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Patient personal details:

Client Name	Maitri Kapadia
ClientID	12	Age	17
Gender	Female	Marital Status	Single
Weight	57	Height	160
BMI	22	Ideal Wt	52
Email	dharmishthakapadia23@gmail.com	Mobile	9821453146
First Consultation Date	22 January 2022	Next Review Date	30 January 2022
Record creation date	22 January 2022	ClientID	12
Address

Patient history form:

Family History

NIL

Current medication

NIL

Surgical History

h/o Typhoid 2 yrs back, Appendictomy in 2017, Covid last year

Menstrual History

28 days cycle, 5 days, associated with menstrual cramps

Pregnancy Details

NIL

My overall health goals are:

get relief from IBS

Techniques I have used in the past to reach my goals:

NIL

Current medication

NIL

I am having the current weight since:

1 year

Activities

Yoga	-
Cardio	Running- alternate days 30 min
Training	-
Sports	-

Average Sleep

Week end
Week day	7-8 hours

Do you associate any digestive symptoms with eating certain foods?	Yes
Do you have regular bowel movement?	No
Have you made any recent changes your diet for any reason?	No

Culture

gujrathi

Diet prefrences

VEGETARIAN

Strong likes

NO

Strong dislikes

Allergic food

milk, wheat, garlic, onion, chick peas

Sleep time

Wake up time	8.00am
Sleep time	11.30pm

Meal schedule

wake up- 1 glass of warm water + almonds , raisins breakfast- poha, dhokla, handwa, dosa, masala jowar roti lunch- moong dal, rice chapati, buttermilk, rice, salad fruit/ coconut water/ dry homemade snacks/ lactose free milk dinner- pulao/ khichadi + kadhi

Final Diagnosis

IBS?

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