PatientInfo

Is child enrolled in school

Yes

Intervention plan

IDP 2/week + PMT 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

Craving for sweets

HR

Neuropsychiatric condition

Yes

Place of Birth

Institutional

Hospitalization

Yes

Tactile

PatientId

542ea68c-212d-44e5-ac72-73ee925171d0

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Kanak Soni

Age

10 Year 2 Month 21 Days

Gender

Female

DOB

2016-01-21

Mother’s age (years)

38 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

45 years

Father’s education

Father’s occupation

Medofarm

Type of family

Nuclear

Number of family members

4

Number of siblings

1

Details of siblings (Age and sex)

17 year old female

Address

Naka chandravadni

Contact

8103284195

Referred By

Doctor

Informant

Mother

Chief concerns

unable to do ADLs, doesnt prefer socializing

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Suboptimal

Interaction

Quality of Interaction

Repetitive behaviors (RRBs)

If yes- Details

Stimmimg

Patterned behavior or activities

If yes- Details

Others

Details:

Hits father

Impression

Hopes from the consultation