PatientInfo

Is child enrolled in school

No

Intervention plan

Consanguinity

No

Neck holding

Achieved

Food preferences

Mixed

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

Yes

Tactile

PatientId

08494c52-08a2-482c-a2a1-681383f015fa

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Akay Singh

Age

2 Year 5 Month 4 Days

Gender

Male

DOB

2024-02-27

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)

8 year old female

Address

Gwalior

Contact

9304340285

Referred By

Camp

Informant

Parents

Chief concerns

Infantile spasms

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Interaction

Quality of Interaction

Repetitive behaviors (RRBs)

If yes- Details

Jumping, running to and fro, toe walking

Patterned behavior or activities

If yes- Details

Others

Details:

Scratches small kids face

Impression

IESS

Hopes from the consultation