Details

PatientInfo


Is child enrolled in school
Intervention plan
Consanguinity
Neck holding
Food preferences
HR
Neuropsychiatric condition
Place of Birth
Hospitalization
Tactile
PatientId
a222b7e5-9212-4aa5-9b09-bd78e8bd043f
FollowUpId
a5851f38-c04b-4c44-9473-acd33f311dc1
Child's Name
dsdssdsd
Age
12
Gender
fdfd
DOB
2010-05-01
Mother’s age (years)
12
Mother’s education
212
Mother’s occupation
12
Father’s age (years)
21
Father’s education
21
Father’s occupation
212
Type of family
1212
Number of family members
212
Number of siblings
221
Details of siblings (Age and sex)
Address
Contact
23232
Referred By
Informant
2323
Chief concerns
Duration of symptoms
Concerns noticed by school (if any)
Strengths of child
Eye contact
Interaction
Quality of Interaction
Repetitive behaviors (RRBs)
If yes- Details
Patterned behavior or activities
If yes- Details
Others
Details:
Impression
Hopes from the consultation

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