PatientInfo

Is child enrolled in school

No

Intervention plan

IDP (+ PT) 5/week + PMT 1/m

Consanguinity

No

Neck holding

Achieved

Food preferences

accepts food in liquid form

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

Yes

Tactile

PatientId

56d2fc05-76c5-4bf2-9922-497fe475ce22

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Shivansh Batham

Age

3 Year

Gender

Male

DOB

2023-02-20

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

9

Number of siblings

1

Details of siblings (Age and sex)

2 months

Address

Contact

9669328851

Referred By

Doctor

Informant

Parents

Chief concerns

Delayed milestones

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Sustained

Interaction

Quality of Interaction

Repetitive behaviors (RRBs)

If yes- Details

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

Hopes from the consultation