* Approximate water intake per day:

<4glass

1Ltr

2Ltr

3Ltr

>3Ltr

Please select one option. * Approximate oil consumption of entire family per month:

1Ltr

2Ltr

>2Ltr

Please select one option.
* How often you eat outside:

Daily

Weekly

Rarely

Please select one option.
* Alcohol consumption:

Yes

No

Please select one option.
* Smoking:

Yes

No

Please select one option.