PatientInfo

Is child enrolled in school

No

Intervention plan

IDP 2/week + LDP 1/week + PMT 1/month

Consanguinity

Neck holding

Food preferences

Mixed

HR

Neuropsychiatric condition

Place of Birth

Hospitalization

Tactile

PatientId

3f8af7dd-82d7-4239-b241-65470fe12e04

FollowUpId

d8a7802c-620d-4572-b6a1-c1e46a102eb5

Child's Name

Shivansh Singh Tomar

Age

2 Year 8 Month 22 Days

Gender

Male

DOB

2024-02-02

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

9806709042

Referred By

Informant

Chief concerns

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Fleeting

Interaction

Improved with known people

Quality of Interaction

Repetitive behaviors (RRBs)

If yes- Details

Handflapping

Patterned behavior or activities

If yes- Details

Others

Details:

Reduced

Impression

Hopes from the consultation