Online Consultation Please fill out the form below for our specialized Doctors to assess your details and give you a prescription to our medicines. The Consultation charges will be Rs.700/- per session.Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Phone Number *Address *Age *Gender *Profession *Weight *HeightBlood Pressure *Blood SugarBowelNormalDryHardPasteUrinePale YellowYellowPainfulSleep CycleNormalAbnormalDisturbedCannabis Use Experience *YesNoList of Medicines you are currently taking, including Supplements and Vitamins *Brief Medical History (What are you diagnosed and treated for? What other illness or conditions do you have?) *Allergic to any medicines?* (If so, Mention) *History of Drugs (Alcohol, Tobacco, Drugs)Illness / Ailments / DiseaseHistory of any Illness / Ailments / DiseaseSubmit