Details

PatientInfo


Is child enrolled in school
No
Intervention plan
Home Based Program
Consanguinity
Neck holding
Food preferences
Mixed
HR
Neuropsychiatric condition
Place of Birth
Hospitalization
Tactile
Hypersensitive
PatientId
5525e870-0703-4924-9ee2-10a1f2daf716
FollowUpId
c1b1b4f2-a058-4b9b-82d5-161bf9b18d34
Child's Name
Diyansh Rao
Age
7 Year 2 Month 21 Days
Gender
Male
DOB
2019-04-15
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
8445788550
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
Patterned behavior or activities
If yes- Details
Others
Details:
Reduced
Impression
Hopes from the consultation

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