*Mandatory Field
Name : *
Address : *
Age :*
Weight :*
Height :*
Email : *
Sex:	Male Female
Occupation :
Country :	Albania Algeria AndorraAngolaAnguilla Antigua and BarbudaArgentina ArmeniaAruba Australia AustriaAzerbaijanAzores BahamasBahrainBangladesh BarbadosBelarusBelgium BelizeBeninBermuda BhutanBoliviaBorneo Bosnia and HerzegovinaBotswana BrazilBritish Indian Ocean Territories BruneiBulgariaBurkina Faso (Upper Volta) BurundiCamaroonCambodia CanadaCanary IslandsCape Vere IslandsCayman Island Central African RepChad ChileChinaChristmas Island ColombiaComoros IslandsCongo, Democratic Republic of Costa RicaCroatiaCuba CyprusCzech RepublicDenmarkDjibouti DominicaDominican Republic East TimorEcuadorEgyptEl Salvador Equatorial GuineaEritriaEstonia EthiopiaFalkland IslandsFaroe Islands Fed Rep YugoslaviaFijiFinland FranceFrench GuianaFrench PolynesiaFyro Macedonia GabonGambiaGeorgiaGermany GhanaGibraltarGreeceGreenland GrenadaGuadeloupeGuatemalaGuinea Guinea-BissauGuyanaHaiti HondurasHong KongHungaryIcelandIndia IndonesiaIranIraqIrelandIsraelItaly Ivory CoastJamaicaJapanJordan KazakhstanKenyaKiribatiKoreaKuwaitKyrgyzstan LaosLatviaLebanonLesothoLiberiaLibyaLiechtenstein LithuaniaLuxembourgMacaoMadagascarMalawi MalaysiaMaldivesMaliMaltaMartiniqueMauritania MauritiusMexicoMoldovaMonacoMongoliaMontserrat MoroccoMozambiqueMyanmar (Burma)NamibiaNaura NepalNetherlandsNetherlands AntillesNew Caledonia New ZealandNicaraguaNigerNigeriaNiueNorway OmanPakistanPanamaPapua New GuineaParaguayPeru PhilippinesPitcairn IslandPolandPortugalQatarRepublic of Korea Reunion IslandRomaniaRussiaRwandaSaint BarthelemySaint Croix Saint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre and Miquelon Saint Vincent and GrenadiSan MarinoSao Tome and PrincipeSaudi Arabia SenegalSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon Islands Somalia Northern RegionSomalia Southern RegionSouth AfricaSouth Sandwich IslandsSpain Sri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwan TajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkey TurkmenistanTurks and Caicos IslndTuvaluUSAUgandaUkraineUnited Arab Emirates United KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnam Virgin Islands (United Kingdom)Wallis and Futuna IslandsWestern SaharaWestern Samoa YemenZambiaZimbabwe (Rhodesia)
Short descriptions of present complaints : *
Duration of Complaints : *
Diagnosis according to Allopathic Medicine : *
Details about other associated problems like Diabetes, Hypertension, Cardiac Problems etc. : *
*Your privacy is important to us. Your e-mail address will not be disclosed to anyone, and it is not tied in any way to your personal identity. All the information you provide here will be kept strictly confidential.

Our constitution is the inherent balance of energies within our bodies and our minds. It describes who you are on the most fundamental level. By understanding your own unique nature or constitution you can begin to understand how you interact with your environment and thus make choices that will lead you toward greater health. Ayurveda shows that the path to optimal health is different for each person depending upon their constitution. To help identify your constitution please read the questions below and try to answer them to the best of your knowledge. (Please tick the right one)

*Mandatory Field
Name : *
Age :*
Weight :*
Height :*
Email : *
Country :	Albania Algeria AndorraAngolaAnguilla Antigua and BarbudaArgentina ArmeniaAruba Australia AustriaAzerbaijanAzores BahamasBahrainBangladesh BarbadosBelarusBelgium BelizeBeninBermuda BhutanBoliviaBorneo Bosnia and HerzegovinaBotswana BrazilBritish Indian Ocean Territories BruneiBulgariaBurkina Faso (Upper Volta) BurundiCamaroonCambodia CanadaCanary IslandsCape Vere IslandsCayman Island Central African RepChad ChileChinaChristmas Island ColombiaComoros IslandsCongo, Democratic Republic of Costa RicaCroatiaCuba CyprusCzech RepublicDenmarkDjibouti DominicaDominican Republic East TimorEcuadorEgyptEl Salvador Equatorial GuineaEritriaEstonia EthiopiaFalkland IslandsFaroe Islands Fed Rep YugoslaviaFijiFinland FranceFrench GuianaFrench PolynesiaFyro Macedonia GabonGambiaGeorgiaGermany GhanaGibraltarGreeceGreenland GrenadaGuadeloupeGuatemalaGuinea Guinea-BissauGuyanaHaiti HondurasHong KongHungaryIcelandIndia IndonesiaIranIraqIrelandIsraelItaly Ivory CoastJamaicaJapanJordan KazakhstanKenyaKiribatiKoreaKuwaitKyrgyzstan LaosLatviaLebanonLesothoLiberiaLibyaLiechtenstein LithuaniaLuxembourgMacaoMadagascarMalawi MalaysiaMaldivesMaliMaltaMartiniqueMauritania MauritiusMexicoMoldovaMonacoMongoliaMontserrat MoroccoMozambiqueMyanmar (Burma)NamibiaNaura NepalNetherlandsNetherlands AntillesNew Caledonia New ZealandNicaraguaNigerNigeriaNiueNorway OmanPakistanPanamaPapua New GuineaParaguayPeru PhilippinesPitcairn IslandPolandPortugalQatarRepublic of Korea Reunion IslandRomaniaRussiaRwandaSaint BarthelemySaint Croix Saint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre and Miquelon Saint Vincent and GrenadiSan MarinoSao Tome and PrincipeSaudi Arabia SenegalSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon Islands Somalia Northern RegionSomalia Southern RegionSouth AfricaSouth Sandwich IslandsSpain Sri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwan TajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkey TurkmenistanTurks and Caicos IslndTuvaluUSAUgandaUkraineUnited Arab Emirates United KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnam Virgin Islands (United Kingdom)Wallis and Futuna IslandsWestern SaharaWestern Samoa YemenZambiaZimbabwe (Rhodesia)
Sex:	Male Female
Your skin texture is :	Dry and Rough Warm, Oily Pale and cold
Your hair are :	Dry and thin Thin and Oily Thick and oily
Your teeth are :	Poorly formed Moderate, bleeding gums Large
Your nails :	Small and nervous  Yellowish, Red Large, White
Your eyes :	Rough and brittle  Soft and pink Soft and white
Your thirst :	Low High Moderate
Your stool :	Hard and dry Soft and loose Normal
Your activity:	Very active Medium Low
Your sleep :	Poor and disturbed  Medium Excess
Your memory :	Quick, forget easily  Sharp and clear Slow but steady
Decision taking Capacity:	Nervous Very clear Medium
Sexually you are :	Nervous dominant Strong
You tend to develop gas or constipation	Yes No
You prone to cold hand and feet	Yes No
You frequently anxious & worried	Yes No
You like cold weather	Yes No
Your mood changes easily	Yes No
You are easily excitable	Yes No
You consider yourself very efficient	Yes No
You are very discipline & precise In your work	Yes No