Case History

الطب النبوي

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Home
Online Courses
Tibb-e-Nabawi Diet Package
Articles
Testimonials
Why Zilmarwah
About
How To Enroll
Gallery Page
FAQ’S
Contact Us

To select a suitable diet plan, we need to know your case history.

Please take some time & fill this form carefully with correct information, your details will be kept hidden as your privacy matters to us.

Your Name *

Email Address *

Telephone / WhatsApp Number *

Country Of Residence *

Body Weight *

If you want to lose weight, what is your target weight? *

Height *

Gender *MaleFemale

Your Age *

Are you married or single ? *

Foods you love to eat *

How many meals + snacks you take daily? Also write the timings of your meals *

Foods that trigger you & cause allergies / reactions? *

How milk & yogurt suit your body? *

How cold natured foods like watermelon, cucumber suit your body ? *

Do you feel that your body’s temperament is hot natured, cold natured or balanced in between? *

For what purpose / health concern you want to adopt Tibb-e-Nabawi diet ? *

Do you have any chronic illnesses, like Diabetes, Hypertension, Coronary Artery disease, High Cholesterol, etc. If you have any, how old is your chronic disease? (i.e. if you have Diabetes for 10 years, etc.) *

Any medications which you are taking ? *

Any history of heart failure or heart attack? Any member in your family had a heart failure or heart attack? *

Do you suffer with mental stress, Anxiety ? *

Did you ever have any kind of surgery performed on you ? *

Your Hemoglobin level ? *

Have you ever taken Hijamah ? *

Is your lifestyle active or sedentary ? *

If you are a woman, send your menstrual cycle history for the last 6 months. (If you are a male, just type NO) *

If you have a baby, are you breastfeeding ? (If you are a male, just type NO) *

Apart from above, do you want to add any information further ? *

الطب النبوي Search

Case History

Your Name *

Email Address *

Telephone / WhatsApp Number *

Country Of Residence *

Body Weight *

If you want to lose weight, what is your target weight? *

Height *

Gender *MaleFemale

Your Age *

Are you married or single ? *

Foods you love to eat *

How many meals + snacks you take daily? Also write the timings of your meals *

Foods that trigger you & cause allergies / reactions? *

How milk & yogurt suit your body? *

How cold natured foods like watermelon, cucumber suit your body ? *

Do you feel that your body’s temperament is hot natured, cold natured or balanced in between? *

For what purpose / health concern you want to adopt Tibb-e-Nabawi diet ? *

Any medications which you are taking ? *

Any history of heart failure or heart attack? Any member in your family had a heart failure or heart attack? *

Do you suffer with mental stress, Anxiety ? *

Did you ever have any kind of surgery performed on you ? *

Your Hemoglobin level ? *

Have you ever taken Hijamah ? *

Is your lifestyle active or sedentary ? *

If you are a woman, send your menstrual cycle history for the last 6 months. (If you are a male, just type NO) *

If you have a baby, are you breastfeeding ? (If you are a male, just type NO) *

Apart from above, do you want to add any information further ? *

Case History

Case History

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