Details

PatientInfo


Is child enrolled in school
Yes
Intervention plan
Consanguinity
No
Neck holding
Achieved
Food preferences
Picky eater
HR
Neuropsychiatric condition
No
Place of Birth
Institutional
Hospitalization
No
Tactile
PatientId
ecf4d7e1-a329-40cd-b2f5-2fe322936487
FollowUpId
00000000-0000-0000-0000-000000000000
Child's Name
lakshit Raguwanshi
Age
6 Year 7 Month 7 Days
Gender
Male
DOB
2019-12-04
Mother’s age (years)
Mother’s education
Mother’s occupation
Father’s age (years)
Father’s education
Father’s occupation
Type of family
Number of family members
Number of siblings
Details of siblings (Age and sex)
Address
Shivpuri
Contact
8770745343
Referred By
Doctor
Informant
Parents
Chief concerns
Social interaction deficit
Duration of symptoms
Noticed at 9 months age
Concerns noticed by school (if any)
Strengths of child
Eye contact
Suboptimal
Interaction
Wants to play in his own way
Quality of Interaction
limited
Repetitive behaviors (RRBs)
If yes- Details
toe walking
Patterned behavior or activities
If yes- Details
Others
Details:
used to arrange toys in line; starnger anxiety; aggressive if his wish is not followed
Impression
Poor self regulation
Hopes from the consultation

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