PatientInfo

Is child enrolled in school

No

Intervention plan

Home based program 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

Picky eating, likes sweets

HR

Neuropsychiatric condition

Yes

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

6aa4f7a5-4a51-4c6b-9167-fbc6de4738d6

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Kumar Adwait Dwivedi

Age

3 Year 7 Month 1 Days

Gender

Male

DOB

2022-07-27

Mother’s age (years)

36 years

Mother’s education

Mother’s occupation

Asst Professor

Father’s age (years)

38 years

Father’s education

Father’s occupation

Advocate in Supreme Court

Type of family

Nuclear

Number of family members

3

Number of siblings

1

Details of siblings (Age and sex)

Address

Contact

8285208935

Referred By

Doctor

Informant

Parents

Chief concerns

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Fleeting

Interaction

Quality of Interaction

limited

Repetitive behaviors (RRBs)

If yes- Details

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

Hopes from the consultation