Details

PatientInfo


Is child enrolled in school
No
Intervention plan
IDP 3 /week+ PMT 1/15 days
Consanguinity
No
Neck holding
Achieved
Food preferences
HR
Neuropsychiatric condition
Yes
Place of Birth
Institutional
Hospitalization
No
Tactile
PatientId
b0051226-68ee-434c-b9b1-99ac32ec49ce
FollowUpId
00000000-0000-0000-0000-000000000000
Child's Name
Anaija Shah
Age
Gender
Female
DOB
2022-04-10
Mother’s age (years)
Mother’s education
Mother’s occupation
Father’s age (years)
Father’s education
Father’s occupation
Type of family
Joint
Number of family members
6
Number of siblings
1
Details of siblings (Age and sex)
1- 7 year old male
Address
Gormi, Bhind
Contact
8871177040
Referred By
Doctor
Informant
Father and grandmother
Chief concerns
Delayed speech and walking
Duration of symptoms
Realized delayed milestones since 8 months of age, no intervention done
Concerns noticed by school (if any)
Strengths of child
Eye contact
Sustained
Interaction
Quality of Interaction
Repetitive behaviors (RRBs)
If yes- Details
Patterned behavior or activities
If yes- Details
Others
Details:
Thumb sucking
Impression
Hopes from the consultation

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