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Hair Fall Treatment
Hair Transplant
Hair Fall Treatment
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Hair Fall Treatment
Wanted to Know about your Hair
1
2
3
Body Shapes
Thin
Medium
Fat
Body Sweat
Less
Normal
A lot
Appetites
Irregular
Strong
Normal
Hair Volume
Fine
Medium
Thick
Hair Type
Wavy
Straight
Curly
Hair Texture
Rough and dry
Silky and smooth
Full and lustrous
Scalp Texture
Dry
Oily
Normal to Oily
Dandruff
Yes
No
Secondary Hair Issue
Greying
Greasy hair
No concerns
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Alcohol Consumption
No
Occasionally
Regular
How Often do you smoke?
No
Occasionally
Regular
How Often do you do exercise?
No
Occasionally
Regular
Do you sleep properly?
No
Difficulties For Sleep
Yes
What is the Stress level?
Low
Moderate
High
Water Consumption
Low
Moderate
High
Water used for bath
Normal
Hard Water
Having junk food
No
Occasionally
Regular
Shampoo uses
No
Occasionally
Regular
How often you do hair Oiling
Not Using
Occasionally
Regular
Chemical uses Quantity
Low
Medium
High
Is Hair fall issue from heredity
Yes
No
Marital status
Single
Married
Are you planning for baby
Yes
No
Liviing atmosphere
Good
Bad
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