PatientInfo

Is child enrolled in school

No

Intervention plan

Consanguinity

No

Neck holding

Achieved

Food preferences

Mixed. Bottlefeeding+

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

adfe762c-4ad7-4e53-883a-f6988295a441

FollowUpId

0a9eb830-5b8f-4e1f-ae81-ff0f6b19d92a

Child's Name

Deepansh Kushwah

Age

1 Year 9 Month 18 Days

Gender

Male

DOB

2024-08-22

Mother’s age (years)

26 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

30 years

Father’s education

Father’s occupation

Govt job

Type of family

Joint

Number of family members

5

Number of siblings

0

Details of siblings (Age and sex)

Address

Mau, Bhind

Contact

8109779601

Referred By

Doctor

Informant

Parents

Chief concerns

Delayed milestones (unable to walk, speech delay)

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:

Impression

Hopes from the consultation