PatientInfo

Is child enrolled in school

No

Intervention plan

Home Based Program

Consanguinity

No

Neck holding

Achieved

Food preferences

Mixed

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

Hypersensitive

PatientId

16d550db-ec14-4b09-918a-14cff2148276

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Brashav Ahirwar

Age

8 Year 10 Month 21 Days

Gender

Male

DOB

2017-06-21

Mother’s age (years)

27 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

29 years

Father’s education

Father’s occupation

Private job

Type of family

Joint

Number of family members

5

Number of siblings

0

Details of siblings (Age and sex)

Address

Chhatarpur

Contact

9479841050

Referred By

Doctor

Informant

Parents

Chief concerns

Poor understanding, speech delay

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Poor

Interaction

Quality of Interaction

limited

Repetitive behaviors (RRBs)

If yes- Details

Patterned behavior or activities

If yes- Details

Others

Details:

Scratching

Impression

ASD

Hopes from the consultation