Online Consultation

*Name

*Email

*Contact No.

*Age.

*City.

*Suffering from Diabetes for last how many yrs (when Sugar Detected)

*First checkup BI. sugar was
Fast mgm
PP mgm

*Treatment
Tab 1
Tab 2
Tab 3
Tab 4
Tab 5

Insuline
Morning (in Unit )
Afternoon (in Unit )
Night (in Unit)

Insuline
Morning (in Unit )
Afternoon (in Unit )
Night (in Unit)

*Blood Sugar
Fast mgm.
PP. mgm.

Date

HbA1c
Date

Other Diseases
B.P.Vision ProblemOver WeightWeight LossNeuro ProblemGenetic HistoryOver Urine FlowMental StressAnemiaJoint PainDigestion ProblemSleep Disturb