PatientInfo

Is child enrolled in school

Yes

Intervention plan

IDP 1/week + PMT 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

Mixed

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

5b60c1a6-44ec-4acd-a041-e04486959795

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Sufiyan Khan

Age

6 Year 3 Month 5 Days

Gender

Male

DOB

2020-03-31

Mother’s age (years)

Mother’s education

Mother’s occupation

Father’s age (years)

Father’s education

Father’s occupation

Type of family

Nuclear

Number of family members

Number of siblings

1

Details of siblings (Age and sex)

1.5y f

Address

Kailaras

Contact

7724073083

Referred By

Doctor

Informant

Mother

Chief concerns

Behavioral concerns

Duration of symptoms

Since early infancy

Concerns noticed by school (if any)

Behavioral issues

Strengths of child

Interaction- good

Eye contact

Sustained

Interaction

Quality of Interaction

age-appropriate

Repetitive behaviors (RRBs)

If yes- Details

Patterned behavior or activities

If yes- Details

Others

Details:

Doesnt play cooperatively, wants to play with his rules

Impression

? ADHD

Hopes from the consultation