Details

PatientInfo


Is child enrolled in school
Intervention plan
Consanguinity
Neck holding
Food preferences
HR
Neuropsychiatric condition
Place of Birth
Hospitalization
Tactile
PatientId
36a65a20-219e-4015-8c99-a7e6a1627255
FollowUpId
b6ffa4d9-eb7d-473e-aafb-c0e14236203f
Child's Name
test
Age
0 Days
Gender
Male
DOB
2026-05-15
Mother’s age (years)
yus
Mother’s education
Mother’s occupation
ghik
Father’s age (years)
hhh
Father’s education
Father’s occupation
Type of family
Joint
Number of family members
2
Number of siblings
4
Details of siblings (Age and sex)
Address
nnnn
Contact
2535698562
Referred By
Informant
Chief concerns
Duration of symptoms
Concerns noticed by school (if any)
Strengths of child
Eye contact
Sustained
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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