PatientInfo

Is child enrolled in school

Yes

Intervention plan

Home startegies adviced

Consanguinity

No

Neck holding

Achieved

Food preferences

Mixed

HR

Neuropsychiatric condition

No

Place of Birth

Home

Hospitalization

No

Tactile

PatientId

33a630e0-8323-452c-98bb-ca29db54be49

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Abhishek Patel

Age

5 Year 11 Month 28 Days

Gender

Male

DOB

2020-07-25

Mother’s age (years)

29 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

36 years

Father’s education

Father’s occupation

Farming

Type of family

Joint

Number of family members

8

Number of siblings

0

Details of siblings (Age and sex)

Address

Banda

Contact

6268906805

Referred By

Doctor

Informant

Parents

Chief concerns

Speech delay

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Sustained

Interaction

Avoids due to difficulty in communication

Quality of Interaction

avoids

Repetitive behaviors (RRBs)

If yes- Details

Patterned behavior or activities

If yes- Details

Others

Details:

Hitting, pushing

Impression

?ID

Hopes from the consultation