PatientInfo

Is child enrolled in school

No

Intervention plan

IDP 2/week + PMT 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

Mixed

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

bd060c5e-162f-4fb6-8a39-608e4b7018bd

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Dharvi Singh

Age

2 Year 11 Month 10 Days

Gender

Female

DOB

2023-07-03

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

6

Number of siblings

1

Details of siblings (Age and sex)

7 year old male

Address

Contact

7987853809

Referred By

Doctor

Informant

Parents

Chief concerns

Duration of symptoms

Noticed 6 months back

Concerns noticed by school (if any)

Strengths of child

Eye contact

Poor

Interaction

Quality of Interaction

limited

Repetitive behaviors (RRBs)

If yes- Details

Toe walking

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

?ASD

Hopes from the consultation