Details

PatientInfo


Is child enrolled in school
No
Intervention plan
LDP 2/week + PMT 1/month
Consanguinity
Neck holding
Food preferences
Mixed
HR
Neuropsychiatric condition
Place of Birth
Hospitalization
Tactile
PatientId
11ccac86-34c3-47ee-b47c-9e3d7df83c17
FollowUpId
f9d313f3-8e17-4c2c-8387-8c4321c5df28
Child's Name
Madhav Yadav
Age
3 Year 4 Month 9 Days
Gender
Male
DOB
2022-12-25
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
7898897842
Referred By
Informant
Chief concerns
Duration of symptoms
Concerns noticed by school (if any)
Strengths of child
Eye contact
Sustained
Interaction
Quality of Interaction
age-appropriate
Repetitive behaviors (RRBs)
If yes- Details
Patterned behavior or activities
If yes- Details
Others
Details:
Impression
Hopes from the consultation

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