City WhatsApp No.Occupation Past illness (B.P, Diabetes, Thyroid etc.)
Tick all the boxes that apply to you.
1)How is your physique?
Thin MediumObese
2) Your weight?
Underweight (in relation to height) Optimum – as per age and heightOverweight
3) How is your complexion?
DuskyWheatishFair
4)What is the colour of your hair?
Jet blackGolden/ brownBlack
5) How are your eyes?
Small, dry, white part of eye is turbid (not clear white)Small, white part of eye is yellow/red, Brown eyes (iris)Big, attractive, black eyes (iris), white part of eye is milky white
6)How are your lips?
Slightly thinYellowish red (pink)Reddish/ pinkish, attractive, beautiful
7)How are your teeth?
Very small/ very big, teeth pushed forward, can be seen out of lips, broken, irregular in shape and size, dry Medium size, yellowish or yellow coloured Ivory white, attractive shape, even-sized
Rough, cracked Reddish/ pinkish in colorDelicate/ small
10 )How is your skin?
Dry, rough, looks like dried twigDelicateSoft, delicate, smooth, oily (unctuous)
11)Your strength?
Weak, intolerant to strenuous activities, unable to lift heavy weight, easily tired by little workMedium strength Good endurance, can easily perform strenuous activities, can carry heavy loads, does not experience fatigue easily, can work all day
12)What is the temperature of your body?
Low, hands and feet feel cold even in summers Body feels warm all timeNormal temperature (neither cold nor hot)
13)How are your joints?
Crepitus is heard on movements of jointsJoints, bones cannot be seenJoints are strong, well covered with muscles, bony prominences cannot be seen
14)How is your body above stomach(umbilicus)?
Stomach is lean (lean belly) Size of stomach is medium/optimum (medium belly) Abdominal obesity (large belly)
15)How is your hunger?
Irregular (sometimes intense, sometimes low hunger) Intense hunger – cannot control hungerLow hunger – can skip one meal
16)How is your digestive capacity?
Digestive capacity is erratic – sometimes good, sometimes low. Sometimes ingestion leads to excess burpingVery good. Food taken as per hunger gets digested in 3-4 hours and after that there is manifestation of proper hunger again.Low digestive capacity. Sometimes there is no desire to have food in the evening.
17)What is your quantitative food intake?
Sometimes too much in quantity, sometimes too lessAlways too much (voracious eater)Moderate – not too much or too less
Not muchExcess thirst. Needs to drink more water even in cold seasonModerate
20)Do you prefer warm food or cold food?
Sometimes warm, sometimes coldColdWarm
21)Do you prefer warm beverages or cold beverages?
Sometimes warm, sometimes coldColdWarm
22)Do you experience constipation?
Many a times
Always pass liquid stoolsNot much
23)Do you experience excess sweating?
Sometimes too much, sometimes too lessExcess – excess as compared to people aroundSometimes
24)How do you speak?
Very fast. Some words are not clearly spoken. Few words are not audible to people around.Very fastSlowly. Calmly. Emphasizing on each word while speaking
25)What is the speed of your walking?
Brisk/ rapid. Walks like one’s runningFastSlow. Walks like an elephant stepping foot properly on the ground
26)What is the pace of your daily activities?
Very fast Medium speedVery slow
27)How do you react to any incident? Do you react impulsively?
Cannot tell. Sometimes react impulsively, sometimes give no reaction.Always impulsiveDepending on the incident. Thoughtful reaction. Reacts after due thinking
28)How do you perform your daily activities?
With high energyWith moderate energySometimes with low energy/ lethargy
29)How is your grasping power?
Very quick to grasp thingsVery easy to grasp things and understands properlySlow to grasp things but understands completely
30)How is your memory?
Low memory – remembers for 2-3 monthsMedium memory – can remember if revised frequentlyLong-term memory
31) How is your learning (memorizing) power?
Remembers after speaking-repeating many timesRemembers after reading for 3-4 timesRemembers after reading even once
32)How is your sleep pattern?
Less sleep. Breaks in between. Not continuous or sound sleepModerate. 5-7 hoursExcessive sleep. More than 8 hours, sound, continuous, deep sleep
33) Do you dream when sleeping?
Excess dreamsSometimesSeldom/ sometimes
34) What is generally the pattern of your dreams?
Scary, flying, running, jumping, climbing on a tree or mountainAnger, fighting, quarrelling, dream about bright light, sun, goldDreams about sea, ponds, lotuses, reservoirs, swans, thundering clouds, gardens, love/affection
35) How do you solve your problems?
Very stressed, confused, changes decision, unable to come to conclusion/ final decisionVery angrily, very impulsiveAfter proper thinking, calmly, slowly. Generally is firm on decision