Skip to content

“We are committed to provide Quality Unani and Ayurvedic medicinal formulations!!!”

GOLDEN NIGHT

“We always believe in Quality”

Facebook Twitter Linkedin

Menu

Home
About
Unani & Ayurveda
Products
- Golden knight
Disease Awareness
Contact
Consultation
info@goldenknight.in

Consultation

Golden knight > Consultation

For consultation you can contact our competent team of Hakims and Vaids who implement and monitor the quality of our products.

ENQUIRY FORM

General

Male

Female

General

General

Name of Patient *

Email Address *

Phone No. *

Age (Yrs.) *

Weight (Kg)

Height (Feet & Inch)

Profession

Marital Status *

Postal Address

City *

State *

PIN / Zip Code

Country *

Do you suffer from Hypertension? *

If yes, mention your BP

Are you suffering from Diabetes ? *

If yes, mention Blood Sugar Level

1. Main problems *

2. For how long, are you suffering from these complaints?

3. Appetite

4. Motion

5. Food Habit

6. Built

7. Do you have the problem of burning chest ?

Often

Sometimes

Never

8. Do you suffer from headache ?

Often

Sometimes

Never

9. Do you suffer from sleeplessness ?

Often

Sometimes

Never

10. Do you smoke or chew tobacco ?

Yes

No

11. Do you drink excessive tea or coffee ?

Yes

No

12. Do you consume alcohol ?

Yes

No

13. If you have suffered from any major disease earlier, kindly do mention it here ?

14. If there is a history of any hereditary disease in your family, kindly do mention it here ?

15. If you have undergone any medical investigations, kindly mention here

16. Any other problem, which you would like to describe

reCAPTCHA

If you are human, leave this field blank.

Male

General

Name of Patient *

Email Address *

Phone No. *

Age (Yrs.) *

Weight (Kg)

Height (Feet & Inch)

Profession

Marital Status *

Postal Address

City *

State *

PIN / Zip Code

Country *

Do you suffer from Hypertension? *

If yes, mention your BP

Are you suffering from Diabetes ? *

If yes, mention Blood Sugar Level

1. Main problems *

2. For how long, are you suffering from these complaints?

3. Appetite

4. Motion

5. Food Habit

6. Built

7. Do you have the problem of burning chest ?

Often

Sometimes

Never

8. Do you suffer from headache ?

Often

Sometimes

Never

9. Do you suffer from sleeplessness ?

Often

Sometimes

Never

10. Do you smoke or chew tobacco ?

Yes

No

11. Do you drink excessive tea or coffee ?

Yes

No

12. Do you consume alcohol ?

Yes

No

13. If you have suffered from any major disease earlier, kindly do mention it here ?

14. If there is a history of any hereditary disease in your family, kindly do mention it here ?

15. If you have undergone any medical investigations, kindly mention here

16. Any other problem, which you would like to describe

reCAPTCHA

If you are human, leave this field blank.

Female

General

Name of Patient *

Email Address *

Phone No. *

Age (Yrs.) *

Weight (Kg)

Height (Feet & Inch)

Profession

Marital Status *

Postal Address

City *

State *

PIN / Zip Code

Country *

Do you suffer from Hypertension? *

If yes, mention your BP

Are you suffering from Diabetes ? *

If yes, mention Blood Sugar Level

1. Main problems *

2. For how long, are you suffering from these complaints?

3. Appetite

4. Motion

5. Food Habit

6. Built

7. Do you have the problem of burning chest ?

Often

Sometimes

Never

8. Do you suffer from headache ?

Often

Sometimes

Never

9. Do you suffer from sleeplessness ?

Often

Sometimes

Never

10. Do you smoke or chew tobacco ?

Yes

No

11. Do you drink excessive tea or coffee ?

Yes

No

12. Do you consume alcohol ?

Yes

No

13. If you have suffered from any major disease earlier, kindly do mention it here ?

14. If there is a history of any hereditary disease in your family, kindly do mention it here ?

15. If you have undergone any medical investigations, kindly mention here

16. Any other problem, which you would like to describe

reCAPTCHA

If you are human, leave this field blank.

About Golden Knight

” We always believe in quality “

Advanced Pakiza Unani, is a dynamic organization engaged in manufacturing and marketing of quality Unani and Ayurvedic medicinal formulations.

www.scienuvobiopharma.com www.tykhehealthcare.com
www.pakizaunani.com

Products

Golden Knight

Quick Links

Unani & Ayurveda
Disease Awareness
Disclaimer
Terms of use
Privacy Policy
Grievance
Contact

Get in Touch

Raviraj Astria 102, Opp: Sai Service Maruti Service Station, Kondhwa, Pune 411048
+91-8788727276
+91-8600106637
+91-9422204849
info@goldenknight.in

Copyright © 2026 Golden knight | Powered by Golden knight