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Dr. Sarkar's online clinic
 
 
Now Systematic Homoeopathic treatment based on symptomatic peculiarities is just a mouse click away. Dr. Sarkar and his panel of well qualified Doctors of great reputation would provide you the Homoeopathic treatment you always wanted to undergo but never found in your locality.
Now access a world class Homoeopathic treatment from the comfort of your home.
The Doctors can also refer  to this clinic for consultation and necessary tips for their daily practice.
 
Your Name* :
Age* : years months
Sex* :
Blood Group*

:
Weight* :
Height : ft. inch.
Occupation :
Your Address* :
Your Contact No* :
Your Email* :
CHIEF COMPLAINT
Description of the complaint in own words* :
HISTORY OF PRESENT COMPLAINT
When did this Symptom first appear :
Any treatment already undergone (Any Stream of Medicine) :
Any family history of similar complaint :
ASSOCIATED COMPLAINTS IF ANY
Give detail of each associated complaint :
MENTAL SYMPTOMS
Easily angered or not/any specific phobia/Memory and intellect/dreams etc. Anything about the mental condition which does not seem normal to the patient or as observed by others
Self Observation :
As Observed by A Close Relative/Friend :
PARTICULAR SYSTEMS
Respiratory System (Breathing as a whole) :
Gastro – Intestinal system
(Digestive system including nature of stool e.g Diarrhoea/Constipation)		 :
Cardio Vascular System
(problem realated to the Heart, Blood & Blood Vessels)		 :
Nervous Sytem
(Any problem related to the nerves, Spinalcord & Brain)		 :
Musculo-Skeletal System
(Any problem realated to the bones, joints, muscles)		 :
Skin (Problems related to the skin) :
DESIRES AND AVERSIONS
In this segment note all Desires and Aversions
(Food , Drink, Weather conditions in particular)		 :
AGGRAVATION/AMELIORATION
In this segment note the conditions Physical/mental/environmental which cause Aggravation (Increase) and Amelioration (Decrease) of Disease Symptoms :
Addictions or Habits if any :
Allergies if any :
 
 
 
 
 
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