Mrityunjaya Ayurveda

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Mrityunjaya Ayurveda

Swarnaprashana Registration

Email *

Name of the child *

Age of the child *

Address *

Mobile number ( with whatsApp) *

Gender *

Male

Female

Other

Date of Birth *

YYYY

Time of Birth *

Time

Birth Star *

Birth Weight *

Type of Delivery *

Normal

Cesarean

Forceps

Other

Blood group *

Any Complications during delivery *

Mother's name *

Mother's blood group *

Father's name *

Father's blood group *

Any medication child is taking at present *

Any other complaints/ disease child is having? *

Family history any disease *

Height the child in cm ( at present) *

Weight the child in kg ( at present) *

Name of school/playschool child is studying *

Any difficulty in learning/ at school *

Aadhar card number *

If no Aadhar card , please write '0'

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