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Translate this pageLibido Analysis Form (Please enter the customer code that has been sent to you through email in the text box provided below "Customer Code") * The fields are compulsory * Email: * Customer Code: Penis Size Small Medium Large Scrotum Are testicles descended in scrotum ? Yes No Is there any swelling or pain in scrotum ?Yes No Semen Quantity More Less Moderate Semen Quality Bad odour Normal odour Bad odour with blood and pus Erection Hard No erection Moderate Erection time Less More Moderate Others More mental exertion Less mental exertion Moderate mental exertion More physical exertion Less physical exertion Moderate physical exertion Do you become more tensed about the present problem during sexual act? Yes No If you have a rescent semen analysis report please mention (optional) If you have any other chronic illness like diabetes , hypertension, bronchitis please give a brief history(optional) History of present problem
Libido Analysis Form (Please enter the customer code that has been sent to you through email in the text box provided below "Customer Code")
Penis Size
Scrotum
Semen Quantity
Semen Quality
Erection
Erection time
Others
If you have a rescent semen analysis report please mention (optional)
If you have any other chronic illness like diabetes , hypertension, bronchitis please give a brief history(optional)
History of present problem