PatientInfo

Is child enrolled in school

Yes

Intervention plan

Home strategies adviced

Consanguinity

No

Neck holding

Achieved

Food preferences

Mixed

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

Yes

Tactile

PatientId

0d2e4d67-2a21-41dc-b1fd-9352cecc7b32

FollowUpId

87d1f8e9-6c39-47ba-8f08-defd407956f8

Child's Name

Dherya Bhilwar

Age

7 Year 2 Month 28 Days

Gender

Male

DOB

2019-04-24

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

7

Number of siblings

1

Details of siblings (Age and sex)

Address

Lashkar

Contact

9827285970

Referred By

Doctor

Informant

Chief concerns

Poor social behaviors

Duration of symptoms

Noticed since till 2 years age

Concerns noticed by school (if any)

Strengths of child

Eye contact

Suboptimal

Interaction

Quality of Interaction

limited

Repetitive behaviors (RRBs)

If yes- Details

Hand flapping, jumping

Patterned behavior or activities

If yes- Details

Others

Details:

Likes arranging toys in line, blocks

Impression

Hopes from the consultation