PatientInfo

Is child enrolled in school

No

Intervention plan

IDP 2/week + PMT 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

2276d4d8-c31d-4794-a119-eafbcbb65769

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Divyangi baghel

Age

3 Year

Gender

Female

DOB

2023-02-21

Mother’s age (years)

23 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

31 years

Father’s education

Father’s occupation

MP Police

Type of family

Joint

Number of family members

5

Number of siblings

0

Details of siblings (Age and sex)

Address

Contact

9516687340

Referred By

Doctor

Informant

Chief concerns

Delay in speech

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

Toe walking

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

Hopes from the consultation