PatientInfo

Is child enrolled in school

No

Intervention plan

IDP 2/week + PMT 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

vegetarian diet

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

Hyposensitive

PatientId

e779193e-8f7f-4256-8ce3-0ae6624ba2e8

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Sarthak Lodhi

Age

4 Year 8 Month 17 Days

Gender

Male

DOB

2021-06-29

Mother’s age (years)

35 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

34 years

Father’s education

Father’s occupation

Farmer

Type of family

Nuclear

Number of family members

5

Number of siblings

3

Details of siblings (Age and sex)

1- 16yr, 2- 14 yr, 3-12 yr (females)

Address

Gadhaipura

Contact

8357981567

Referred By

Doctor

Informant

Parents

Chief concerns

Speech delay, doesnt follow command

Duration of symptoms

Realized around 3 years that child has speech delay

Concerns noticed by school (if any)

Strengths of child

Eye contact

Fleeting

Interaction

Quality of Interaction

limited

Repetitive behaviors (RRBs)

If yes- Details

Looking from lateral side of eye

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

Hopes from the consultation