PatientInfo

Is child enrolled in school

Intervention plan

Adolescent counselling 1/week + PMT 1/week

Consanguinity

No

Neck holding

Food preferences

Mixed

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

Yes

Tactile

PatientId

150574d1-00f3-44c0-a47c-4c7920997b90

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Manav Agrawal

Age

17 Year 10 Month 20 Days

Gender

Male

DOB

2008-08-10

Mother’s age (years)

42 years

Mother’s education

Mother’s occupation

Govt school teacher

Father’s age (years)

46 years

Father’s education

Father’s occupation

Private school teacher

Type of family

Nuclear

Number of family members

4

Number of siblings

1

Details of siblings (Age and sex)

8 year old female

Address

Morena

Contact

9907824540

Referred By

Doctor

Informant

Mother, nani

Chief concerns

Low confidence

Duration of symptoms

Since 1 year

Concerns noticed by school (if any)

Strengths of child

Eye contact

Sustained

Interaction

Prefers to stay alone

Quality of Interaction

age-appropriate

Repetitive behaviors (RRBs)

If yes- Details

Patterned behavior or activities

If yes- Details

Others

Details:

2 episodes of aggressive bursts, back answering

Impression

Hopes from the consultation