WeeksMonthsYears


YesNoOccasionallyduring an attack


RightLeftBoth


YesNoOccasionally


YesNoOccasionally


YesNoOccasionally


YesNoOccasionally


YesNoOccasionally


YesNo

Do you drink less amount of water than normal ?
YesNoNot Sure

Are kidney stones common in the area you live in ?
YesNoNot Sure

Have you had kidney stones in the past ?
YesNoNot Sure

Have you got any investigation done like an ultrasound or ,x-ray done ? (If yes, then please mention the details of the report in the 'more symptoms' column at the end of the questionnaire)
YesNo

Are you already a patient with Dr.Manoj's Homeopathy? If yes, then please give your Registration Number in the 'more symptoms' column.
YesNo