PatientInfo

Is child enrolled in school

Intervention plan

Home based program

Consanguinity

No

Neck holding

Achieved

Food preferences

Wants to drink milk only

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

57a5ce12-114d-49f4-bfd9-fa6286fc20af

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Anirudh Dixit

Age

2 Year

Gender

Male

DOB

2024-02-08

Mother’s age (years)

33 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

Father’s education

Father’s occupation

Type of family

Nuclear

Number of family members

3

Number of siblings

1

Details of siblings (Age and sex)

1- 6 year old female

Address

Contact

9826538873

Referred By

Informant

Chief concerns

Delayed

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Interaction

Quality of Interaction

Repetitive behaviors (RRBs)

If yes- Details

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

Hopes from the consultation