TerraBlue XT - TJay Suite

1) What was the age when you got menarche?

2) Are you married or single?

Married Single

3) Was there a tendency to fall to one side?

No Yes

4) Are you sexually active?

No Yes

5) Did you had any unprotected sex?

No Yes

6) Do you feel any pain during intercourse?

No Yes

7) Can you tell about your last menstrual period? (first day of last menstrual period)

8) What was the menstrual cycle length(Interval from first day of ones menstrual period to final day of next menstrual period)

9) What is the duration of flow?

10) Are there any molimal symptoms? (mood swing, increased appetite, abdominal distension etc)

11) Is it associated with any pain? (abdominal or back pain)

No Yes
If Yes, Mention Symptom

12) Is it accompanied by any feeling of headache or nausea?

No Yes

13) Do you notice any intermenstrual bleeding? (Spotting small amount or spot of blood between bleeding midcycle)

No Yes

14) Do you have any history of sexually transmitted disease?

No Yes

15) Is it accompanied by any vaginal discharge?

No Yes

16) Do you feel any burning sensation?

No Yes

Mr. Vinod Sharma
DOB: 01/01/1978 (Age 37), Male

+91 97420 56787

Chat

Video Call