Do you urinate frequent? YesNoOccasionally
Is there any urgency to urinate? YesNoOccasionally
Have you experienced involuntary urination (Dribbling of drops without knowledge/dribbling after urination?) YesNoOccasionally
Does it burn when you urinate or is it painful when you urinate? YesNoOccasionally
How many times do you wake up to urinate at night NoneOnceMore Than Once
Do you have a frequent Urinary Track Infections? YesNoOccasionally
Does it pain when you ejaculate or when you have an erection? YesNoOccasionally
Have you got any investigations done, like an ultrasound, or PSA (If yes, then please mention the details of the reports in the ‘more information’ 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 at the end of the questionnaire.YesNo
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