Details

PatientInfo


Is child enrolled in school
Yes
Intervention plan
LDP 3/week
Consanguinity
Neck holding
Food preferences
Mixed
HR
Neuropsychiatric condition
Place of Birth
Hospitalization
Tactile
PatientId
b7c7398a-a9a3-426a-ab34-5c9762fbe4ee
FollowUpId
f895c5a7-c9fb-451c-adb2-af9748a026c6
Child's Name
Darsh Pratap Singh
Age
3 Year 7 Month 21 Days
Gender
Male
DOB
2023-02-25
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
9827734986
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
Patterned behavior or activities
If yes- Details
Others
Details:
Impression
Expressive speech delay
Hopes from the consultation

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