Details
PatientInfo
- Is child enrolled in school
- Intervention plan
- Consanguinity
- Neck holding
- Food preferences
- HR
- Neuropsychiatric condition
- Place of Birth
- Hospitalization
- Tactile
- PatientId
- 40f3440f-1b0d-479a-8100-f07d7e3a8f3e
- FollowUpId
- 00000000-0000-0000-0000-000000000000
- Child's Name
- Amar
- Age
- 12 Year 7 Month 15 Days
- Gender
- Male
- DOB
- 2013-06-13
- Mother’s age (years)
- Mother’s education
- Mother’s occupation
- Father’s age (years)
- Father’s education
- Father’s occupation
- Type of family
- Number of family members
- Number of siblings
- Details of siblings (Age and sex)
- Address
- Contact
- 09827095546
- Referred By
- Informant
- Chief concerns
- Duration of symptoms
- Concerns noticed by school (if any)
- Strengths of child
- Eye contact
- Interaction
- Quality of Interaction
- Repetitive behaviors (RRBs)
- If yes- Details
- Patterned behavior or activities
- If yes- Details
- Others
- Details:
- Impression
- Hopes from the consultation