Q1. YOUR GENERAL APPEARENCE Pleasing Appearance/Look Calm(Not
Bewildered/Not Confused Look) Normal/Can't
Specify
Q2. YOUR BODY SIZE
Medium
Size Thin or
Slim Well
Built(Proportational Body
Structure
Q3. BODY STRENGTH
Less Medium Strength
Firm or
Strong
Q4. CHARACTERISTICS
OF CHEST Normal
Size Broad & Well
Formed Thin or
Small
Q5. APPEARANCE OF
VEINS AND TENDONS ?
Very
Prominent Less
Prominent Not
Prominent
Q6. CHARACTERISTICS
OF JOINTS ? Emits
Cracking Sounds when moves Soft & Flabby
Joints Well-Knit &
Fleshy
Q7. YOUR SKIN COLOUR
/ COMPLEXION ? Greyish Black Pale Yellow Color Of
Lotus/Gold
Q8. YOUR SKIN NATURE
?
Rough &
Dry Cracked / Wrinkled
Oily
Q9. YOUR BODY IS
Hot To Touch/Raised Body Temperature
Cold To
Touch /Lower Body
Temperature
Q10. YOUR BODY ODOUR
AS EXPERIENCED BY OTHERS
Normal Odour
Slight Body
Odour Unpleasent Body
Odour
Q11. NATURE OF YOUR
HAIR ?
Oily In
Nature Firm,Thick/Brushy
Deep black in
colour Brown/copper in
colour Rough
in touch
Q12. NATURE OF HAIR
GROWTH
Tendency for early baldness is seen
Tendency
for early greying is found Interwined /
Curled in nature Scanty / Thin hair
Easily breaking
hair
Q13. NATURE OF NAILS
? Rough / hard / small Brownish yellow
Smooth and
shining
Q14. CHARACTERISTICS
OF FOREHEAD ? Narrow Medium or Normal
Broad
Q15. NATURE / COLOUR
OF LIPS ? Rough
Pink /
Reddish Cannot
specify
Q16. COLOUR / NATURE
OF EYES ? Grayish in colour Yellow in colour
White /
red tint at corners EYES
BECOME RED due to heat/sun /anger/ alchohol
White /
red tint at
corners
Q17. SHAPE OF YOUR
EYES Small
/ Round Dull / Gloomy
eyes Wide
long and clear Unsteady or
Rolling With Thin
and short / less
EYE-BROWS
Q18. NATURE OF TEETH
AND GUMS...? Rough or broken Regular and well
formed Yellowish teeth
Whitish
teeth
Q19.
NATURE OF SPEECH AND VOICE....?
Low /feeble /interrupted speech / broken
voice Measured
conversation Talkative/
tendency to contradict / argue Voice is clear
and resonant Talkative/
tendency to contradict / argue Voice is clear and
resonant
Q20.
NATURE OF WALKING....?
Unsteady / Habit of wandering
Quick / light
footed Walk with
heavy measured steps Walking
slowly
Q21.
PERSPIRATION.....?
Sweats
profusely Less
perspiration
Q22.
NATURE OF HUNGER....?
Irregular
hunger Too
much hunger Less appetite /
thirst Normal
Q23.
TASTE PREFERENCE Sweet Sour Saltish Pungent Bitter Astringent
Q24.
TEMPERATURE PREFERENCE
Unable to
tolerate heat Unable to tolerate
cold Like to have
hot food and drinks Like to have
cold food and drinks Cannot
specify
Q25.
EXCRETORY HABITS....?
Hard and
constipated bowels Loose Passing
large amount of Urine / Feaces Passing less
amount of Urine Normal
Q26.
NATURE OF SLEEP...?
Sleeps
with eyes half open Disturbed,
or habit of grinding teeth Deep sleep Moderate sleep Less
Sleep
Q27.
WHAT ABOUT YOUR DREAMS ?
With dreams of Travelling, Flying, Wind
etc. With
dreams of lightining,lustrous objects,flame
With
dreams of Lakes, Birds, Flora etc. With dreams
of animals and
birds
Q28. DO
YOU Have
Long hand Found
many marks / moles / pimples on body Grind your teeth
Walk
/ Work / read/ eat very fast Move
your legs/hands/eye
lids/head,unnecessarily
Q29.
PSYCHOLOGICAL STATUS
Moods change
often Having good
endurance/ toleranc Changing
friends often / fallow relation ships Having
permanent relationships Liberal
minded towards favourite / who
appease
Q30.
GRASPING POWER & ACTION ..?
Slow grasping
Quick grasping
Quick action
Slow
action
Q31.
MEMORY POWER.....?
Good Moderate Bad
Q32.
Are you
interested in ?
Excess sexual
indulgence Less sexual
indulge Arts or sports
or fashionable Interested in
music very much Moderate in above
cases Please
select
Q33. Your
financial status ?
Please select Excellent Moderate Less
Q34. Are
You?
Please select Austere / Pious
Truthful Supporter of
justice Devoted to your
teachers Religious
Q35. Are
You?
Please
select Humble
Far sighted
Competitive
(negatively) Adventurous Taking pride in
your deeds
Your name :
Your email address
Your Address