Patient Prediction
Name:
Age:
Occupation:
Engineer
Doctor
Teacher
Nurse
Lawyer
Manager
Clerk
Technician
Artist
Scientist
Salesperson
Cashier
Student
Retired
Unemployed
Gender:
Male
Female
Other
Height (cm):
Weight (kg):
BMI:
BP Value (eg:120/80 mmHg):
Diabetes:
No
Yes
Energy Levels:
Very High
High
Moderate
Low
Very Low
Sleep Issues:
None
Mild
Moderate
Severe
Chronic
Diet:
Balanced
High in Fat
High in Sugar
Low in Protein
Vegetarian
Vegan
Keto
Other
Physical Activity Level:
Very Active
Active
Moderate
Low
Sedentary
Smoking/Alcohol:
None
Occasional
Regular
Heavy
Mental Health:
Excellent
Good
Fair
Poor
Symptoms:
Common Issues:
Weight Loss
Weight Gain
Swelling in legs
Swelling in foot
Snoring
Hair fall
Fever
Varicose Veins
Skin:
Obvious change in size, color & shape of wart or mole
Dry skin
Allergic Rash
White patches
Darkening of skin
Fungal infection
Wart
Corn
Head Brain & Nerves:
Headache / Migraine
Memory Loss
Dizziness
Fainting
Tingling in parts of the body
Numbness in parts of the body
Tingling / Numbness in hands, legs & feet
Epilepsy / Seizure / Fits
Eye:
Redness of Eye
Watering of Eye
Itching of Eye
Disturbance in vision
Eye Pain
Ear:
Ear Pain
Ear Discharge
Hearing Loss
Ringing Sound in Ears
Vertigo or Spinning sensation
Nose:
Sneezing due to allergies
Sinusitis
Nose bleeding
Dental:
Pain in teeth or gums
Sensitive teeth
Cavities
Bad breath
Mouth Ulcers
Bleeding in Gums
Throat:
Difficulty in Swallowing
Throat Irritation or Pain
Voice change
Snoring
Swelling on the face
Swelling on the neck / throat
Chest:
Wheezing
Cough
Difficulty in breathing
Blood in phlegm/Spit
Breast:
Breast pain
Swelling
Lump
Discharge
Change in breast size
Change in breast skin color or texture
Heart:
Chest pain
Raising heartbeat or palpitations
Dizziness
Fainting
Stomach:
Gastric Reflex
Constipation
Diarrhea
Change in bowel habits
Bloating
Passing Gas
Rectal Bleeding
Loss of Appetite
Abdominal Pain
Acidity
Vomiting
Nausea
Belching
Family History (eg:Diabetes,Cancer etc):
Diagnosis Conditions:
Hyperthyroidism
Hypoparathyroidism
Hyperparathyroidism
Hypothyroidism
Gall Bladder Stones
Gall Bladder Polyp
Cancer (Stage 1)
Cancer (Stage 2)
Cancer (Stage 3)
Cancer (Stage 4)
Ayush Practices:
Ayurveda
Yoga
Unani
Siddha
Homeopathy
Naturopathy
None
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