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HEALTH TOURISM IN OUR AGENCY THROUGH OUR E-MAIL

Name of the Patient *
Age *
years
Sex
Male
Female
Address
Email *
Phone No.
Fax No.
For Certain Important Diseases you can get Modern Indian Herbal & Ayurvedic Medicines from India from us.
Height
cm
Weight kg  
Married Yes No   Children Yes No
Satisfactory Sex Yes No   Impotency Yes No
Smoking / Drinks Yes No   Diabetes Yes No
Hypertension Yes No   Traveling often Yes No
Family / Business Worries Yes No   Any Investigations done earlier ? Yes No
Any Drugs Taken Yes No   Any Other Diseases Treated Yes No
Any Operation Done Yes No   Good Appetite / Sleep Yes No
Constipation / Burning / Micturition Yes No   Any Skin Diseases Yes No
Please enter your complaints or the problems you have. Our Panel of Experts in various Systems to Medicine will give you their Medical Consultation.

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