesses like gases, indigestion, constipation, acidity, cough & cold, general weakness?
How is your appetite on the whole ?
Any other information that you would like to provide?
How did you hear about us