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HEALTH DETAILS
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Planning for Pregnancy in next 6 Months
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Main Complaint
Duration of the complaint
Year
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2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
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1996
1995
1994
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1992
1991
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1988
1987
1986
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24
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Any other associated minor Complaints
Taking any Medication at present
Functional history
Appetite
Acidity
Gas
Motion
Urination – day/night
Sleep – day/night
Diet - veg/non veg
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