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

749241f9-8a8d-4443-9520-7386f10a8073

FollowUpId

0f32aa28-2d0a-43da-aed4-c241c366a4e9

Child's Name

Shree Sharma

Age

1 Year 10 Month 1 Days

Gender

Female

DOB

2024-11-01

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

0

Details of siblings (Age and sex)

Address

Morar

Contact

9399929445

Referred By

Doctor

Informant

Parents

Chief concerns

Poor response to name call

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Fleeting

Interaction

Quality of Interaction

limited

Repetitive behaviors (RRBs)

If yes- Details

running to and fro

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

? ASD. M chat- 16

Hopes from the consultation