Details

PatientInfo


Is child enrolled in school
No
Intervention plan
IDP 2/week + PMT 1/week
Consanguinity
No
Neck holding
Achieved
Food preferences
Mixed diet
HR
Neuropsychiatric condition
No
Place of Birth
Hospitalization
Yes
Tactile
PatientId
715d663a-8850-4424-b024-4b1dee8713c7
FollowUpId
2522bb40-76c8-4756-b1aa-1c7f1ab0b737
Child's Name
Shorya Khushwah
Age
2 Year 5 Month 8 Days
Gender
Male
DOB
2024-03-04
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
9977570515
Referred By
Informant
Chief concerns
Duration of symptoms
Concerns noticed by school (if any)
Strengths of child
Eye contact
Fleeting
Interaction
Quality of Interaction
limited
Repetitive behaviors (RRBs)
If yes- Details
Hand flapping, spinning, stimming, toe walking, running to and
Patterned behavior or activities
If yes- Details
Others
Details:
arranges objects in line
Impression
? ASD
Hopes from the consultation

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