Holiday(s)

No.	Holiday Name	Start Date	End Date

Note
Klang Valley Delivery Area: 2 Days Buffer after holiday ends
Outstation Delivery Area: 3 Days Buffer after holiday ends

Please fill according to the severity of the matching symptoms. Leave blank for non-relevant symptoms

** Note: if the item does not conform to the table, then skip the item, do not fill in any scores.

Heaty Indicators	Severe (Score: 3)	Moderate (Score: 2)	Mild (Score: 1)	Non-relevant (Score: 0)
Frequent thirst and dry lips
Frequent constipation
Often feel heat on the head, hot flashes
Often heaty and has inflammation
Dislike hot drinks, prefer cold drinks
Bad temper, restlessness
Less urine, yellowish
Early menstrual cycle
Higher body temperature than others, sweat easily
Afraid of hotness
Thick layer of yellowish moss on tongue
Gland hyperactivity, high metabolism, hunger easily
Pimples easily grown on the face and body
Visible blood vessels covering eye balls
Excited or nervous easily, accelerated heart beat
Smelly sweat and odour body
Smelly vagina discharge

Cold Indicators	Severe (Score: 3)	Moderate (Score: 2)	Mild (Score: 1)	Non-relevant (Score: 0)
Cold limb
Anaemia, looks pale
Frequent diarrhea or loose type stools
Plenty of urine and colourless
Frequently flu, weak immune system
Dislike cold drink, prefer hot drinks
Slow recovery after sickness
Delay in menstrual cycle
Low blood pressure
Frequent giddy
Pale tongue
Not thirsty easily, dislike drinking water
Always sleepy
Weak knee and back pain
Low pulse rate
Pale and dim face
Impair digestion system, indigestion