PatientInfo

Is child enrolled in school

No

Intervention plan

IDP 1/week + PMT 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

Picky eater

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

75b07e21-9ceb-4572-889c-ed562fd3fb97

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Dishant Savita

Age

3 Year 10 Month 23 Days

Gender

Male

DOB

2022-11-05

Mother’s age (years)

28 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

30 years

Father’s education

Father’s occupation

Hospital store

Type of family

Joint

Number of family members

6

Number of siblings

1

Details of siblings (Age and sex)

1 month old

Address

Contact

7747828360

Referred By

Doctor

Informant

Parents

Chief concerns

Behavioral concerns

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Suboptimal

Interaction

Wants to interact

Quality of Interaction

Repetitive behaviors (RRBs)

If yes- Details

Hand flapping, running to and fro

Patterned behavior or activities

If yes- Details

Others

Details:

arranges toys in line

Impression

Hopes from the consultation