PatientInfo

Is child enrolled in school

Yes

Intervention plan

IDP 2/week +PMT 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

Mixed diet. Botttlefeeding 4 times

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

a33ddb9c-fc14-4187-bbda-0928ab6ad07d

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Abir Gupta

Age

3 Year 6 Month 21 Days

Gender

Male

DOB

2022-10-14

Mother’s age (years)

35 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

35 years

Father’s education

Father’s occupation

Jewellery business

Type of family

Joint

Number of family members

6

Number of siblings

1

Details of siblings (Age and sex)

5.5 year old female

Address

Kampoo

Contact

8130023717

Referred By

Doctor

Informant

Parents

Chief concerns

interaction age appropriate

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Suboptimal

Interaction

Quality of Interaction

avoids

Repetitive behaviors (RRBs)

If yes- Details

Patterned behavior or activities

If yes- Details

spins wheels of

Others

Details:

Impression

M chat R score- 11 (High risk)

Hopes from the consultation