Diabeticare
 
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Diabeticare
c/o Community Health Solutions
A member of Pharmatrade LLC 		P.O.Box : 94620
Hor Al Anz
Deira, Dubai
United Arab Emirates.

Tel : +971 4 2667002
Fax : +971 4 2667004 		Dr.Adarsh Kishore

Diabetes Specialist

Mob: +971 50 2760651
Tel: +971 4 2653257
 
Please click here if you are a Type 1 Diabetes.
 
Type II Diabetes Mellitus (non-insulin dependent) Questionnaire
  PERSONAL DETAILS
     
* COMPLETE NAME :
* CITY :
* COUNTRY :
* NATIONALITY :
* EMAIL :
  TELEPHONE :
* AGE :
  HEIGHT :
  WEIGHT :
       
  MEDICAL INFORMATION
     
  DIABETIC SINCE WHEN (age) :
       
  MEDICATION
 
SYRINGE PEN PUMP INHALATION TABLET
ORAL INSULIN      
       
  LAB TESTS    
 
ACTIVITY LEVEL :
S.CHOLESTEROL:
S.CREATININE:
HDL:
LDL:
S.TRIGLYCERIDE
     
  COMMENTS/QUESTIONS :
     
  Fields marked as * are required  
 
 
 
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