PatientInfo

Is child enrolled in school

Yes

Intervention plan

Home Based Program 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

Mixed diet

HR

92/min

Neuropsychiatric condition

No

Place of Birth

Home

Hospitalization

No

Tactile

PatientId

98ec024c-a678-485d-9bde-281dcd8a4800

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Shivay singh Rajawat

Age

8 Year 8 Month 12 Days

Gender

Male

DOB

2017-09-03

Mother’s age (years)

Mother’s education

Mother’s occupation

Father’s age (years)

Father’s education

Father’s occupation

Type of family

Joint

Number of family members

-2

Number of siblings

1

Details of siblings (Age and sex)

1 year female

Address

Shivpuri

Contact

9907399109

Referred By

Doctor

Informant

Parents, child

Chief concerns

Irritability, poor self regulation

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Sustained

Interaction

Quality of Interaction

limited

Repetitive behaviors (RRBs)

If yes- Details

Patterned behavior or activities

If yes- Details

Others

Details:

sibling rivalry

Impression

Poor self regulation

Hopes from the consultation