PatientInfo

Is child enrolled in school

Yes

Intervention plan

Consanguinity

No

Neck holding

Achieved

Food preferences

Dairy product, gluten, sugar restricted

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

d6b70f07-8222-41c4-a5f3-d048cd6955af

FollowUpId

d4ba2027-3849-47d7-b890-47bd3b1a2417

Child's Name

Adwick Narwariya

Age

4 Year 9 Month 20 Days

Gender

Male

DOB

2021-09-25

Mother’s age (years)

Mother’s education

Mother’s occupation

Father’s age (years)

Father’s education

Father’s occupation

Type of family

Nuclear

Number of family members

3

Number of siblings

0

Details of siblings (Age and sex)

Address

City centre

Contact

9074731668

Referred By

Doctor

Informant

Father

Chief concerns

Duration of symptoms

Noticed at 1.5 years age

Concerns noticed by school (if any)

Strengths of child

Eye contact

Suboptimal

Interaction

Quality of Interaction

limited

Repetitive behaviors (RRBs)

If yes- Details

running to and fro

Patterned behavior or activities

If yes- Details

Others

Details:

Fidgetiness

Impression

GDD

Hopes from the consultation