Reservation Name Date of Birth Age Gender GenderMaleFemaleOther Marital Status Marital StatusMarriedSingleDivorcedWidowed Nationality Occupation Height: (in Cms) Weight : (Kgs) Contact Number Email Address Address Health/Disease Condition Purpose of Visit Date of Arrival Date of Departure Room Category Room CategoryBamboo HouseMud HouseHollywood CottageWooden CottageSun SuiteSun Standard Have you undergone any surgery in recent years Have you undergone any surgery in recent years Yes No If yes please give details Do you suffer from any kind of infectious Disease or skin disease Do you suffer from any kind of infectious Disease or skin disease Yes No If yes please give details Do you suffer from any heart disease or undergone angioplasty / bypass / openheart surgery in the past Do you suffer from any heart disease or undergone angioplasty / bypass / openheart surgery in the past Yes No If yes please give details Do you suffer from any type of Kidney / Liver / Lung Disease Do you suffer from any type of Kidney / Liver / Lung Disease Yes No If yes please give details Are you physically or visually disabled in anyway Are you physically or visually disabled in anyway Yes No If yes please give details Can you walk 1 km without support Can you walk 1 km without support Yes No If No please give details Details of addiction if any Details of addiction if any No Addiction Smoking Alcohol Tobacco PanMasala Tea Coffee Medication Drug Addiction Other How did you get to know of Sun Ayurveda How did you get to know of Sun Ayurveda Friends/Family Website Social Media Other 1 + 10 = Submit