PatientInfo

Is child enrolled in school

No

Intervention plan

Parents counselled

Consanguinity

No

Neck holding

Achieved

Food preferences

Mixed

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

0af7d7e1-ec3e-469a-a7b5-29d017dec994

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Vidhi Pal

Age

3 Year 8 Month 27 Days

Gender

Female

DOB

2022-10-10

Mother’s age (years)

Mother’s education

Mother’s occupation

Father’s age (years)

Father’s education

Father’s occupation

Type of family

Joint

Number of family members

8

Number of siblings

1

Details of siblings (Age and sex)

3 years old female

Address

Jalon

Contact

9651620732

Referred By

Doctor

Informant

Parents

Chief concerns

Delayed milestones

Duration of symptoms

Noticed since 2 years

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

GDD

Hopes from the consultation