Online Counselling
Online Counselling
Please first visit
www.YogPranayam.com & search very carefully for more
information on your specific Diseases/ Ailments etc. and its complete
package for treatment, with Aurvedic Herbal Medicines & VCDs/ DVDs on
specific Yoga Pranayama regimen to cure your disease/s.
Patients must visit the following pages, to get the proper treatment for
your medical/ mental condition/s.
For Package For various Diseases- Complete prescriptions of Ayurvedic Medicines from Swami Ramdev's D Y M Trust, please search for your specific disease online at:
For Package For various Diseases- Complete prescriptions of Ayurvedic Medicines from Swami Ramdev's D Y M Trust, please search for your specific disease online at:
http://www.yogpranayam.com/package-for-various-diseases-c-1.html
Also please search for your disease specific VCDs/ DVDs and Books etc. by Swami Ramdev online at:
Also please search for your disease specific VCDs/ DVDs and Books etc. by Swami Ramdev online at:
http://www.yogpranayam.com/swami-ramdev-dvds-c-6.html
For Specific Individual Ayurvedic Medicines from Swami Ramdev's D Y M Trust, please search for your specific Ayurvedic Medicines, by their specific names, online at:
http://www.yogpranayam.com/swami-ramdev-medicines-c-8.html
For Specific Individual Ayurvedic Medicines from Swami Ramdev's D Y M Trust, please search for your specific Ayurvedic Medicines, by their specific names, online at:
http://www.yogpranayam.com/swami-ramdev-medicines-c-8.html
Please order the medicines, which are listed on our website online & get back to us for the rest, we shall
send you the online Invoice for the same, via the secured payment
gateway.
Please get back to us on phone as per our Contact us page, if there is any ordering or payment
hassle.
Also please send the following information on your each patient
separately, duly completed, via email to
YogaSale@gmail.com for record/ statistical purposes.
(Please "Copy & Paste" this form in you Email browser; then fill it up
& send to: YogaSale@gmail.com )
All personal information shall be kept strictly confidential. We do
not share your email IDs with anyone. ::
Case Record Sheet for Online Counselling
The answers to any questions, like name & other inconvenient/
irrelevant questions of personal nature, my be left blank, as it is optional, but give all information to unserstand Patient Medical/ Mental condition.
===================================================
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? ::
Why do you want to try Yoga Pranayama & Ayurveda Treatment? ::
Other information which you think might be helpful ::
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? ::
Why do you want to try Yoga Pranayama & Ayurveda Treatment? ::
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 diffenrent ::
======================================================
Hope you have first visited
www.YogPranayam.com for more information on your Diseases/ Ailments & its treatment already available online.
For counselling, any clarifications etc. please call our customer care, during our timings, per our Contact us page.
Calls from NGOs, Medical Professionals, friends, relatives &
associates of the affected people are welcome.
Callers identity is kept strictly confidential.





