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Sangeeta Patki's

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3 Mahesh Apts, Vise Mala, Off College Rd, Nashik

☏ +91-9823014446

Patient History

First name

Last name

Email

Whatsapp Phone

Age (years)

Weight (kgs)

Height (cms)

Health Problems (please tick mark the fields below as applicable * Required

Acidity

Constipation

Fatigue

Un-fresh Mornings

Easy Irritation

Diabetes runs in family

Presently Suffering from Diabetes

(For Women) PCOD

(for Women) Irregular Periods

What Exercise do you follow?

Please Elaborate your Present Diet

Breakfast / Early Morning

Lunch / Afternoon

Evening / Dinner

Do you consume? * Required

Chocolates/sweets for more than THREE time a week?

Fried Foods for more than TWO times a week?

Alcohol

Cigarette

Tobacco (Gutka/Tambakku)

Revival Health Clinic

Get your customised Diet plan

Home
About
Appointments
Blog
Contact
More

Use tab to navigate through the menu items.

© 2010 by Rational Solutions, Nashik 422005, India

SA: 2020600314263373

FSSAI: 21521135000445

Address:
3 Mahesh Appts, Alpha Cresent Society,
Bh. Big Bazar, Vise Mala, Off College Rd.,

Nashik 422005, Maharashtra, India

Contact:
Mrs Sangeeta Patki - ® Dietitian

Phone: +91 - 98230 14446

Email: sap (at) revival-health (dot) com

Affiliate Company:
Indus Enterprise, Nashik
SA: 2220600316116193

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Sangeeta Patki's Revival Health

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