Aster-Survey UI Design Prototype Overview 🏥 COMPLETE HEALTHCARE ASTER-SURVEY DESIGN1. ADMIN BACKEND INTERFACE🎛️ Dashboard OverviewMain Navigation:Header Bar: Aster DM Healthcare logo, user profile (with photo), notification bell (with count), settings gear, logoutSidebar Menu:📊 Dashboard (with live stats)📋 Survey Management❓ Question Bank👥 Patient Responses📈 Analytics & Reports🏥 Department Settings👨‍⚕️ User Management⚙️ System SettingsDashboard Cards:Active Surveys: 24 surveys (↑12% this month)Total Responses: 15,847 patients (↑8% this week)Completion Rate: 87.3% (↑2.1% improvement)Average Response Time: 14.2 minutesDepartment Performance: Cardiology (highest), Orthopedics, General MedicinePatient Satisfaction Score: 4.6/5.0 ⭐⭐⭐⭐⭐📋 Advanced Survey BuilderSurvey Creation Wizard:Step 1: Survey DetailsSurvey Title, Description, Category (Patient Satisfaction, Medical History, Symptom Assessment)Department Selection (Cardiology, Orthopedics, Neurology, etc.)Target Audience (Inpatients, Outpatients, Emergency, Post-surgery)Step 2: Question DesignDrag & Drop Interface: Visual question builder with real-time previewMedical Question Templates: Pre-built questions for different specialtiesSmart Question Suggestions: AI-powered recommendations based on survey typeQuestion Types with Medical Context:Personal Information SectionName, Age, Gender with medical relevance indicatorsContact details with privacy controlsEmergency contact (auto-validates relationships)Insurance information with real-time verificationCurrent Health StatusSymptom Checker Interface:Visual body diagram for symptom locationSeverity sliders (1-10) with pain scale descriptionsDuration selectors with medical timeframesAssociated symptoms with conditional branchingPast Medical HistoryMedical Condition Database: Searchable conditions with ICD-10 codesMedication Management: Drug interaction warningsAllergy Tracker: Severity levels and reaction typesFamily History Tree: Visual genealogy with medical conditions🎨 Question Designer InterfaceAdvanced Question Configuration:Question Text: Rich text editor with medical terminology autocompleteChoice Type Selector:🔘 Single Select: Radio buttons with medical iconography☑️ Multiple Select: Checkboxes with "Select all that apply" indicators📝 Free Text: Auto-expanding text areas with character limitsConditional Logic Builder:Visual Flowchart: Drag-and-drop logic buildingMedical Branching: "If fever → temperature questions"Gender-Specific Paths: Pregnancy questions for females onlyAge-Based Logic: Pediatric vs adult question sets📊 Advanced Analytics DashboardReal-Time Metrics:Response Heatmap: Geographic distribution across IndiaDepartment Performance: Comparative analyticsQuestion Analytics: Most/least answered questionsDrop-off Analysis: Where patients abandon surveysMedical-Specific Reports:Symptom Prevalence: Most common symptoms by departmentPatient Satisfaction Trends: By doctor, department, timeRisk Factor Analysis: Population health insightsOutcome Correlation: Survey responses vs patient outcomes2. PATIENT-FACING SURVEY INTERFACE🌐 Landing PageProfessional Medical Design:Hero Section: Aster branding with trust indicators (JCI accredited, ISO certified)Survey Information:Estimated time: 15-20 minutesPrivacy assurance: HIPAA compliantLanguage options: English, Hindi, Arabic, Baluchi, Persian, Malayalam, Telugu, KannadaGetting Started: "Begin Assessment" with accessibility options📱 Survey Flow ExperienceProgress Tracking:Multi-Step Progress Bar: Section-based with medical icons👤 Personal Information (20%)🏥 Current Health Status (50%)📋 Medical History (45%)💊 Medications & Allergies (75%)✅ Review & Submit (100%)Section 1: Personal Information (Enhanced)Smart Form Fields:Name with title options (Mr., Mrs., Dr.)Age with DOB auto-calculationGender with inclusive options + "Prefer not to say"Phone with country code auto-detectionAddress with Google Maps integrationInsurance Integration:Policy number with real-time verificationCoverage checker with Aster networkSection 2: Current Health Status (Medical Focus)Symptom Assessment Interface:Visual Body Diagram: Click on body parts to indicate symptomsSymptom Severity Scales:Pain scale with Wong-Baker facesBreathing difficulty with visual indicatorsFatigue levels with activity descriptionsAdvanced Symptom Branching:Fever → Sub-questions:Temperature input with thermometer visualDuration with timeline selectorPattern recognition (continuous/intermittent)Associated symptoms checklistChest Pain → Detailed Assessment:Location mapper on chest diagramPain type selector with descriptionsRadiation pattern indicatorTrigger identificationSection 3: Past Medical History (Comprehensive)Medical Condition Search:Type-ahead search with medical databaseCommon conditions as quick-select buttonsRare disease option with text inputMedication Manager:Drug name autocomplete with generic/brand namesDosage selectors with common prescriptionsFrequency with visual scheduleSide effects tracker🎯 Advanced UI FeaturesSmart Question Logic:Conditional Branching:Gender = Female → Reproductive health questionsAge > 50 → Enhanced screening questionsSymptoms selected → Relevant follow-up questionsAccessibility & Usability:Voice Input: "Tell me about your symptoms"Large Text Mode: For elderly patientsHigh Contrast: For visually impairedScreen Reader Support: Full WCAG complianceMulti-language: Real-time translationMobile Optimization:Touch-Friendly: Large tap targets for medical formsOffline Mode: Continue survey without internetCamera Integration: Upload prescription imagesSignature Pad: Electronic consent forms3. SPECIALIZED MEDICAL MODULES🤰 Women's Health ModulePregnancy Assessment:Gestational age calculatorSymptom severity trackingRisk factor identificationPrevious pregnancy history👶 Pediatric ModuleAge-Appropriate Interface:Child-friendly icons and colorsParent/guardian response modeGrowth chart integrationVaccination tracker🧠 Mental Health AssessmentPHQ-9 Integration: Depression screeningGAD-7 Integration: Anxiety assessmentSuicide Risk Screening: With immediate referral protocols❤️ Cardiac AssessmentRisk Calculator: Framingham Risk Score integrationEKG Rhythm Assessment: Visual rhythm stripsExercise Tolerance: Functional capacity questions4. INTEGRATION FEATURES🔗 Electronic Health Record (EHR) IntegrationPatient ID Matching: Automatic record linkingMedical History Import: Pre-populate known informationLab Results Integration: Recent test results displayMedication Reconciliation: Current prescriptions auto-fill📧 Communication HubAutomated Notifications:Survey completion confirmationsFollow-up remindersCritical response alertsProvider Notifications:High-risk patient alertsIncomplete critical assessmentsUrgent symptom flags5. ADVANCED REPORTING & ANALYTICS📊 Executive DashboardKPI Tracking:Patient satisfaction scores by departmentSurvey completion ratesResponse time analyticsQuality metric correlations🔬 Clinical InsightsPopulation Health Metrics:Disease prevalence by demographicsRisk factor distributionOutcome predictionsIntervention effectiveness📈 Quality ImprovementPerformance Benchmarking:Hospital vs industry standardsDepartment comparisonsPhysician-specific metricsTrend analysis over time6. SECURITY & COMPLIANCE🔐 Data ProtectionHIPAA Compliance: End-to-end encryptionPatient Consent: Granular privacy controlsAudit Trail: Complete activity loggingData Retention: Configurable retention policies🛡️ Access ControlRole-Based Permissions: Doctor, Nurse, Admin, AnalystDepartment Restrictions: Cardiology staff see cardiology data onlyPatient Data Masking: Sensitive information protectionTwo-Factor Authentication: Enhanced security for admin accessAster DM Healthcare - Comprehensive Patient Medical SurveySection 1: Personal Information (Questions 1-20)1. What is your full name? (Text input)2. What is your age? (Numeric input)3. What is your gender?3.1 Male3.2 Female3.3 Other3.4 Prefer not to say4. What is your contact number? (Phone input)5. What is your email address? (Email input - optional)6. What is your nationality? (Text input)7. What is your current address?7.1 Street address7.2 City7.3 State/Province7.4 Country7.5 Postal code8. What is your occupation? (Text input)9. What is your marital status?9.1 Single9.2 Married9.3 Divorced9.4 Widowed9.5 Separated10. Emergency contact information:10.1 Name10.2 Relationship to you10.3 Phone number10.4 Alternative phone number11. What is your preferred language for medical communication?11.1 English11.2 Hindi11.3 Malayalam11.4 Tamil11.5 Telugu11.6 Kannada11.7 Other (specify)12. What is your highest level of education?12.1 Primary school12.2 High school12.3 Bachelor's degree12.4 Master's degree12.5 Doctoral degree12.6 Professional certification13. What is your annual household income range?13.1 Below ₹2 lakhs13.2 ₹2-5 lakhs13.3 ₹5-10 lakhs13.4 ₹10-20 lakhs13.5 Above ₹20 lakhs13.6 Prefer not to say14. Do you have health insurance?14.1 Yes - Government scheme14.2 Yes - Private insurance14.3 Yes - Employer provided14.4 No14.5 Don't know15. If you have insurance, what is your policy number? (Text input)16. What is your height?16.1 In centimeters16.2 In feet and inches17. What is your current weight?17.1 In kilograms17.2 In pounds18. What is your blood group?18.1 A+18.2 A-18.3 B+18.4 B-18.5 AB+18.6 AB-18.7 O+18.8 O-18.9 Don't know19. Are you currently employed?19.1 Yes - Full time19.2 Yes - Part time19.3 Self-employed19.4 Student19.5 Retired19.6 Unemployed19.7 Homemaker20. How did you hear about Aster DM Healthcare?20.1 Doctor referral20.2 Friend/family recommendation20.3 Internet search20.4 Advertisement20.5 Insurance provider20.6 Previous patient20.7 Other (specify)Section 2: Current Health Status (Questions 21-100)21. How would you rate your overall health today?21.1 Excellent21.2 Very good21.3 Good21.4 Fair21.5 Poor22. Are you currently experiencing any symptoms?22.1 Yes22.2 No23. If yes, which symptoms are you experiencing? (Multi-select)23.1 Fever23.1.1 Temperature measured? (specify degrees)23.1.2 Duration of fever?23.1.3 Pattern (continuous/intermittent)?23.1.4 Associated with chills?23.1.5 Any medications taken?23.2 Headache23.2.1 Location of headache?23.2.2 Severity (1-10 scale)?23.2.3 Type (throbbing/sharp/dull)?23.2.4 Triggers identified?23.2.5 Duration of each episode?23.2.6 Associated with nausea?23.2.7 Light sensitivity?23.2.8 Sound sensitivity?23.3 Cough23.3.1 Dry or productive?23.3.2 Color of sputum?23.3.3 Blood in sputum?23.3.4 Duration of cough?23.3.5 Worse at night?23.3.6 Associated with breathing difficulty?23.4 Shortness of breath23.4.1 At rest or with exertion?23.4.2 How many stairs can you climb?23.4.3 Sleep disturbance due to breathing?23.4.4 Need to sleep with extra pillows?23.4.5 Wheezing sounds?23.5 Chest pain23.5.1 Location of pain?23.5.2 Type of pain (sharp/burning/pressure)?23.5.3 Radiation to arms/jaw/back?23.5.4 Associated with activity?23.5.5 Duration of pain episodes?23.5.6 What relieves the pain?23.6 Fatigue23.6.1 Duration of fatigue?23.6.2 Interferes with daily activities?23.6.3 Improved with rest?23.6.4 Associated with weakness?23.7 Dizziness23.7.1 Room spinning sensation?23.7.2 Loss of balance?23.7.3 Associated with position changes?23.7.4 Any falls?23.8 Nausea/Vomiting23.8.1 Frequency of episodes?23.8.2 Blood in vomit?23.8.3 Relationship to meals?23.8.4 Associated with abdominal pain?23.9 Abdominal pain23.9.1 Location of pain?23.9.2 Severity (1-10)?23.9.3 Relationship to meals?23.9.4 Associated with bowel movements?23.9.5 Type of pain (cramping/sharp/burning)?23.10 Changes in bowel habits23.10.1 Constipation or diarrhea?23.10.2 Blood in stool?23.10.3 Color of stool?23.10.4 Frequency changes?23.11 Urinary symptoms23.11.1 Burning during urination?23.11.2 Frequent urination?23.11.3 Blood in urine?23.11.4 Difficulty starting urination?23.11.5 Incomplete emptying feeling?23.12 Skin changes23.12.1 New rashes or lesions?23.12.2 Changes in moles?23.12.3 Persistent itching?23.12.4 Unusual bruising?23.13 Joint pain23.13.1 Which joints affected?23.13.2 Morning stiffness?23.13.3 Swelling present?23.13.4 Limits daily activities?23.14 Sleep disturbances23.14.1 Difficulty falling asleep?23.14.2 Frequent awakening?23.14.3 Early morning awakening?23.14.4 Daytime sleepiness?23.15 Memory problems23.15.1 Difficulty concentrating?23.15.2 Forgetting recent events?23.15.3 Word-finding difficulties?23.16 Mood changes23.16.1 Persistent sadness?23.16.2 Anxiety or worry?23.16.3 Irritability?23.16.4 Loss of interest in activities?23.17 Weight changes23.17.1 Unintentional weight loss?23.17.2 Unintentional weight gain?23.17.3 Amount of weight change?23.17.4 Time period of change?23.18 Vision changes23.18.1 Blurred vision?23.18.2 Double vision?23.18.3 Loss of visual field?23.18.4 Light sensitivity?23.18.5 Eye pain?23.19 Hearing changes23.19.1 Decreased hearing?23.19.2 Ringing in ears?23.19.3 Ear pain?23.19.4 Discharge from ears?23.20 Swelling23.20.1 Location of swelling?23.20.2 Pitting or non-pitting?23.20.3 Worse at end of day?23.20.4 Associated with shortness of breath?24. When did your current symptoms begin?24.1 Today24.2 Within the past week24.3 Within the past month24.4 Within the past 3 months24.5 More than 3 months ago25. Have your symptoms been:25.1 Getting worse25.2 Getting better25.3 Staying the same25.4 Coming and going26. On a scale of 1-10, how much do your symptoms interfere with daily activities? (1 = not at all, 10 = completely unable to function)27. Have you taken any medications for your current symptoms?27.1 Yes27.1.1 What medications?27.1.2 Dosage and frequency?27.1.3 How long have you been taking them?27.1.4 Are they helping?27.1.5 Any side effects?27.2 No28. Have you seen another healthcare provider for these symptoms?28.1 Yes28.1.1 What type of provider?28.1.2 When?28.1.3 What was the diagnosis?28.1.4 What treatment was recommended?28.2 No29. Are you currently taking any prescription medications?29.1 Yes (list all medications, dosages, and frequencies)29.2 No30. Are you taking any over-the-counter medications or supplements?30.1 Yes (list all)30.2 NoSection 3: Past Medical History (Questions 31-150)31. Have you ever been diagnosed with high blood pressure (hypertension)?31.1 Yes31.1.1 At what age were you diagnosed?31.1.2 What was your blood pressure at diagnosis?31.1.3 Are you currently on medication for it?31.1.3.1 What medications?31.1.3.2 How long have you been on these medications?31.1.3.3 Do you monitor your blood pressure at home?31.1.3.4 What are your typical readings?31.1.4 Have you ever had complications from high blood pressure?31.1.4.1 Heart problems?31.1.4.2 Kidney problems?31.1.4.3 Eye problems?31.1.4.4 Stroke?31.1.5 Do you follow any dietary restrictions?31.1.6 How often do you see your doctor for blood pressure management?31.2 No31.3 Don't know32. Have you ever been diagnosed with diabetes?32.1 Yes32.1.1 Type 1 or Type 2?32.1.2 At what age were you diagnosed?32.1.3 How was it discovered?32.1.4 What medications are you taking?32.1.4.1 Insulin?32.1.4.1.1 Type of insulin?32.1.4.1.2 How many times per day?32.1.4.1.3 Do you adjust doses based on blood sugar?32.1.4.2 Oral medications?32.1.4.2.1 Which medications?32.1.4.2.2 How often do you take them?32.1.5 Do you check your blood sugar regularly?32.1.5.1 How often?32.1.5.2 What are your typical readings?32.1.5.3 What was your last HbA1c?32.1.6 Have you had any complications?32.1.6.1 Eye problems (retinopathy)?32.1.6.2 Kidney problems?32.1.6.3 Nerve problems (neuropathy)?32.1.6.4 Foot problems?32.1.6.5 Heart disease?32.1.7 Do you follow a diabetic diet?32.1.8 Do you see an endocrinologist?32.2 No32.3 Prediabetic32.4 Don't know33. Have you ever been diagnosed with heart disease?33.1 Yes33.1.1 What type of heart disease?33.1.1.1 Heart attack (myocardial infarction)?33.1.1.1.1 How many heart attacks?33.1.1.1.2 When did they occur?33.1.1.1.3 What treatment did you receive?33.1.1.1.4 Were stents placed?33.1.1.1.5 Did you have bypass surgery?33.1.1.2 Angina (chest pain)?33.1.1.2.1 How often do you experience chest pain?33.1.1.2.2 What triggers it?33.1.1.2.3 What relieves it?33.1.1.3 Heart failure?33.1.1.3.1 What is your ejection fraction?33.1.1.3.2 Do you have shortness of breath?33.1.1.3.3 Do you have swelling in your legs?33.1.1.4 Arrhythmia (irregular heartbeat)?33.1.1.4.1 What type of arrhythmia?33.1.1.4.2 Do you have a pacemaker?33.1.1.4.3 Are you on blood thinners?33.1.1.5 Valve disease?33.1.1.5.1 Which valve(s)?33.1.1.5.2 Have you had valve replacement?33.1.2 Are you currently under cardiology care?33.1.3 What heart medications are you taking?33.1.4 How often do you have cardiac follow-ups?33.2 No33.3 Don't know34. Have you ever been diagnosed with lung disease?34.1 Yes34.1.1 What type of lung disease?34.1.1.1 Asthma?34.1.1.1.1 Do you use an inhaler?34.1.1.1.2 How often do you have asthma attacks?34.1.1.1.3 What triggers your asthma?34.1.1.1.4 Have you been hospitalized for asthma?34.1.1.2 COPD (Chronic Obstructive Pulmonary Disease)?34.1.1.2.1 Do you use oxygen at home?34.1.1.2.2 Do you have frequent exacerbations?34.1.1.3 Pneumonia?34.1.1.3.1 How many times have you had pneumonia?34.1.1.3.2 When was the most recent episode?34.1.1.4 Tuberculosis?34.1.1.4.1 When were you treated?34.1.1.4.2 Did you complete the full treatment?34.1.1.5 Lung cancer?34.1.1.5.1 When were you diagnosed?34.1.1.5.2 What treatment did you receive?34.1.2 Do you currently see a pulmonologist?34.1.3 Do you use any breathing treatments?34.2 No35. Have you ever been diagnosed with kidney disease?35.1 Yes35.1.1 What type of kidney disease?35.1.1.1 Chronic kidney disease?35.1.1.1.1 What stage?35.1.1.1.2 What is your creatinine level?35.1.1.1.3 Do you see a nephrologist?35.1.1.2 Kidney stones?35.1.1.2.1 How many times have you had stones?35.1.1.2.2 What type of stones?35.1.1.2.3 Have you had procedures to remove stones?35.1.1.3 Kidney infection?35.1.1.4 Polycystic kidney disease?35.1.2 Are you on dialysis?35.1.2.1 What type of dialysis?35.1.2.2 How often?35.1.2.3 For how long?35.1.3 Have you had a kidney transplant?35.1.3.1 When?35.1.3.2 Any complications?35.2 No36. Have you ever been diagnosed with liver disease?36.1 Yes36.1.1 What type of liver disease?36.1.1.1 Hepatitis?36.1.1.1.1 Hepatitis A, B, or C?36.1.1.1.2 How was it treated?36.1.1.2 Cirrhosis?36.1.1.2.1 What caused the cirrhosis?36.1.1.2.2 Do you have complications?36.1.1.3 Fatty liver disease?36.1.1.4 Liver cancer?36.1.2 Have you had a liver transplant?36.1.3 Do you see a gastroenterologist or hepatologist?36.2 No37. Have you ever been diagnosed with thyroid disease?37.1 Yes37.1.1 What type of thyroid disease?37.1.1.1 Hypothyroidism (underactive)?37.1.1.1.1 Are you taking thyroid hormone replacement?37.1.1.1.2 What is your TSH level?37.1.1.2 Hyperthyroidism (overactive)?37.1.1.2.1 What treatment did you receive?37.1.1.2.2 Did you have radioactive iodine treatment?37.1.1.3 Thyroid nodules?37.1.1.3.1 Have you had a biopsy?37.1.1.3.2 Are they benign or cancerous?37.1.1.4 Thyroid cancer?37.1.1.4.1 What type of thyroid cancer?37.1.1.4.2 Did you have surgery?37.1.2 How often do you have thyroid function tests?37.2 No38. Have you ever been diagnosed with cancer?38.1 Yes38.1.1 What type of cancer?38.1.2 When were you diagnosed?38.1.3 What stage was the cancer?38.1.4 What treatment did you receive?38.1.4.1 Surgery?38.1.4.2 Chemotherapy?38.1.4.3 Radiation therapy?38.1.4.4 Immunotherapy?38.1.4.5 Hormone therapy?38.1.5 Are you currently in remission?38.1.6 Do you have regular follow-up appointments?38.1.7 Have you had any recurrence?38.2 No39. Have you ever been diagnosed with mental health conditions?39.1 Yes39.1.1 What conditions?39.1.1.1 Depression?39.1.1.1.1 When were you first diagnosed?39.1.1.1.2 Are you currently taking antidepressants?39.1.1.1.3 Have you had counseling or therapy?39.1.1.1.4 Have you been hospitalized for depression?39.1.1.2 Anxiety?39.1.1.2.1 What type of anxiety disorder?39.1.1.2.2 Do you have panic attacks?39.1.1.2.3 Are you taking anti-anxiety medications?39.1.1.3 Bipolar disorder?39.1.1.3.1 Type I or Type II?39.1.1.3.2 Are you taking mood stabilizers?39.1.1.4 Schizophrenia?39.1.1.5 PTSD (Post-Traumatic Stress Disorder)?39.1.1.6 Eating disorders?39.1.1.7 Substance abuse disorders?39.1.2 Are you currently seeing a mental health professional?39.1.3 What medications are you taking for mental health?39.2 No40. Have you ever been diagnosed with neurological conditions?40.1 Yes40.1.1 What conditions?40.1.1.1 Stroke?40.1.1.1.1 When did you have the stroke?40.1.1.1.2 What type of stroke?40.1.1.1.3 Do you have any residual weakness?40.1.1.1.4 Are you on blood thinners?40.1.1.2 Seizures or epilepsy?40.1.1.2.1 When did seizures start?40.1.1.2.2 How often do you have seizures?40.1.1.2.3 Are you taking anti-seizure medications?40.1.1.2.4 What triggers your seizures?40.1.1.3 Multiple sclerosis?40.1.1.3.1 What type of MS?40.1.1.3.2 Are you taking disease-modifying drugs?40.1.1.4 Parkinson's disease?40.1.1.4.1 When were you diagnosed?40.1.1.4.2 What medications are you taking?40.1.1.5 Alzheimer's disease or dementia?40.1.1.6 Migraine headaches?40.1.1.6.1 How often do you get migraines?40.1.1.6.2 What triggers your migraines?40.1.1.6.3 Do you take preventive medications?40.1.2 Do you see a neurologist?40.2 NoSection 4: Reproductive Health (Questions 151-250)(This section branches based on gender selection)For Females (Questions 151-200):151. Are you currently pregnant?151.1 Yes151.1.1 How many weeks pregnant are you?151.1.2 Is this your first pregnancy?151.1.2.1 If no, how many previous pregnancies?151.1.2.2 How many live births?151.1.2.3 How many miscarriages?151.1.2.4 How many abortions?151.1.3 Are you receiving prenatal care?151.1.3.1 Who is your obstetrician?151.1.3.2 How often do you have prenatal visits?151.1.3.3 Have you had any prenatal testing?151.1.4 Do you have any complications in this pregnancy?151.1.4.1 Gestational diabetes?151.1.4.2 Preeclampsia?151.1.4.3 Placenta previa?151.1.4.4 Previous C-section?151.1.5 Are you experiencing any symptoms currently?151.1.5.1 Nausea/Vomiting?151.1.5.1.1 How severe (mild/moderate/severe)?151.1.5.1.2 How often?151.1.5.1.3 Are you able to keep food down?151.1.5.1.4 Have you lost weight?151.1.5.2 Excessive Fatigue?151.1.5.2.1 Interfering with daily activities?151.1.5.2.2 Getting adequate rest?151.1.5.3 Vaginal Bleeding?151.1.5.3.1 When did the bleeding start?151.1.5.3.2 How heavy is the bleeding?151.1.5.3.2.1 Spotting only?151.1.5.3.2.2 Light bleeding?151.1.5.3.2.3 Moderate bleeding?151.1.5.3.2.4 Heavy bleeding (soaking pad hourly)?151.1.5.3.3 What color is the blood?151.1.5.3.3.1 Bright red?151.1.5.3.3.2 Dark red?151.1.5.3.3.3 Brown?151.1.5.3.3.4 Pink?151.1.5.3.4 Are you passing clots?151.1.5.3.4.1 Size of clots?151.1.5.3.4.2 Frequency?151.1.5.3.5 Is there associated pain?151.1.5.3.5.1 Cramping?151.1.5.3.5.2 Sharp pain?151.1.5.3.5.3 Location of pain?151.1.5.3.6 Did bleeding start suddenly or gradually?151.1.5.3.7 Any triggers (intercourse, exercise, straining)?151.1.5.3.8 Have you seen a doctor for this bleeding?151.1.5.3.9 Any tests done (ultrasound, blood work)?151.1.5.3.10 Are you on bed rest?151.1.5.3.11 Any medications prescribed?151.1.5.3.12 Do you have a history of bleeding in pregnancy?151.1.5.3.13 Any recent trauma or injury?151.1.5.3.14 Associated fever or chills?151.1.5.3.15 Are you feeling dizzy or faint?151.1.5.3.16 Any changes in baby's movement?151.1.5.3.17 Any fluid leakage along with bleeding?151.1.5.3.18 History of previous miscarriages at this stage?151.1.5.3.19 Any family history of pregnancy complications?151.1.5.3.20 Are you experiencing contractions?151.1.5.4 Swelling (hands/feet)?151.1.5.4.1 Location of swelling?151.1.5.4.2 Severity of swelling?151.1.5.4.3 Worse at end of day?151.1.5.4.4 Associated with weight gain?151.1.5.4.5 Face swelling?151.1.5.4.6 High blood pressure?151.1.5.5 Headache/Blurred Vision?151.1.5.5.1 Severity of headache?151.1.5.5.2 Associated with high blood pressure?151.1.5.5.3 Visual disturbances?151.1.5.5.4 Light sensitivity?151.1.5.5.5 Neck stiffness?151.1.5.6 Baby Movement Changes?151.1.5.6.1 Decreased movement?151.1.5.6.2 When did you last feel movement?151.1.5.6.3 Have you done kick counts?151.1.5.6.4 Any concerning patterns?151.1.6 Are you taking prenatal vitamins?151.1.6.1 Folic acid?151.1.6.2 Iron supplements?151.1.6.3 Calcium?151.1.6.4 DHA/Omega-3?151.1.7 Do you have any lifestyle concerns?151.1.7.1 Smoking during pregnancy?151.1.7.2 Alcohol consumption?151.1.7.3 Drug use?151.1.7.4 Caffeine intake?151.1.8 Where do you plan to deliver?151.1.9 Have you attended childbirth classes?151.1.10 Do you have a birth plan?151.2 No151.3 Not sure151.4 Trying to conceive152. When was your last menstrual period?152.1 Date: ____152.2 Don't remember exactly152.3 Irregular periods152.4 No periods (menopause/other)153. Are your menstrual periods regular?153.1 Yes153.1.1 Cycle length (days)?153.1.2 Duration of flow (days)?153.1.3 Heavy, moderate, or light flow?153.2 No153.2.1 How irregular?153.2.2 Missing periods?153.2.3 Very heavy periods?153.2.4 Bleeding between periods?154. Do you experience menstrual pain?154.1 Yes154.1.1 Severity (1-10 scale)?154.1.2 Interferes with activities?154.1.3 Requires medication?154.1.4 Getting worse over time?154.2 No155. Are you currently using contraception?155.1 Yes155.1.1 What type?155.1.1.1 Birth control pills?155.1.1.2 IUD?155.1.1.3 Implant?155.1.1.4 Injection?155.1.1.5 Barrier methods?155.1.1.6 Natural family planning?155.1.2 How long have you been using it?155.1.3 Any side effects?155.2 No156. Have you gone through menopause?156.1 Yes156.1.1 At what age?156.1.2 Natural or surgical menopause?156.1.3 Are you taking hormone replacement therapy?156.1.4 Any menopausal symptoms?156.1.4.1 Hot flashes?156.1.4.2 Night sweats?156.1.4.3 Mood changes?156.1.4.4 Sleep problems?156.1.4.5 Vaginal dryness?156.2 No156.3 Perimenopause157. Have you ever had gynecological procedures?157.1 Hysterectomy157.1.1 Partial or complete?157.1.2 Reason for procedure?157.1.3 Age at time of procedure?157.2 Tubal ligation157.3 Ovarian surgery157.4 Cesarean section157.4.1 How many C-sections?157.4.2 Reasons for C-section?157.5 D&C (dilation and curettage)157.6 Laparoscopy157.7 Other gynecological surgery158. Have you ever been diagnosed with:158.1 PCOS (Polycystic Ovary Syndrome)?158.1.1 Irregular periods?158.1.2 Facial hair growth?158.1.3 Weight gain?158.1.4 Acne?158.1.5 Difficulty conceiving?158.2 Endometriosis?158.2.1 Pelvic pain?158.2.2 Painful periods?158.2.3 Pain during intercourse?158.2.4 Infertility issues?158.3 Uterine fibroids?158.3.1 Heavy menstrual bleeding?158.3.2 Pelvic pressure?158.3.3 Treatment received?158.4 Ovarian cysts?158.5 Pelvic inflammatory disease?158.6 Sexually transmitted infections?159. Have you ever had fertility issues?159.1 Yes159.1.1 How long were you trying to conceive?159.1.2 Did you receive fertility treatment?159.1.3 What type of treatment?159.1.4 Was treatment successful?159.2 No159.3 Not applicable160. When was your last Pap smear?160.1 Within the last year160.2 1-3 years ago160.3 More than 3 years ago160.4 Never had one160.5 Don't remember161. Have you ever had an abnormal Pap smear?161.1 Yes161.1.1 What was the result?161.1.2 What follow-up was done?161.1.3 Any treatment required?161.2 No161.3 Don't know162. When was your last mammogram?162.1 Within the last year162.2 1-2 years ago162.3 More than 2 years ago162.4 Never had one162.5 Don't remember163. Do you perform breast self-examinations?163.1 Yes, regularly163.2 Yes, occasionally163.3 No163.4 Don't know how164. Have you ever found a breast lump?164.1 Yes164.1.1 When?164.1.2 Was it evaluated by a doctor?164.1.3 What was the diagnosis?164.2 No165. Do you have a family history of breast or ovarian cancer?165.1 Yes165.1.1 Which relatives?165.1.2 At what age were they diagnosed?165.2 No165.3 Don't knowFor Males (Questions 166-200):166. Have you ever been diagnosed with prostate problems?166.1 Yes166.1.1 What type?166.1.1.1 Enlarged prostate (BPH)?166.1.1.1.1 Difficulty urinating?166.1.1.1.2 Frequent urination at night?166.1.1.1.3 Weak urine stream?166.1.1.1.4 Feeling of incomplete emptying?166.1.1.1.5 Are you taking medications?166.1.1.2 Prostatitis?166.1.1.2.1 Pelvic pain?166.1.1.2.2 Pain during urination?166.1.1.2.3 Treatment received?166.1.1.3 Prostate cancer?166.1.1.3.1 When diagnosed?166.1.1.3.2 Gleason score?166.1.1.3.3 Treatment received?166.1.1.3.4 Current PSA levels?166.2 No167. When was your last prostate exam?167.1 Within the last year167.2 1-2 years ago167.3 More than 2 years ago167.4 Never had one167.5 Don't remember168. Have you ever had a PSA blood test?168.1 Yes168.1.1 When was the last one?168.1.2 What was the result?168.1.3 Any follow-up required?168.2 No168.3 Don't know169. Do you have any sexual health concerns?169.1 Erectile dysfunction169.1.1 How long has this been a problem?169.1.2 Is it getting worse?169.1.3 Are you taking medications for it?169.1.4 Have you discussed with a doctor?169.2 Decreased libido169.3 Premature ejaculation169.4 Pain during intercourse169.5 No concerns170. Have you ever been diagnosed with low testosterone?170.1 Yes170.1.1 Are you receiving testosterone replacement?170.1.2 What symptoms led to testing?170.1.3 How often do you have levels checked?170.2 No170.3 Don't know171. Have you ever had a testicular examination?171.1 Yes, by a doctor171.2 Yes, self-examination171.3 No172. Have you ever noticed any testicular lumps or changes?172.1 Yes172.1.1 When?172.1.2 Was it evaluated?172.1.3 What was the diagnosis?172.2 No173. Do you have any urinary symptoms?173.1 Difficulty starting urination173.2 Weak urine stream173.3 Frequent urination173.4 Nighttime urination173.5 Urgent need to urinate173.6 Blood in urine173.7 Painful urination173.8 No symptoms174. Have you ever been diagnosed with sexually transmitted infections?174.1 Yes174.1.1 Which infections?174.1.2 When?174.1.3 Were they treated?174.1.4 Any complications?174.2 No175. Are you sexually active?175.1 Yes175.2 No176. Do you practice safe sex?176.1 Always176.2 Sometimes176.3 Never176.4 Not applicableSection 5: Cardiovascular System (Questions 201-280)201. Do you currently experience chest pain?201.1 Yes201.1.1 How often?201.1.1.1 Daily201.1.1.2 Weekly201.1.1.3 Monthly201.1.1.4 Rarely201.1.2 What does the pain feel like?201.1.2.1 Sharp, stabbing pain201.1.2.2 Dull, aching pain201.1.2.3 Burning sensation201.1.2.4 Pressure or squeezing201.1.2.5 Crushing sensation201.1.3 Where is the pain located?201.1.3.1 Center of chest201.1.3.2 Left side of chest201.1.3.3 Right side of chest201.1.3.4 Upper chest201.1.3.5 Lower chest201.1.4 Does the pain spread to other areas?201.1.4.1 Left arm201.1.4.2 Right arm201.1.4.3 Both arms201.1.4.4 Jaw201.1.4.5 Neck201.1.4.6 Back201.1.4.7 Shoulder201.1.4.8 Abdomen201.1.5 What triggers the pain?201.1.5.1 Physical exertion201.1.5.2 Emotional stress201.1.5.3 Cold weather201.1.5.4 After eating201.1.5.5 Deep breathing201.1.5.6 Movement201.1.5.7 Nothing specific201.1.6 What relieves the pain?201.1.6.1 Rest201.1.6.2 Nitroglycerin201.1.6.3 Pain medications201.1.6.4 Antacids201.1.6.5 Change of position201.1.6.6 Nothing helps201.1.7 How long does each episode last?201.1.7.1 Seconds201.1.7.2 1-5 minutes201.1.7.3 5-15 minutes201.1.7.4 15-30 minutes201.1.7.5 More than 30 minutes201.1.8 Rate the severity (1-10 scale)201.1.9 Associated symptoms during chest pain?201.1.9.1 Shortness of breath201.1.9.2 Sweating201.1.9.3 Nausea201.1.9.4 Dizziness201.1.9.5 Rapid heartbeat201.1.9.6 Feeling of doom201.2 No202. Do you experience palpitations or irregular heartbeat?202.1 Yes202.1.1 How often?202.1.2 What does it feel like?202.1.2.1 Racing heart202.1.2.2 Skipping beats202.1.2.3 Fluttering202.1.2.4 Pounding202.1.3 How long do episodes last?202.1.4 What triggers them?202.1.4.1 Caffeine202.1.4.2 Alcohol202.1.4.3 Stress202.1.4.4 Exercise202.1.4.5 Certain medications202.1.5 Associated symptoms?202.1.5.1 Chest pain202.1.5.2 Shortness of breath202.1.5.3 Dizziness202.1.5.4 Fainting202.2 No203. Do you experience shortness of breath?203.1 Yes203.1.1 When does it occur?203.1.1.1 At rest203.1.1.2 With mild exertion203.1.1.3 With moderate exertion203.1.1.4 With strenuous activity only203.1.2 Do you get short of breath lying flat?203.1.2.1 Yes, need extra pillows to sleep203.1.2.2 Sometimes203.1.2.3 No203.1.3 Do you wake up short of breath at night?203.1.4 How many stairs can you climb before getting breathless?203.1.4.1 Less than 5 steps203.1.4.2 5-10 steps203.1.4.3 1 flight of stairs203.1.4.4 2-3 flights203.1.4.5 More than 3 flights203.1.5 Is the shortness of breath getting worse?203.2 No204. Do you have swelling in your legs, ankles, or feet?204.1 Yes204.1.1 Is it in one leg or both?204.1.2 Is it worse at the end of the day?204.1.3 Does it improve with elevation?204.1.4 How long have you had the swelling?204.1.5 Is it pitting (leaves indentation when pressed)?204.1.6 Any skin changes over the swelling?204.1.7 Any pain or tenderness?204.2 No205. Have you ever fainted or lost consciousness?205.1 Yes205.1.1 How many times?205.1.2 When was the most recent episode?205.1.3 What were you doing when it happened?205.1.4 Any warning signs before fainting?205.1.5 How long were you unconscious?205.1.6 Any injuries from falling?205.1.7 Were you evaluated by a doctor?205.2 No206. Do you have a family history of heart disease?206.1 Yes206.1.1 Which relatives?206.1.1.1 Parents206.1.1.2 Siblings206.1.1.3 Grandparents206.1.1.4 Children206.1.2 What type of heart disease?206.1.2.1 Heart attack206.1.2.2 Heart failure206.1.2.3 Arrhythmia206.1.2.4 Sudden cardiac death206.1.3 At what age were they diagnosed?206.2 No206.3 Don't know207. Have you ever had an electrocardiogram (ECG/EKG)?207.1 Yes207.1.1 When was the most recent one?207.1.2 What were the results?207.1.3 Any abnormalities found?207.2 No207.3 Don't know208. Have you ever had an echocardiogram (heart ultrasound)?208.1 Yes208.1.1 When?208.1.2 What were the results?208.1.3 What was your ejection fraction?208.2 No208.3 Don't know209. Have you ever had a stress test?209.1 Yes209.1.1 What type?209.1.1.1 Exercise stress test209.1.1.2 Nuclear stress test209.1.1.3 Stress echocardiogram209.1.2 When?209.1.3 What were the results?209.2 No210. Have you ever had a cardiac catheterization?210.1 Yes210.1.1 When?210.1.2 What were the findings?210.1.3 Were any procedures done?210.1.3.1 Angioplasty210.1.3.2 Stent placement210.1.4 How many stents do you have?210.1.5 Any complications?210.2 No211. What is your current blood pressure?211.1 I know my numbers: /211.2 Normal (told by doctor)211.3 High (told by doctor)211.4 Low (told by doctor)211.5 Don't know212. Do you monitor your blood pressure at home?212.1 Yes212.1.1 How often?212.1.2 What are your typical readings?212.1.3 Do you keep a log?212.2 No213. Have you ever been told you have high cholesterol?213.1 Yes213.1.1 What were your cholesterol levels?213.1.1.1 Total cholesterol213.1.1.2 LDL (bad cholesterol)213.1.1.3 HDL (good cholesterol)213.1.1.4 Triglycerides213.1.2 Are you taking cholesterol medication?213.1.3 Have you made dietary changes?213.1.4 When was your last cholesterol check?213.2 No213.3 Don't know214. Are you currently taking any heart medications?214.1 Yes214.1.1 Which medications?214.1.1.1 Blood pressure medications214.1.1.2 Cholesterol medications214.1.1.3 Blood thinners214.1.1.4 Heart rhythm medications214.1.1.5 Diuretics (water pills)214.1.1.6 Nitroglycerin214.1.2 How long have you been taking them?214.1.3 Any side effects?214.1.4 Do you take them as prescribed?214.2 No215. Do you have any implanted cardiac devices?215.1 Pacemaker215.1.1 When was it implanted?215.1.2 What type?215.1.3 Any complications?215.1.4 Regular device checks?215.2 Defibrillator (ICD)215.2.1 When was it implanted?215.2.2 Has it ever fired?215.2.3 Any complications?215.3 CRT device (cardiac resynchronization therapy)215.4 NoneSection 6: Respiratory System (Questions 281-350)make a excellent project use python django rest framework for backend and react js for front end with code structure and all