Empower with Self-Check for heart disease

Empower with Self-Check for heart disease

Hello there!👋

What is your age (in years)

What is your gender?

smoking

Male

smoking

Female

smoking

Others

Do you experience any of these symptoms?

smoking

Chest pain

smoking

Shortness of breath

smoking

Palpitations

smoking

Restlessness

smoking

Tiredness

smoking

Giddiness

smoking

Sweating

smoking

None

Apart from the above symptoms,do you experience any of the following?

smoking

Blackouts

smoking

Jaw pain

smoking

Back and upper abdomen pain

smoking

Heaviness in left arm

smoking

None

Has any member of your family been diagnosed with Heart Diseases?

smoking

Parents

smoking

Grandparents

smoking

Immediate uncles

smoking

Immediate aunts

smoking

Siblings

smoking

None

Does your diet include excessive amounts of

smoking

Non-veg-red meat

smoking

Sweets

smoking

Junkfood

smoking

Bakery products

smoking

None

What is your height in cms?

What is your weight in kgs?

Do you consume tobbaco in any form?

smoking

Smoking

smoking

Chewing

smoking

Sniffing

smoking

None

Do you consume alcohol?

smoking

Yes

smoking

No

smoking

In the past

How is your routine lifestyle?

smoking

Sedentary

smoking

Mildly active

smoking

Active

smoking

Very active

Do you exercise?

smoking

Never

smoking

Daily

smoking

Sometimes

How do define your stress level?

smoking

Minimal

smoking

Moderate

smoking

High

smoking

None

Do you get adequate sleep daily?

smoking

4-6 hours

smoking

6-8 hours

smoking

Less than 4 hours

Are you on any regular medication?

smoking

Any Cardiac Meditation

smoking

Herbal

smoking

Others

smoking

None

Do you have any of the following condition?

smoking

Dyslipidemia

smoking

Hypertension

smoking

Obesity

smoking

Peripheral Vascular Disease

smoking

Diabetes

smoking

Any congenital or acquired heart disease

smoking

None

Were any of following tests done, on the higher side?

Your Name

Whatsapp No

City

Big Congratulations, !
Your health assessment for is Successfully Completed
Your Health Assessment Score is within the range.
Your risk evaluation and recommendations are ready for your review on WhatsApp (No. ).

Thanks & Regards,
Team Indus

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