PatientInfo

Is child enrolled in school

Intervention plan

Consanguinity

Neck holding

Food preferences

HR

Neuropsychiatric condition

Place of Birth

Hospitalization

Tactile

PatientId

4ad6e318-f8fc-46d1-8e42-45a5501712f6

FollowUpId

daa48d74-d452-4df8-b19a-8a94b1791b39

Child's Name

Pragyan Prajapati

Age

2 Year

Gender

Male

DOB

2024-04-21

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

9617139133

Referred By

Informant

Chief concerns

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Sustained

Interaction

Quality of Interaction

age-appropriate

Repetitive behaviors (RRBs)

If yes- Details

Patterned behavior or activities

If yes- Details

wants to switch off lights by himself

Others

Details:

Stubborness, temper tantrums improved

Impression

Hopes from the consultation