:: Welcome to Santhigram Ayurvedic & Spiritual Resorts Pvt. Ltd. Website ::

If it is not possible for you to visit our centres for treatment, you can write to us about your problem and we can offer advise regarding the treatment, For many problems our medicines and proper diet control can alleviate the suffering.

ABOUT YOURSELF
Name : First Name : Last Name :
Birth Date :
Age : Gender :
Main Complaint with Duration :


CONTACT INFO
Address :

City :	State : Pin/Zip :
Country :
Tel. No. :	Fax . No. :
E-Mail :


OTHER USEFUL INFO
Occupation :
Climate at the Place of residence :
Environment at the Place of Work :
History of previous major illness (if any) :
Present medication (if any) :
Investigation Report (if any) :
Normal diet :
Bowel movements :
Any other factor you think may help in diagnosis :