WuXing Medicina Tradicional Chinesa
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Name
*
Phone number
*
Gender
*
Male
Female
Is it severe?
*
yes
no
Lunar year of the solar calendar
Wechat
telegram
1、Comparing the temperature of the palm and the back of the hand, which one is higher?
Palm
Back of hand
Same
2、Are you afraid of heat or cold? Which one?
Afraid of heat
Be afraid of cold
No
3、Is there any phlegm? Is the color white or yellow?
White
Yellow
No phlegm
4、Do you sweat easily?
Yes
No
5、Do you often feel thirsty and drink a lot of water?
Yes
No
6、Are there any obvious painful areas on the body?
Yes
No
7、Do you feel itchy skin or eyes?
Yes
No
Have no idea
8、Do your hands and feet vibrate involuntarily?
Yes
No
Have no idea
9、Do you urinate frequently?
Yes
No
Have no idea
10、Is the urine light or dark in color?
Light
Dark Yellow
Other colours(Red、Brown)
Have no idea
11、How long have the main symptoms been present?
Within 1 month
Within 3 month
3-6Ms
6Ms to 1Y
1-5 Ys
5-10 Ys
12、Do you feel that your chest is full?
Yes
No
Have no idea
Other symptoms you want to tell:
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