PatientInfo

Is child enrolled in school

Intervention plan

IDP 2/week + PMT 1/week

Consanguinity

Neck holding

Food preferences

HR

Neuropsychiatric condition

Place of Birth

Hospitalization

Tactile

PatientId

2276d4d8-c31d-4794-a119-eafbcbb65769

FollowUpId

193397e7-b71f-4705-9533-d2e59fe7dc74

Child's Name

Divyangi baghel

Age

3 Year

Gender

Female

DOB

2023-02-21

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

9516687340

Referred By

Informant

Chief concerns

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Fleeting

Interaction

Improved with

Quality of Interaction

Repetitive behaviors (RRBs)

If yes- Details

Toe walking reduced

Patterned behavior or activities

If yes- Details

Others

Details:

Mouthing of objects reduced, spitting reduced

Impression

Hopes from the consultation