Details

PatientInfo


Is child enrolled in school
Intervention plan
Consanguinity
Neck holding
Food preferences
HR
Neuropsychiatric condition
Place of Birth
Hospitalization
Tactile
PatientId
fd314610-2306-4235-90f1-c6013b556159
FollowUpId
26d470a0-23c2-43a1-8302-48e96745786e
Child's Name
Aandhun
Age
9
Gender
Male
DOB
2010-01-05
Mother’s age (years)
35
Mother’s education
12
Mother’s occupation
no
Father’s age (years)
40
Father’s education
no
Father’s occupation
no
Type of family
joint
Number of family members
5
Number of siblings
5
Details of siblings (Age and sex)
na
Address
local
Contact
9854445554
Referred By
doc
Informant
na
Chief concerns
na
Duration of symptoms
2
Concerns noticed by school (if any)
no
Strengths of child
Eye contact
Interaction
Quality of Interaction
Repetitive behaviors (RRBs)
If yes- Details
Patterned behavior or activities
If yes- Details
Others
Details:
Impression
Hopes from the consultation

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