PatientInfo

Is child enrolled in school

No

Intervention plan

IDP 2/week + PMT 1/week

Consanguinity

Neck holding

Food preferences

Mixed

HR

Neuropsychiatric condition

Place of Birth

Hospitalization

Tactile

PatientId

c4232fa5-ee67-49fd-ada0-d79dbd3b81e8

FollowUpId

139966b4-2b0e-4baf-9b6b-439adae475d0

Child's Name

Tejas Dubey

Age

2 Year 11 Month 13 Days

Gender

Male

DOB

2023-07-27

Mother’s age (years)

Mother’s education

Mother’s occupation

Father’s age (years)

Father’s education

Father’s occupation

Type of family

Number of family members

Number of siblings

Details of siblings (Age and sex)

Address

Contact

8120000046

Referred By

Informant

Chief concerns

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Fleeting

Interaction

Improved with parents

Quality of Interaction

limited

Repetitive behaviors (RRBs)

If yes- Details

Reduced

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

?ASD

Hopes from the consultation