Details

PatientInfo


Is child enrolled in school
No
Intervention plan
IEP 2/week + PMT 1/15 days
Consanguinity
Neck holding
Food preferences
Mixed
HR
Neuropsychiatric condition
Place of Birth
Hospitalization
Tactile
PatientId
fa020b2e-4df6-44ab-adf4-dfa88ab0b8a7
FollowUpId
5331901b-5911-4112-ac55-8bc3b861dc14
Child's Name
Ansh Agrawal
Age
12 Year 10 Month 19 Days
Gender
Male
DOB
2013-07-03
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
8770327188
Referred By
Informant
Chief concerns
Duration of symptoms
Concerns noticed by school (if any)
Strengths of child
Eye contact
Suboptimal
Interaction
Quality of Interaction
age-appropriate
Repetitive behaviors (RRBs)
If yes- Details
Patterned behavior or activities
If yes- Details
Others
Details:
Impression
Hopes from the consultation

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