Date / 日期 | Client Name / 客户姓名 | I/C No. / 身份证 | DOB / 出生日期 | Gender / 性别 | Contact No. / 电话 | Marital Status / 婚姻状况 | No of children | Address / 地址 | Height / 身高 | Weight / 体重 | Body Mass Index (BMI) / 身体质量指数 | Blood Pressure Level / 血压值 | Eating Habits / 饮食习惯 | Exercise Habits /运动习惯 | Defecation Habits / 排便习惯 | Pregnancy / 怀孕 | Duration / 怀孕期长 | Health Conditions Checklist / 健康状况检视 | Other illness / 其他疾病 | Date of illness / 病发日期 | Duration / 患病期长 | Surgery / 手术 | Medication / 用药 | Remarks / 备注 | The health condition you want to improve most in the short term / 短期内最想改善的健康状况 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
11/05/2023 | Tan chai hon | S1721279f | female | 98343865 | married | 1 | 158 | 63 | 110 | 1 / week | Normal | no | allergy, bruises | Feb 2023 | 右膝跌倒损伤 | 养生保健 | |||||||||
Lim chooi | 585A | female | +6590693389 | married | 152 | 61 | no | allergy, bruises | 10 | 右脚踝扭伤 | 右脚踝 | ||||||||||||||
Fransisca | female | 83665299 | 158 | 60 | 24 | Moderate healthy | 2-3/week | Once/2-3day | other | 胆结石 | 右上背/腿不适 | ||||||||||||||
Helen Low | 04/05/1957 | 91906026 | married | 2 | 157 | 60 | 140/80 | 走路 | 正常 | hypertension, tumor | 高血压药半粒 | 肩周炎、喘、左项有肿瘤、右腿抽筋 | 肩周炎 | ||||||||||||
09/02/2019 | Tan Sheue Yean | female | 97388875 | single | 164 | 69 | 3天1次 | allergy, bruises | 2016 | 慢性湿疹、过敏时内服外敷 | 西医疹断过敏由圧力造成贺尔蒙失调、右肩/关节受伤3个月 | 湿疹、便秘、右肩/关节痛 | |||||||||||||
05/06/2021 | Tan Yu Jin 玉金 | 02/12/1954 | female | 91547048 | single | Blk 623 #01-684 Bukit Batok Central S 650623 | 156 | 68 | 28 | 1~2次/周 步行 | 毎天 | hypertension, bruises | 10岁时右手骨折、*过去长期值班造成迟睡习惯 | 手臂痛无法向后穿内衣、眉心紧张 | |||||||||||
Steven Lim | male | 88288570 | married | 3 | Blk 185 #11-18 Jelebal rd Bukit Panjan S 670185 | 182 | 77 | 140/80 | 不吃海鲜、包菜 | 无 | 便秘,需靠药物才能排便 | allergy, hypertension, bruises | 食物过敏、曾经理疗后升高 | 便秘、腰痛、膝关节不适 | |||||||||||
Shirley Ang | female | 98357767 | married | 2 | Blk 60 Geylang Bahru #03-3313 S 330060 | 163 | 61 | 无 | 2-4天/周 | no | allergy | 虾过敏 | 眉心紧、胃涨风 | ||||||||||||
08/04/2020 | Pang Kim Poh | female | 96815995 | married | 155 | 53 | 爱吃巧克力…甜食、吸烟 | 无 | 1/周 | no | allergy | 海鲜过敏、经痛 | 经痛、便秘、腰痛 | ||||||||||||
Priscilla Leong | female | 91457848 | single | 158 | 57 | 不吃海鲜、芋头 | 游泳、步行 | allergy, hypertension, bruises | 止痛药过敏、20年以上高血压、静脉血栓、10cm子宫肌瘤、手脚跌打损伤、*左小腿肿,血小板低下,易皮下出血 | 腿部肿胀、气短呼吸不畅 | |||||||||||||||
Lim Check Boon | male | 90484321 | married | 2 | Blk 868 yishun st 81, #10-95 S760868 | 165 | 72 | 109/59 | 2/周、羽毛球、拉筋 | 每天 | allergy | 30 | 药物,鼻子过敏30年、右腹部粉瘤 | 左腿痛、鼻塞、老花 | |||||||||||
Lynda Yusof | 98243117 | married | 2 | 166 | 25 | hypertension | 2015 | 左上背痛、膝关节疼痛 | |||||||||||||||||
Lim Chin Hoe | male | 96578457 | married | 174 | 70 | 右手臂痛、第十4~5指间痛 | |||||||||||||||||||
Jess Lee | female | 91468002 | single | 161 | 82 | 25 | Gym 、Yoga | 每天 | allergy | Panadol过敏、鼻子敏感、磨牙、膝关节拉伤 | 睡眠质量、颈部大包、胃涨风 | ||||||||||||||
Jenny Tan | 07/07/1968 | female | 97659947 | single | 154 | 70 | 29 | 无 | 2~3天 | hypertension | 2010 | 有 | 颈部紧张、睡眠不好、胃涨风 | ||||||||||||
Choo Puai Eng | female | 85880246 | married | 159 | 73 | 25 | 无 | 便秘 | no | stomach-ulcer | 2014始胃溃疡 | B肝带菌、肝水泡、肾水泡 | 腰腿无力、胃涨风、炎症 | ||||||||||||
Eunice Chong Kwi Fong | female | 85806603 | single | 157 | 65 | 25 | 正常 | 步行 | 正常 | 颈部酸痛、胃涨风 | |||||||||||||||
Amanda Lim -Steven女儿 | female | 92991617 | single | Blk 185 Jelebu road #11-18 | 161 | 43 | No | Under weight 需增重 ~>48kg | 头痛、胃胀风 | ||||||||||||||||
07/10/2020 | Athena Tan | female | 97450764 | 18E Ford road | 165 | 110 | No | 正常 | 右腿外侧胆经结节 | 腰背酸痛 | |||||||||||||||
Annie Yong - Carol mum | 06/02/1957 | female | 93881180 | married | 3 | Blk 202 08-589 Compassvale dr S 540202 | 便秘 | no | tumor | 10 | 地中海贫血症、皮肤疣 | 肩膀酸痛 | |||||||||||||
Aom Potchatatraiphan Rutsunln | female | 83536453 | married | 3 | Blk 202 Compassvale Drive #08-589 S 540202 | 159 | 53 | 1天2歺、常喝啤酒 | 2天1次 | no | 内置UID避孕、胸部填充置入、爱喝啤酒 | 肩、背酸痛 | |||||||||||||
11/06/2021 | Susie Quek | S0014995J | 03/09/1954 | 97457026 | married | 2 | 165 | 75 | 28 | 70/130 | 拉筋 | hypertension, bruises | 跌倒3次,最后一次2018,后背受伤 | 右手臂,腰酸,右环跳 | |||||||||||
Candy Lim | S8036765A | female | 90887552 | single | 211 Serangoon Ave 4 | 163 | 57 | Cycling | |||||||||||||||||
Date / 日期 | Client Name / 客户姓名 | I/C No. / 身份证 | DOB / 出生日期 | Gender / 性别 | Contact No. / 电话 | Marital Status / 婚姻状况 | No of children | Address / 地址 | Height / 身高 | Weight / 体重 | Body Mass Index (BMI) / 身体质量指数 | Blood Pressure Level / 血压值 | Eating Habits / 饮食习惯 | Exercise Habits /运动习惯 | Defecation Habits / 排便习惯 | Pregnancy / 怀孕 | Duration / 怀孕期长 | Health Conditions Checklist / 健康状况检视 | Other illness / 其他疾病 | Date of illness / 病发日期 | Duration / 患病期长 | Surgery / 手术 | Medication / 用药 | Remarks / 备注 | The health condition you want to improve most in the short term / 短期内最想改善的健康状况 |
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