Agni Assessment

Date: Full Name: Age: Gender: Birth Date: Actual Birthplace: Height (cm): Weight (kg): Body Mass Index (BMI): Occupation: Address: Your E-mail:

	Samagni	Vishamagni	Mandagni	Teekshnagni
Belching	Clear belching	Irregular belching	No clear belching	Strongly clear belching
Bowel Evacuation	Proper bowel evacuation	Irregular evacuation	Improper evacuation	Evacuation > 3times
Stool Sink	Stool does not sink in water	Sometimes stool sink	Stool sinks in water	Stool mixed with water
Evacuation Frequency	Evacuation daily once	Constipation	Daily 2-3 times	Feels hungry even after consumption of heavy food
Stool_Consistency	Normal consistency of stool	Hard consistency	Soft bowel	Loose
Urination & Sweating	Proper urination and sweating	Less sweating and urination	Very less sweating	Increased urination & excessive sweating
Post-Meal Feeling	Feel light even after taking food	Feel cramps with bloating & gurgling sounds	Dull pain abdomen with distension, Feels heaviness	Intense thirst after taking food
Body Weight	No change in body weight	Uncertain	Gain body weight	Loss of body weight
Food Desire	Desire to take food	Uncertain	No desire for food, indigestion even after take of less food	More desire to take food
Sleep	Normal sleep	Disturbed	Sweet taste of mouth, Nausea. Excess salivation (Sthivan)	Dahaa & Sosha in Talu & Ostho
Digestion Time	Digestion in 3-6hrs	Uncertain digestion	> 6hrs	Yellowish discolouration of eyes & skin
Digestion Time	Digestion in 3-6hrs	Uncertain digestion	> 6hrs	Yellowish discolouration of eyes & skin
Body Temperature	Normal body temperature	Temperature sometimes high or low	<97 ℉	>98 ℉
Pulse	Pulse- normal (Sthir)	Pulse- irregular	Mandagati	Vegavati
Burning sensation	No	Less	Less	Burning sensation in chest
Strength	Normal	Ordinary	Low	Lack of strength even after having sufficient food
Observation
	Samagni	Vishamagni	Mandagni	Teekshnagni
Total Acquired Points	0	0	0	0
Percentage	0%	0%	0%	0%