YOUR NAME:                         

YOUR E-MAIL:                       

YOUR BIRTH DATE:             

YOUR BIRTH TIME (AS YOU KNOW IT):    

YOUR BIRTH LOCATION:    

YOUR SKIN:
Grey or earthy color Yellowish or pinkish Whitish pale color
Dry, cracked & cold Dry & warm Smooth, moist, oily & cold

YOUR HAIR:
Dry & Dull      Oily     Thick     Fine & Curly     Straight
Wavy, Thick & Shiny   Average   Thin to early balding   Full Thick

YOUR BODY
FRAME:
Thin, bony, tall or short Medium, Balanced Large, broad

WEIGHT:
Low Moderate Heavy

FINGER NAILS:
Rough, dry, brittle, bitten Soft, pink, strong Soft, large, white, shinning

FOREHEAD SIZE:
Narrow Medium Broad

EYES:
Small, unsteady, dry Medium, unsteady,    Burning Big, steady, Moist
very short & falling lashes Short & falling lashes Long lashes

LIPS:
Cracking, thin, dry Medium, short Large,  Smooth

TEETH:
Protruding, big, uneven Moderate, yellowish Strong, even, white

YOUR PHYSICAL TRAITS
APPETITE:
Variable, small Good, regular Slow and steady

THIRST:
Variable Excessive Minimal

ELIMINATION:
Dry, hard, constipated Soft, oily, loose Thick, heavy, slow

URINATION:
Frequent bur spares Yellow, copious Infrequent, average

SWEAT:
Minimal Profuse, pungent in odor Slow to begin, heavy

CIRCULATION:
Variable, poor, sluggish Good Moderate

PULSE:
Weak, erratic, fast Stable, strong Slow, smooth

SLEEP:
Light, disturbed, minimal Sound, moderate Heavy, excessive

STAMINA:
Variable Good Excellent

LIKING OF TASTE:
Sweet Sour Pungent

IMMUNITY:
Variable, poor Moderate High

ACTIVITY:
High, restless, mobile Moderate, directed Minimal, slow

YOUR MENTAL TRAITS
TEMPERAMENT:
Nervous, insecure, shy Determined, motivated Conservative resilient

MEMORY:
SHORT MEDIUM LONG

DREAMS:
Frequent, fearful Fiery, violent, vivid Romantic, calm

CREATIVITY:
Original, fertile Technical, scientific Entrepreneurial

MOODS:
Change quickly Change slowly Consistent, not changing

HOBBIES:
Travel, art, philosophy Sports, politics, luxuries Serene, leisurely, types

SENSITIVITIES:
Cold, wind, dryness Heat, sun, fires Cold, damp, humidity

FINANCES:
Rich, thirsty Moderate, buys luxuries Poor, spends, rapidly

YOUR EMOTIONAL TRAITS
NATURE:
Restless, curious Aggressive, clever Calm, steady

EMOTIONS:
Change often & easily Intense Even tempered

SPEECH:
Quick or talkative, Moderate or argues Deep or tonal

LIBIDO:
Varies, directed in fantasy Passveionate, excessive Slow but strong, loyal

FAITH:
Erratic, changeable Fanatical Steady, devoted

I GET EXCITED:
Easily and often Less easily & less often Slowly, not easily excited

I BECOME ANXIOUS AND WORRIED:
Very easily Occasionally Rarely

MY INTEREST IN SEX IS:
Minimal, unless romance is involved Moderate to strong Generally very strong

I AM SENSITIVE TO:
Loud noises, or chaotic Bright glaring lights Strong odors

MY REACTION TO STRESS IS :
Fearfulness, anxiety Irritation, frustrations or anger Calm and collected

IN RELATIONSHIPS, I :
Am able to adapt to many different kinds of people & have many friends
Often choose friends on the basic of their values
Am slower to make friends, but am loyal

I TAKE DRUGS, ALCOHOL & STIMULANTS:
Never Occasionally Frequently

YOUR COSMIC TRAITS
MY CONTROL OF SENSES:
Good Moderate Weak

PEACE OF MIND:
Generally Partly Rarely

SPIRITUAL STUDY:
Daily Occasionally Never

MANTRA, PRAYER:
Daily Occasionally Never

MEDITATION:
Daily Occasionally Never