PatientInfo

Is child enrolled in school

No

Intervention plan

IDP 2/week + LDP 1/week + PMT 1/week

Consanguinity

Neck holding

Food preferences

Mixed

HR

Neuropsychiatric condition

Place of Birth

Hospitalization

Tactile

PatientId

7c49da96-2300-4bc8-b256-fe41fefcd97a

FollowUpId

2e6e9be3-bbdd-45ee-87d3-b5c3829ba6fe

Child's Name

kartik

Age

2 Year 3 Month 13 Days

Gender

Male

DOB

2023-12-01

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

7987004412

Referred By

Informant

Chief concerns

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Suboptimal

Interaction

Quality of Interaction

limited

Repetitive behaviors (RRBs)

If yes- Details

Toe walking, hand flapping

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

Hopes from the consultation