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DATE
NAME.
Test Scoring Comments
Orientation
Orientation for Place 12345678
Orientation for Time 1704847
Perception
Visual Indent of Objects 1234
Visual Indent of Shapes 1234
‘Overlapping Figures 1234
Object Constancy ey
‘Spatial Perception
A. Directions on Body 1234
B. Directions in Front 1 a4
C. Spatial Relations tas
Praxis
Motor Imitation 1234
Utilization of Objects 123
‘Symbolic Actions 1234
‘Visuomotor Organization
‘Copy Geometric Forms 1234
“Two Dimensional Model 1234
‘Pegboard Construction 123.4
Block Design 23
Reproduction of Puzzle 1234
Drawing a Clock 1234
‘Thinking Operations
Categorization 1234
Pictorial Sequence 1234
Memory
‘A Famous Personality 1234
A Personal Possession: 1234
Everyday Objects 1234
Attention & Concentration 1438
Given in: 1 Session 2 Sessions
Indicate Length of Time:
971626521
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