PatientInfo

Is child enrolled in school

No

Intervention plan

HBP 1/week

Consanguinity

Neck holding

Food preferences

Prefers mashed food

HR

Neuropsychiatric condition

Place of Birth

Hospitalization

Tactile

PatientId

2303cf5d-ca2f-4dd9-b889-ef99a8d124f4

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Tanush Shakya

Age

2 Year 1 Month 13 Days

Gender

Male

DOB

2024-07-16

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

9893349857

Referred By

Informant

Chief concerns

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Suboptimal

Interaction

Improved with known people

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