PatientInfo

Is child enrolled in school

Yes

Intervention plan

IEP 3/week + PMT 1/week

Consanguinity

Neck holding

Food preferences

Mixed

HR

Neuropsychiatric condition

Place of Birth

Hospitalization

Tactile

PatientId

7542d145-5278-4a4c-a366-60004b88284e

FollowUpId

0032abd0-369b-4390-a246-631f34b49498

Child's Name

Suryansh Rathore

Age

9 Year

Gender

Male

DOB

2017-07-16

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

7000609314

Referred By

Informant

Chief concerns

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Suboptimal

Interaction

Quality of Interaction

age-appropriate

Repetitive behaviors (RRBs)

If yes- Details

Hand flapping reduced, screaming

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

Improvement in attention, understanding, expression

Hopes from the consultation