Patient age

Patient Gender

Male
Female

Complaint

Headaches
Arthritis
Backpain and Siciatica
Asthma
Diabetes
Hypertention
Other, if so please specify in the next field

if Other please specify the complaint

Number of cupping treatments

Type of cupping used

wet cupping hijama
dry cupping
massage cupping

Cupping locations

results from pain grade score or other scientific means

is there is any complications from cupping

yes
no

Researcher information and biography

Write here your name, address, contact information and credentials

If you need any help in submitting the case, or need any scientific methods contact us