PatientInfo

Is child enrolled in school

No

Intervention plan

IDP 2/week + PMT 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

Picky eater

HR

Neuropsychiatric condition

Yes

Place of Birth

Institutional

Hospitalization

No

Tactile

Hypersensitive

PatientId

e021f0d6-d29b-47e7-b539-c09a08be370c

FollowUpId

1445c8a0-a69a-498a-be9b-b97dd5cc3dab

Child's Name

Manav Batham

Age

4 Year 6 Month 16 Days

Gender

Male

DOB

2021-08-09

Mother’s age (years)

32 years

Mother’s education

Mother’s occupation

Housewife

Father’s age (years)

27 years

Father’s education

Father’s occupation

Pvt job

Type of family

Nuclear

Number of family members

6

Number of siblings

1

Details of siblings (Age and sex)

Address

Contact

8305887088

Referred By

Doctor

Informant

Chief concerns

Speech delay, poor response

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Poor

Interaction

Quality of Interaction

avoids

Repetitive behaviors (RRBs)

If yes- Details

Patterned behavior or activities

If yes- Details

Siymming, spinning

Others

Details:

Impression

Hopes from the consultation