PatientInfo

Is child enrolled in school

No

Intervention plan

Parents counselled

Consanguinity

No

Neck holding

Achieved

Food preferences

Mixed

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

6e456bb6-fe72-4718-a5d5-edc7850992ea

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Abhay Singh

Age

3 Year 1 Month 0 Days

Gender

Male

DOB

2023-04-23

Mother’s age (years)

32 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

37 years

Father’s education

Father’s occupation

Type of family

Nuclear

Number of family members

4

Number of siblings

1

Details of siblings (Age and sex)

3 year 1 month

Address

Sachin Tendulkar marg, Gwalior

Contact

7723911046

Referred By

Doctor

Informant

Parents

Chief concerns

difficulty in walking,

Duration of symptoms

Concerns noticed by school (if any)

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