PatientInfo

Is child enrolled in school

Yes

Intervention plan

Parents counselled

Consanguinity

No

Neck holding

Achieved

Food preferences

Mixed

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

Yes

Tactile

Hypersensitive

PatientId

c02f739c-c151-4fdb-b181-675e5c1070a1

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Abhiraj Pandey

Age

10 Year 5 Month 8 Days

Gender

Male

DOB

2016-04-25

Mother’s age (years)

Mother’s education

Mother’s occupation

Father’s age (years)

Father’s education

Father’s occupation

Type of family

Joint

Number of family members

3

Number of siblings

0

Details of siblings (Age and sex)

Address

New collectorate

Contact

7983157901

Referred By

Doctor

Informant

Parents

Chief concerns

Duration of symptoms

Noticed since 5 months

Concerns noticed by school (if any)

Strengths of child

Eye contact

Suboptimal

Interaction

Better with known people, not with teachers

Quality of Interaction

avoids

Repetitive behaviors (RRBs)

If yes- Details

Visual seeking

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

Hopes from the consultation