Personal InformationName *.DOB *Age (In Years) *Weight *Hight *GenderMaleFemaleOthersMedical HistorySince how long you are diabetic?Less than 3 monthAround 3 yearsIt's been over three yearsAverage random and fasting glucose levels? *What's HbA1c? *Are you using allopathic medicine?YesNoChose medicine type (if yes)MetforminTreviaTagipUpload Recent ReportsDrag and Drop (or) Choose FilesAdditional CommentContact InformationPhoneEmail AddressSubmit
