Questionnaire

Know your Health Quotient

1. WAKE UP TIME :

2. LUNCH TIME

3. DINNER TIME

4. SLEEPING TIME :

5. BOWEL MOVEMENTS : No of Times a day

6. EXERCISE : No of days a week

7. YOGA : No of days a week

8. NON VEG FREQUENCY :

9. EATING OUT :

10. MEDICATION : Are you on medication? No of days in a week you have medication?

11. SEXUAL ACTIVITY : No of days in a week?

12. BLADDER HABITS :COLOR

13. No of times you wake up in the night for urination ?

14. Happiness : How happy are you.

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