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Dr.Sanjay Borude,
General Physician
John Smith
Yesterday
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John Smith
Yesterday
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John Smith
Yesterday
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Profile
Mr. Vinod Sharma
DOB: 01/01/1978 (Age 37), Male
+91 97420 56787
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Height: 163 Cms
|
Weight: 67 Kg
|
Blood Group: A Ve
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Predictive Models
Cardiorespiratory
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Phycomotor
Phycomotor
1)
Rate your insights about the patient:
a) Appearance and dressing:
Poor
Average
Good
b) Hygiene:
Poor
Average
Good
c) Maintaining eye contact:
No
Yes
d) Mood:
Disturbed
Relaxed
Sad
e) Restlessness:
Restless
Composed
f) Any other observation
2)
What did you enjoy doing before or your hobbies?
3)
Do you enjoy doing the same things now?
No
Yes
4)
How is your appetite?
Normal
Tendency to eat less
Tendency to eat more
5)
How do you see your future?
Bright
Dark
6)
How is your sleep pattern? Do you wake you early morning or are you unable to sleep properly?
7)
Did you ever had thoughts of hurt yourself?
No
Yes
If yes, What have you tried to do to hurt yourself?
8)
Have you ever had thoughts of ending your life?
No
Yes
If yes, What exactly did you do?
9)
Do you have any regrets like you did not succeed in your life?
No
Yes
10)
Have you had any mental health issue earlier?
No
Yes
11)
Did you ever visited a physiatrist earlier?
No
Yes
12)
Have you ever been in trouble with police?
No
Yes
13)
Do you have friends?
No
Yes
15)
How is your relations with your parents and siblings?
Good
Poor
16)
What memories you have of growing up?
17)
Are you sexually active?
Good
Poor
18)
Are you straight or bisexual?
Straight
Bisexual
19)
Do you do any job now?
No
Yes
20)
Do you stay alone or with family?
Alone
With Family
With Friends