PatientInfo

Is child enrolled in school

No

Intervention plan

HBP 1/week . IDP when possible

Consanguinity

Neck holding

Food preferences

Mixed

HR

Neuropsychiatric condition

Place of Birth

Hospitalization

Tactile

Hyposensitive

PatientId

24a4b436-18a6-4127-be66-f3d725c41d15

FollowUpId

b30e439c-61d1-4a7f-b1f5-e7a98fea5d03

Child's Name

Ilham Khan

Age

4 Year 1 Month 2 Days

Gender

Male

DOB

2022-05-07

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

Contact

9149210209

Referred By

Informant

Chief concerns

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Fleeting

Interaction

Interaction improved with parents

Quality of Interaction

limited

Repetitive behaviors (RRBs)

If yes- Details

Patterned behavior or activities

If yes- Details

Others

Details:

Object obsession reduced, aggression reduced

Impression

Improvement in interaction, eye contact, response to name call

Hopes from the consultation