GETTING TO KNOW YOUR CHILDChild Name Date of Birth (DOB) Age Sex MaleFemaleOther Date of Admission (D.O.A) Referred By Mother's Name Mother's Occupation Father's Name Father's Occupation Guardian Name Contact Number Address Chief Complaint Speech NoNot ProperProperLanguage NoNot ProperProperHead Control PoorPartialAchievedSitting PartialAchievedStanding UnstableStableWalking SupportedUnsupportedH/o Seizure YesNoEEG Finding NormalAbnormalMRI Brain
