Details

PatientInfo


Is child enrolled in school
Yes
Intervention plan
Consanguinity
No
Neck holding
Achieved
Food preferences
Picky eater
HR
Neuropsychiatric condition
No
Place of Birth
Institutional
Hospitalization
Yes
Tactile
PatientId
0441c09a-5d52-44b7-834f-43f24ddb3e04
FollowUpId
00000000-0000-0000-0000-000000000000
Child's Name
Atharv Sharma
Age
12 Year 5 Month 17 Days
Gender
Male
DOB
2014-03-09
Mother’s age (years)
Mother’s education
Mother’s occupation
Father’s age (years)
Father’s education
Father’s occupation
Type of family
Nuclear
Number of family members
4
Number of siblings
1
Details of siblings (Age and sex)
9 year old male
Address
Bhopal
Contact
7869353525
Referred By
Healthcare worker
Informant
Chief concerns
Inattention, declining academic performance, procastination, distractibility
Duration of symptoms
Concerns noticed by school (if any)
Distractibility
Strengths of child
Good interaction
Eye contact
Sustained
Interaction
Quality of Interaction
age-appropriate
Repetitive behaviors (RRBs)
If yes- Details
Patterned behavior or activities
If yes- Details
Others
Details:
Impression
Hopes from the consultation

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