Since when have You been suffering with cracked feet ? WeeksMonthsYears
Do you have very dry skin? DaysYesNo
Do you suffer from any other skin disease? YesNo
Do you have Psoriasis? YesNo
Is there a family tendency of cracked feet? YesNo
Has there been a change of location ? YesNo
Do you have a hormonal problem or are you on any hormonal therapy? YesNo
Have you got any investigation done ? (Please mention the details of the reports 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
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