PatientInfo

Is child enrolled in school

No

Intervention plan

IDP + PT 3 days/week

Consanguinity

No

Neck holding

Achieved

Food preferences

Mixed

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

6cdfe646-e9e8-4388-ad52-88acc3be5653

FollowUpId

5c5e1429-b1f2-48b8-8b78-5f77cebb06e3

Child's Name

Nishant Baghel

Age

1 Year 7 Month 24 Days

Gender

Male

DOB

2024-12-25

Mother’s age (years)

26 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

27 years

Father’s education

Father’s occupation

Private

Type of family

Joint

Number of family members

7

Number of siblings

1

Details of siblings (Age and sex)

5 year old male

Address

Dabra

Contact

9826913671

Referred By

Doctor

Informant

Parents

Chief concerns

Development delay, seizures

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Interaction

Quality of Interaction

Repetitive behaviors (RRBs)

If yes- Details

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

Hopes from the consultation