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Back Photograph of thechild - January 16th 2001 
A five-month-old male child presented with spontaneous bleeding from posterior of the neck. Child was full term normal vaginal delivery at home by Dai to a primigravida mother and mother did not attend any antenatal check up.
On examination patient is malnourished, pale, show few petechial, ecchymotic rash over face and extremities. CVS and Respiratory system are normal. Per abdo liver is 3.5 cm and spleen is not palpable.
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