GENERAL HEALTH CHECK-UP

Name: Address:
Age: Sex:
Qualification:
Occupation:
Income:
Blood Group: Phone:
HISTORY

1 Ht/Wt:

2 BMI:

3 Waist/ Hip:

4 WHR:

5 SBP/DBP

6 FBS

7 TC

8 TG

9 Stress Scale
1 Emotional
0 Intelligence
1
Addictions Scale
1
1
Sleeping Scale
2
1
Working Hours
3
1
Negative Eating
4
1
Journey Time
5
1 Good habits
6 score
 GENERAL HEALTH CHECK-UP

Name: Address:
Age: Sex:
Qualification:
Occupation:
Income:
Blood Group: Phone:
HISTORY

1 Ht/Wt:

2 BMI:

3 Waist/ Hip:

4 WHR:

5 SBP/DBP

6 FBS

7 TC

8 TG

9 Stress Scale
Emotional
10
Intelligence
11 Addictions Scale

12 Sleeping Scale

13 Working Hours

14 Negative Eating

15 Journey Time

16 Good habits score

 Creative Fruits Nuts Maths Outing Games Science

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