PatientInfo

Is child enrolled in school

Yes

Intervention plan

IDP2/week +PMT1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

3cf73fb5-fc61-46bf-bce9-9e70038ef86c

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Swastik Sharma

Age

5 Year 8 Month 15 Days

Gender

Male

DOB

2020-06-12

Mother’s age (years)

32 years

Mother’s education

Mother’s occupation

Teacher

Father’s age (years)

33 years

Father’s education

Father’s occupation

Professor

Type of family

Joint

Number of family members

6

Number of siblings

1

Details of siblings (Age and sex)

1- 9 years female

Address

D D nagar

Contact

9575111122

Referred By

Relative

Informant

Mother

Chief concerns

Behavioral concerns

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Fleeting

Interaction

Quality of Interaction

limited

Repetitive behaviors (RRBs)

If yes- Details

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

Hopes from the consultation