it's about recording

1. SWAMI DAYANANDA KRUPA HOME - SRI PERUMBUDUR
DATE OF RECORDING THE DATA
SERIAL
NUMB
ER
IDENTIFICATION DATA AND
DEMOGRAPHIC DATA
1 NAME
2 DATE OF BIRTH
3 AGE ON RECORDING DAY OF THE DATA
4 STYLE OF COMMUNICATION :-
[ VERBAL, NON-VERBAL, GESTURAL
SINGLE WORD , FRAGMENTS ]
5 LANGUAGES SPOKEN
6 BIRTH MARKS AT LEAST TWO WHICH ARE
IDENTIFIABLE ON THE UPPER LIMBS,
EARS, NOSE, FACE.
7 AADHAR CARD
8 DISABILITY DIAGNOSIS
9 UNIQUE DISABILTY IDENTIFCATION CARD
NUMBER
10 PERMANENT ADRESS
11 FATHERS NAME
12 FATHERS AADHAR CARD NUMBER
13 MOTHERS NAME
14 MOTHERS AADHAR CARD NUMBER
15 TOTAL NUMBER OF SIBLING MALE
FEMALE
16 SIBLINGS MARITAL STATUS
17 ADRESS OF SIBLINGS
18 COMMUNICATION ADRESS
19 EMAIL OF PARENTS FATHER AND
MOTHER

2. 20 EMAIL OF SIBLINGS
21 ADRESS OF LOCAL POST OFFICE
22 ADRESS OF LOCAL POLICE STATION
23 REFFERED BY
24 REASON FOR CHOOSING SWAMI
DAYANANDA KRUPA HOME
25 CHIEF PRESENTING ISSUES – TO BE
FILLED BY NEUROLOGIST, PSYCHIATRIST
GENERAL PHYSICIAN .
26 SPECIAL EDUCATION, THERAPY HISTORY
TO BE FILLED BY THE SPECIAL
EDUCATOR , OCCUPATIONAL THERAPIST ,
PHYSIOTHERAPIST , SPEECH THERAPIST
27 BEHAVIOURAL THERAPY HISTORY
TO BE FILLED BY THE CONCERNED
BEHAVIOUR THERAPIST
28 ACADEMIC CERTIFICATES
10TH , 12TH, GRADUATION, NIOS
FINANCIAL HISTORY
29 FATHERS BANK NAME AND ACCOUNT
NUMBER
30 MOTHERS BANK NAME AND ACCOUNT
NUMBER
31 RESIDENT BANK NAME AND ACCOUNT
NUMBER
32 ANNUAL INCOME OF THE FAMILY
33 GOVERNMENT MONTHLY BENEFITS
RECEIVED
HEALTH STATUS OF PARENTS
34 THE COMPLETE HEALTH STATUS OF THE
PARENTS TO BE FILLED BY A
REGISTERED MEDICAL PRACTIONER
RECCOMENDED BY SWAMI DAYANADA
KRUPA HOME
35 HEALTH STTATUS OF THE RESIDENT TO
BE FILLED BY THE REGISTERED
MEDICAL PRACTIONER RECCOMENDED
BY SWAMI DAYANADA KRUPA HOME[. [

3. DIABETES, RENAL ISSUES, SEIZURES,
HYPERTENSION, , WEIGHT, SKIN ISSUES
, ANY OTHER HEALTH ISSUES .]
36 GENERAL MEDICINES GIVEN WITH THE
REASON
37 NEUROLOGICAL MEDICINES GIVEN WITH
THE REASONS
38 PSYCHIATRIC MEDICINES GIVEN WITH
THE REASON
39 AYURVEDHA , SIDDHA, UNNANI,
HOMEPATHY MEDICINE GIVEN WITH THE
REASON
40 THERAPIES TO BE GIVEN
41 DIETARY NEEDS [ CASEIN, GLUTIN ]
42 SENSORY NEEDS [ TO BE FILLED BY
OCCUPATIONAL THERAPIST WHO HOLDS
A CERTIFCATION IN SENSORY
INTEGRATION]
43 PRENATAL – NATAL –POST NATAL
HISTORY TO BE FILLED BY GENERAL
PHYSICIAN
44 DEVELOPMENTAL HISTORY TO BE
FILLED BY SPECIAL
EDUCATOR/PHYSIOTHERAPIST
45 SPEECH LANAGUAGE AND
COMMUNICATION HISTORY TO BE FILLED
BY SPEECH PATHOLOGIST
46 MOTOR DEVELOPMENT TO BE FILLED BY
PHYSIIOTHERAPIST
47 VISUAL EVALUATION TO BE FILLED BY
OPTHALOMOLOGIST
48 HEARING EVALUATION BY ENT
48 BEHAVIOUR ;- EVALUATION BY
PSYCHIATRSIT/ CLINICAL PSYCHOLOGIST
49 LEISURE TIME ACTIVITIES
50 FUNCTIONAL ACADEMIC ABILITIES TO
BE EVALUATED BY SPECIAL EDUCATOR
51 INTELLIGENT QUIOTENT BY CLINICAL

4. :
PSYCHOLOGIST
52 ASSOCIATED DISABILITES TO BE FILLED
BY GENERAL PHYSICIAN, NEUROLOGIST,
PSYCHIATRIST.
53 STRENGTH AND WEAKNESS OF THE
RESIDENT
54 VOCAITONAL EVALUATION BY
VOCATIONAL TRAINER
55 SOCIAL /EMOTIONAL SKILL EVALUATION
BY PSYCHOLOGSIT
56 HOBBIES
57 SPECIFC TALENTS
58 PARENTAL REQUIREMENTS
59 LEGAL GUARDIAN
60 LOCAL GUARDIAN
61 PERSON WHO ELSE CAN BE CONTACTED
IN CASE OF EMERGENCY.