PatientInfo

Is child enrolled in school

Yes

Intervention plan

Consanguinity

No

Neck holding

Achieved

Food preferences

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

272d0595-3a6c-4d90-8309-93ede78b81ac

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Akshaya Jain

Age

2 Year 10 Month 9 Days

Gender

Female

DOB

2023-04-22

Mother’s age (years)

30 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

33 years

Father’s education

Father’s occupation

Private job

Type of family

Joint

Number of family members

6

Number of siblings

0

Details of siblings (Age and sex)

Address

Chetakpuri

Contact

9004823322

Referred By

Doctor

Informant

Chief concerns

Speech delay, poor understanding

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:

Likes playing puzzles and shape sorting

Impression

M chat 4 (Medium risk)

Hopes from the consultation