PatientInfo

Is child enrolled in school

No

Intervention plan

IDP2/week +PMT 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

19bccba4-7a32-49e4-8c69-6370207dddcc

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Nivedh Gupta

Age

2 Year

Gender

Male

DOB

2024-01-29

Mother’s age (years)

35 years

Mother’s education

Mother’s occupation

Anaesthesiologist

Father’s age (years)

37 years

Father’s education

Father’s occupation

Surgeon

Type of family

Joint

Number of family members

4

Number of siblings

1

Details of siblings (Age and sex)

Address

Sun valley, Gwl

Contact

8800247044

Referred By

Informant

Chief concerns

Speech Dealy

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