PatientInfo

Is child enrolled in school

Yes

Intervention plan

Consanguinity

No

Neck holding

Achieved

Food preferences

Mixed

HR

Neuropsychiatric condition

Yes

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

5880c3d8-8b8a-4b5b-8f06-1083159ccc77

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Vaidhav Singh Gurjar

Age

6 Year 9 Month 26 Days

Gender

Male

DOB

2019-11-13

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)

3 year old female

Address

Morar

Contact

9755215357

Referred By

Doctor

Informant

Parents

Chief concerns

Stuttering

Duration of symptoms

Noted since 1-2 years

Concerns noticed by school (if any)

Strengths of child

Eye contact

Sustained

Interaction

Takes time to mingle

Quality of Interaction

age-appropriate

Repetitive behaviors (RRBs)

If yes- Details

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

Stuttering

Hopes from the consultation