PatientInfo

Is child enrolled in school

No

Intervention plan

Consanguinity

No

Neck holding

Achieved

Food preferences

Picky eating

HR

Neuropsychiatric condition

Yes

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

4460c7c0-7926-4e5d-8501-81520118b398

FollowUpId

d5509d50-e78a-4e75-8d67-99b9d5851164

Child's Name

Harshal Sharma

Age

2 Year 3 Month 2 Days

Gender

Male

DOB

2023-12-01

Mother’s age (years)

33 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

35 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- 7 year old female

Address

Contact

9575329999

Referred By

Relative

Informant

Chief concerns

Speech delay

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Poor

Interaction

Quality of Interaction

Repetitive behaviors (RRBs)

If yes- Details

Toe walking

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

Hopes from the consultation