Aarogya yoga evam rasahar shodh samiti

286/2A, Saket Nagar, Bhopal Ph. 2452186

 

            Diabetes is a growing epidemic all over the world, particularly in India. According to the World health Organisation, India had over 61 million diabetes patients in 2010. The expected figure for 2030 is 80 million. 

Swami Vivekananda Yoga Anusandhana Samsthana, Bangalore, started a nationwide ‘Stop Diabetes movement’ to eliminate diabetes. To support it, Arogya Yoga evam Rasahar Shodha Samiti, Bhopal has started a survey of diabetics. We hope that people will support this program. The form provided is an obesity survey. In the coming months we will provide Yoga & Rasahar  to those in need who participate in this survey. So those suffering from multiple problems associated with diabetes, will get relief, and in future will not be dependent on medicines.

Purnima Datey                      Parul Kekre

   9425027273                       8989096659

Survey for Diabetes patients

Name ____________________________________________________

Address______________________________________________________

Mo.                                                                     E-mail

Weight____ Height______Age_______Gender______ Marital status______

Family History- Mother/Father/Siblings            Education___________

Latest report    FBS ______ PPBS________ Existing Medicine________

Alchohol/Smoking/Tobacco/Veg/non Veg       

Other associated problems – BP/ Heart/Eyes/Ears/Limbs/Digestion/Skin/

Others_____________________ Income group- Higher /Middle /Low Occupation– Service/Self/Retired/HW/Farmer/Student/Other____________

 Food time –Morning_____, Afternoon______, Evening_____, Night_____

Date________                                                                   Signature________