Details

PatientInfo


Is child enrolled in school
Yes
Intervention plan
IQ evaluation
Consanguinity
No
Neck holding
Achieved
Food preferences
Picky eater
HR
Neuropsychiatric condition
No
Place of Birth
Institutional
Hospitalization
Yes
Tactile
PatientId
17ce59ce-a4c2-4c38-8231-538bbff114f0
FollowUpId
00000000-0000-0000-0000-000000000000
Child's Name
Harsh Thapak
Age
10 Year 8 Month 8 Days
Gender
Male
DOB
2016-01-24
Mother’s age (years)
36 years
Mother’s education
Mother’s occupation
Father’s age (years)
43 years
Father’s education
Father’s occupation
Teacher
Type of family
Nuclear
Number of family members
3
Number of siblings
1
Details of siblings (Age and sex)
Address
Parents
Contact
9669689010
Referred By
Doctor
Informant
Parents
Chief concerns
Doesnt express his thoughts, Academic concerns, low self confidence, doesnt make friends
Duration of symptoms
Concerns noticed by school (if any)
Strengths of child
Eye contact
Sustained
Interaction
Quality of Interaction
age-appropriate
Repetitive behaviors (RRBs)
If yes- Details
Patterned behavior or activities
If yes- Details
Others
Details:
Fidgetiness+, hits himself and mother
Impression
Hopes from the consultation

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