Dr. Nale Ayurveda

Personal Information

Full Name *

Mobile Number *

Email ID

Age

Gender

Address

How long have you been diagnosed with diabetes? *

Average Blood Sugar Level *

HbA1c Level

Current Medications

Family History of Diabetes

Lifestyle Factors

Diabetes Complications

Additional Notes

Are you currently on insulin therapy?

Are you taking any Ayurvedic or Homeopathic medicines?

Do you have a glucometer at home?

Medicine Compliance

Have you experienced hypoglycemia (low blood sugar)?

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