PatientInfo

Is child enrolled in school

Yes

Intervention plan

IDP 2/week + PMT 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

Mixed

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

c10083dc-dc43-409e-a687-2d36345ddad4

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Ojas Sharma

Age

4 Year 2 Month 22 Days

Gender

Male

DOB

2022-07-18

Mother’s age (years)

35 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

39 years

Father’s education

Father’s occupation

Factory

Type of family

Nuclear

Number of family members

3

Number of siblings

Details of siblings (Age and sex)

Address

Patri road

Contact

9685243112

Referred By

Doctor

Informant

Parents

Chief concerns

Speech delay

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

Looks from corner of eye

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

Hopes from the consultation