PatientInfo

Is child enrolled in school

No

Intervention plan

IDP 1/week + PMT 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

Picky eater

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

ab1e6daa-ebec-4e9d-8532-5b9541f3ba31

FollowUpId

2e659c1e-7020-4a0c-8122-188f80d56bf5

Child's Name

Samyak Gautam

Age

4 Year 4 Month 21 Days

Gender

Male

DOB

2021-12-04

Mother’s age (years)

32 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

35 years

Father’s education

Father’s occupation

Govt job

Type of family

Joint

Number of family members

4

Number of siblings

0

Details of siblings (Age and sex)

Address

Suresh Nagar

Contact

9926222231

Referred By

Doctor

Informant

Parents

Chief concerns

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Fleeting

Interaction

Quality of Interaction

limited

Repetitive behaviors (RRBs)

If yes- Details

Stares from corner of eye

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

?ASD

Hopes from the consultation