PatientInfo

Is child enrolled in school

No

Intervention plan

IDP 2/week + PMT 1/week

Consanguinity

Neck holding

Food preferences

Mixed

HR

Neuropsychiatric condition

Place of Birth

Hospitalization

Tactile

PatientId

802c94af-985c-4e91-b88a-5474a63abb81

FollowUpId

7927a50d-d4c9-497e-a228-91859976ae53

Child's Name

Manas Bhadoriya

Age

4 Year

Gender

Male

DOB

2022-06-07

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

9340674913

Referred By

Informant

Chief concerns

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Sustained

Interaction

Quality of Interaction

age-appropriate

Repetitive behaviors (RRBs)

If yes- Details

Stimming reduced, spinning present, screaming reduced

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

Hopes from the consultation