Details

PatientInfo


Is child enrolled in school
Intervention plan
Consanguinity
No
Neck holding
Achieved
Food preferences
HR
Neuropsychiatric condition
Place of Birth
Institutional
Hospitalization
Tactile
PatientId
983bd073-84d1-4e85-acc0-9fe93f6b7619
FollowUpId
e651e157-c9f2-4f5f-b585-171b4a80ec29
Child's Name
Trisha
Age
1 Year
Gender
Female
DOB
2025-09-26
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
9785938323
Referred By
Informant
Chief concerns
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

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