×
Home
About Cardiomersion
Cardiomersion Chairman- Dr Deepak Puri
Medical Section
Hospitals
Previous Hospitals
Current Hospitals
Surgeries
Prevention & Awareness
C M E
CONFERENCES
faculty members
ORGANISING COMMITTEE
Publications
Awards/ Achievements
Media
APPLY FOR MEMBERSHIP
abstracts
Projects & Trainings
Events
Past Events
2010
2011
2012
2013
2014
2015
2016
2017
2018
2018
2019
2020
2021
2022
2023
2024
Upcoming Events
APPLY FOR MEMBERSHIP
Lifestyle & Fitness
Apply For Membership
Lifestyle & Fitness Tips
Cultural Events
Feedback
Blog / V Log
Upcoming Events
Contact Us
MENU
Apply For Membership
Leave this field blank
Name
Contact
Email
Gender
Male
Female
Qualifications
(optional)
Occupation/ Current Position:
(optional)
Income
(optional)
Background Status
Rular
Urban
Family History
(optional)
Heart Attack
High Blood Pressure
Diabetes
Obesity
Cancer
Depression
About You(150 Words)
(optional)
Physical Activity
(optional)
Low /<150mins/Week
Moderate /150mins/Week
High />150mins/Week
Sleep
(optional)
Low /<7hours
Moderate / 7 to 8hours
High /> 8hours
Sugar Intake
(optional)
Low /< 5gm
Moderate / 5gm
High /> 5gm
Salt Intake
(optional)
Low /< 5gm
Moderate / 5gm
High /> 5gm
Fat Intake
(optional)
Low /< 10
Moderate / 10
High /> 10
Fibre Intake
(optional)
Low
Moderate
High
Nuts
(optional)
Low
Moderate
High
Foods And Vegetables
(optional)
Low
Moderate
High
Supplements
(optional)
Low
Moderate
High
Junk Food
(optional)
Low
Moderate
High
Per day
(optional)
Per Week
(optional)
Per Month
(optional)
Type
Beer
Wine
Cider
Strong
Per Day
(optional)
Per Week
(optional)
Per Month
(optional)
Smoking
(optional)
Cigarette
Hookah
Cigar
Bidi
Per day
Per Week
Per Month
Drugs
(optional)
Prescribed Drugs
Sedatives
Narcotics
Hyphnotics
Anti-Depressants
Hobbies
(optional)
Games
Music
Poetry
Dancing
Swimming
Singing
Gyming
Others
History of Anxiety Depression
(optional)
Occasionally
usually
Frequently
Constant
Relieved by
(optional)
Physical Activity
Music
Rest
Yoga
Meditation
Sleep
Alcohol
Smoking
Drugs
Stress
(optional)
Occassionaly
Often
Frequently
Always
Cause
(optional)
Professional
Finanical
Relationship
Household
Marital Status
(optional)
Single
Commited
Live-in Relationship
Married
Open
Multiple
Casual
Height
(optional)
Weight
(optional)
Waist
(optional)
Hip
(optional)
Shoulder
(optional)
Chest/Bust
(optional)
Thigh
(optional)
Mid Arm
(optional)
BMI
(optional)
Height/Waist Ratio
(optional)
Pulse
(optional)
BP
(optional)
Blood Sugar
(optional)
Lipid Profile
(optional)
Thyriod Profile
(optional)
Happiness Quotient
(optional)
Always
Monthy
Occassional
Rarely
Never
Submit Form
Copyright ©2022 all rights reserved
Design & Developed By:
Itronix Solutions
