PatientInfo

Is child enrolled in school

No

Intervention plan

Consanguinity

No

Neck holding

Achieved

Food preferences

Mixed

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

b8f5e43a-158f-444e-9ccc-c409c13663ea

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Harsh Gurjar

Age

4 Year

Gender

Male

DOB

2022-05-03

Mother’s age (years)

27 years

Mother’s education

Mother’s occupation

homemaker

Father’s age (years)

26 years

Father’s education

Father’s occupation

Family

Type of family

Nuclear

Number of family members

3

Number of siblings

2

Details of siblings (Age and sex)

9y female, 7 y male

Address

Sirol

Contact

6264024628

Referred By

Doctor

Informant

Parents

Chief concerns

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

Expressive language delay

Hopes from the consultation