Spiritual Healing - Online/ Telecom Counseling by Swami Ramdev Ji's Yoga Teacher Shri A K Lal - available on great demand for Patients - Format for emailing Patient Details.- May please share with your friends, relatives, associates etc.
AKumar VBtech
Those interested in Spiritual Healing, please email your Patient details in the following format, to yoga...@gmail.com separately for each patient and call us after that as per our contact us page at: www.yogpranayam.com
Name ::
Gender :: Male/ Female
Age ::
Marital Status ::
Blood Pressure - Mention reading, if not normal::
Sugar Level - Mention reading, if not normal::
Cholesterol Level - Mention reading, if not normal::
Weight in Kg .only ::
Height in Feet, Inches ::
Are you Overweight/ Under weight/ Normal? ::
Are you a Vegetarian/ Non-Vegetarian? ::
Dependence on Alcohol Drugs Smoking Coffee/Tea ::
Major Ailment/s or Disease/s ::
All other Ailments - in order of severity ::
Presently taking treatment for which Disease/s ::
Personal Medical History ::
Personal Mental Tension/s, if any::
Family Madical History, in brief - Parents only ::
Do your disease symptoms decrease or increase, when you change places having different climates? ::
Give details about your addictions/cravings, if any, like tea, coffee, alcohol, sugar, smoking, drugs etc. ::
How would you describe yourself emotionally? ::
What time do you usually go to sleep & wake up? ::
Do you want to take Yoga Pranayama & Ayurveda Treatment? :: Yes/ No
Do you also want to take the Spiritual Healing? :: Yes/ No
Other information which you think might be helpful ::
Laboratory Investigation Reports (if any) - Please mention in brief in text only::
USG/MRI/Scan Reports (if any) - Please mention in brief in text only ::
Remarks, if any ::
Patient Contact Information ::
Full Postal Address ::
City & ZIP/ PIN Code ::
State ::
Country ::
Home/ Landline Telephone: (Country Code - Area Code - Phone ) ::
Mobile / Cellular Phone: (Country Code - Area Code - Phone ) ::
Education ::
Email ID ::
Alternate Email ID, if any ::
Profession/ Job Role ::
For Free PC to PC calls to us, get your Skype ID FREE, (visit www.Skype.com to get your ID) ::
Senders' Name & Contact Information, as above, if different ::