PatientInfo

Is child enrolled in school

Intervention plan

IDP 3/week

Consanguinity

Neck holding

Food preferences

Mixed diet

HR

Neuropsychiatric condition

Place of Birth

Hospitalization

Tactile

PatientId

a1ae1a20-17ce-4b97-a0eb-fb06e1089c98

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Harshiv Gupta

Age

2 Year 5 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

7489936093

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:

stubborness reduced

Impression

Weight bearing improved, toe walking reduced, Started cruising

Hopes from the consultation