PatientInfo

Is child enrolled in school

Intervention plan

Home startegies adviced

Consanguinity

Neck holding

Achieved

Food preferences

On predominantly milk

HR

Neuropsychiatric condition

Place of Birth

Hospitalization

Tactile

PatientId

c9340ab5-e647-4e50-b86f-eaa3598b4e32

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Aashutosh Asati

Age

1 Year 1 Month 5 Days

Gender

Male

DOB

2025-04-27

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

7566489028

Referred By

Informant

Chief concerns

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Suboptimal

Interaction

Quality of Interaction

Repetitive behaviors (RRBs)

If yes- Details

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

GDD. Hypotonia. Birth asphyxia sequelae? Genetic

Hopes from the consultation