Details

PatientInfo


Is child enrolled in school
No
Intervention plan
IDP 2/week + PMT 1/week
Consanguinity
Neck holding
Food preferences
Mixed
HR
Neuropsychiatric condition
Place of Birth
Hospitalization
Tactile
PatientId
f53aeea3-e684-4dc0-a36d-bdb80d2d79ee
FollowUpId
43d3284c-8808-4f69-b3c0-6153af91c6c5
Child's Name
Mishita sen
Age
3 Year 11 Month 28 Days
Gender
Female
DOB
2022-04-13
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
8959899819
Referred By
Informant
Chief concerns
Duration of symptoms
Concerns noticed by school (if any)
Strengths of child
Eye contact
Fleeting
Interaction
Quality of Interaction
limited
Repetitive behaviors (RRBs)
If yes- Details
Patterned behavior or activities
If yes- Details
Others
Details:
Impression
ASD
Hopes from the consultation

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