Lipid Disorder Screening Test

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Lipid Disorders Screening

Demographic Details

Gender *
Please Select Gender

M

F

Age *
Please Select Date of Birth

Age must be greater than 0 and less than 125 Years

Months must be less than 12

Days must be less than 31

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-

Days

Mnth

Yrs

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Lipid Disorders Screening

Do you have immediate family history of any of the adjacent diseases? *

Diabetes Hypertension Heart disease Stroke Lipid disorders (Cholesterol) Thyroid disorders PCOD/PCOS Others None

Do you have history of any of the adjacent diseases? *

Diabetes Hypertension Heart disease/Stroke Lipid disorders (Cholesterol) Thyroid disorders PCOD/PCOS Nutritional deficiencies (Vitamin B12/D/Calcium/Iron) Others None

How many minutes in a week do you exercise? *

How many times in a week do you consume Alcohol? *

Never Monthly or less 2-4 times in a month 2-3 times a week 4 or more times in a week

What does your diet predominantly contain? *

Fruits and Vegetables Processed food Junk food Cereals Pulses

Do you consume Tobacco in any form(Smoking/Chewing)? *

Never Reformed Current

Height

Cms

Feet

Inches

Weight *

BMI

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Lipid Disorders Screening

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Lipid Disorders Screening

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