Details

PatientInfo


Is child enrolled in school
Yes
Intervention plan
2 IDP/week + PMT 1/week
Consanguinity
No
Neck holding
Achieved
Food preferences
Mixed
HR
Neuropsychiatric condition
No
Place of Birth
Institutional
Hospitalization
Yes
Tactile
PatientId
e112e98c-d3e4-4af4-bcd6-63b45f13e3e8
FollowUpId
03fc7d9e-99d5-4e75-879c-9f0ec09a3678
Child's Name
Aayushman Chaurasia
Age
7 Year 2 Month 29 Days
Gender
Male
DOB
2019-04-23
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
7
Number of siblings
1
Details of siblings (Age and sex)
5 year old male
Address
Contact
9300998408
Referred By
Doctor
Informant
Parents
Chief concerns
Unclear speech, Behavioral issues
Duration of symptoms
Concerns noticed by school (if any)
Strengths of child
Eye contact
Suboptimal
Interaction
Quality of Interaction
age-appropriate
Repetitive behaviors (RRBs)
If yes- Details
Patterned behavior or activities
If yes- Details
Others
Details:
Screaming, thumb sucking, hitting himself and others. Sniffs objects.
Impression
Hopes from the consultation

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