Css changing
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58e61f0485
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15cc1aea16
@ -55,7 +55,7 @@ const DataTable: React.FC= () => {
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return (
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return (
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<>
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<>
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<FormLabel>Please enter the details below:</FormLabel><br></br>
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<FormLabel>If yes, Please enter the details below:</FormLabel><br></br>
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<FormControl>
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<FormControl>
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<Grid container spacing={1.5} sx={{width:750, marginTop:1}}>
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<Grid container spacing={1.5} sx={{width:750, marginTop:1}}>
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<Grid item xs={2} className='addNew-form-table-style'>
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<Grid item xs={2} className='addNew-form-table-style'>
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@ -89,6 +89,7 @@ export default function FamilyFormSection(){
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<TextField
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<TextField
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variant="outlined"
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variant="outlined"
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type="number"
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label="Number of Children/Ages"
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label="Number of Children/Ages"
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className='collapsable-form-style'
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className='collapsable-form-style'
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name='numberOfChildren'
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name='numberOfChildren'
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@ -142,7 +143,7 @@ export default function FamilyFormSection(){
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<TextField
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<TextField
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variant="outlined"
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variant="outlined"
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label="Business Phone"
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label="Business Phone"
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type="tel"
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type="number"
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className='collapsable-form-style'
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className='collapsable-form-style'
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name='businessPhone'
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name='businessPhone'
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onChange={formik.handleChange}
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onChange={formik.handleChange}
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@ -183,7 +184,7 @@ export default function FamilyFormSection(){
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<TextField
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<TextField
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variant="outlined"
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variant="outlined"
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label="Business Phone"
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label="Business Phone"
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type="tel"
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type="number"
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className='collapsable-form-style'
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className='collapsable-form-style'
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name='spouseBusinessPhone'
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name='spouseBusinessPhone'
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onChange={formik.handleChange}
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onChange={formik.handleChange}
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@ -201,6 +202,7 @@ export default function FamilyFormSection(){
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<TextField
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<TextField
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variant="outlined"
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variant="outlined"
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label="Emergency Contact"
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label="Emergency Contact"
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type="number"
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className='collapsable-form-style'
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className='collapsable-form-style'
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name='emergencyContact'
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name='emergencyContact'
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onChange={formik.handleChange}
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onChange={formik.handleChange}
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@ -222,7 +224,8 @@ export default function FamilyFormSection(){
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<Grid item xs={4} className='collapsable-form-style '>
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<Grid item xs={4} className='collapsable-form-style '>
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<TextField
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<TextField
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variant="outlined"
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variant="outlined"
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label="Phone" type="tel"
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type="number"
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label="Phone"
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className='collapsable-form-style'
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className='collapsable-form-style'
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name='spousePhone'
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name='spousePhone'
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onChange={formik.handleChange}
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onChange={formik.handleChange}
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@ -92,7 +92,7 @@ export default function MedicalHistoryForm(){
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<TextField
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<TextField
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variant="outlined"
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variant="outlined"
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label="Phone"
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label="Phone"
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type="tel"
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type="number"
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name='physicianphone'
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name='physicianphone'
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onChange={formik.handleChange}
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onChange={formik.handleChange}
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value={formik.values.physicianphone}
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value={formik.values.physicianphone}
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@ -40,7 +40,7 @@ export default function OtherDetails8(){
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return(
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return(
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<>
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<>
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<Grid container direction="row">
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<Grid container direction="row">
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<Grid item xs={6} className='collapsable-form-style-multiline'>
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<Grid item xs={12} className='collapsable-form-style-multiline'>
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<FormLabel>Family history and health status:</FormLabel><br></br>
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<FormLabel>Family history and health status:</FormLabel><br></br>
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<TextField
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<TextField
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multiline
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multiline
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@ -56,7 +56,7 @@ export default function OtherDetails8(){
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/>
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/>
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</Grid>
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</Grid>
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<Grid item xs={12} className='collapsable-form-style-radioButtons'>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormControl>
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<FormControl>
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<FormLabel>How do you sleep?</FormLabel>
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<FormLabel>How do you sleep?</FormLabel>
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<RadioGroup
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<RadioGroup
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@ -75,7 +75,7 @@ export default function OtherDetails8(){
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</FormControl>
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</FormControl>
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</Grid>
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</Grid>
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<Grid item xs={12} className='collapsable-form-style-radioButtons'>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormControl>
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<FormControl>
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<FormLabel>Do you use a pillow?</FormLabel>
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<FormLabel>Do you use a pillow?</FormLabel>
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<RadioGroup
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<RadioGroup
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@ -93,7 +93,7 @@ export default function OtherDetails8(){
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</FormControl>
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</FormControl>
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</Grid>
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</Grid>
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<Grid item xs={12} className='collapsable-form-style-radioButtons'>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormControl>
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<FormControl>
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<FormLabel>Do you wear orthotics or arch support?</FormLabel>
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<FormLabel>Do you wear orthotics or arch support?</FormLabel>
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<RadioGroup
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<RadioGroup
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@ -111,10 +111,10 @@ export default function OtherDetails8(){
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</FormControl>
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</FormControl>
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</Grid>
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</Grid>
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<Grid item xs={12} className='collapsable-form-style-radioButtons'>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormLabel>Date of last gynecological and brest exam?</FormLabel><br></br>
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<FormLabel>Date of last gynecological and brest exam?</FormLabel>
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<FormControl>
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<FormControl>
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<LocalizationProvider dateAdapter={AdapterDayjs}><br></br>
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<LocalizationProvider dateAdapter={AdapterDayjs}>
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<DatePicker
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<DatePicker
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value={values.brestExam}
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value={values.brestExam}
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onChange={(event) => {
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onChange={(event) => {
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@ -130,11 +130,11 @@ export default function OtherDetails8(){
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</FormControl>
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</FormControl>
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</Grid>
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</Grid>
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<Grid item xs={12} className='collapsable-form-style' sx={{marginTop:4, marginBottom:2}}>
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{/* <Grid item xs={6} className='collapsable-form-style' sx={{marginTop:4, marginBottom:2}}>
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<FormLabel sx={{fontWeight:600}}>For X-Ray purposes:</FormLabel>
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<FormLabel sx={{fontWeight:600}}>For X-Ray purposes:</FormLabel>
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</Grid>
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</Grid> */}
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<Grid item xs={12} className='collapsable-form-style-radioButtons'>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormControl>
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<FormControl>
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<FormLabel>Possible pregnancy?</FormLabel>
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<FormLabel>Possible pregnancy?</FormLabel>
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<RadioGroup
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<RadioGroup
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@ -152,10 +152,10 @@ export default function OtherDetails8(){
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</FormControl>
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</FormControl>
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</Grid>
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</Grid>
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<Grid item xs={12} className='collapsable-form-style-radioButtons'>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormLabel>Date of last menstrual cycle?</FormLabel><br></br>
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<FormLabel>Date of last menstrual cycle?</FormLabel><br></br>
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<FormControl>
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<FormControl>
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<LocalizationProvider dateAdapter={AdapterDayjs}><br></br>
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<LocalizationProvider dateAdapter={AdapterDayjs}>
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<DatePicker
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<DatePicker
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value={values.menstralCycle}
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value={values.menstralCycle}
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onChange={(event) => {
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onChange={(event) => {
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@ -233,6 +233,10 @@ export default function PastTreatment5(){
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</FormControl>
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</FormControl>
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</Grid>
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</Grid>
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<Grid item xs={12} sx={{marginLeft:2, marginBottom:3}} >
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<Table />
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</Grid>
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<Grid item xs={6} className='collapsable-form-style-multiline'>
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<Grid item xs={6} className='collapsable-form-style-multiline'>
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<FormLabel>Please list current supplements or drugs you may be taking:</FormLabel>
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<FormLabel>Please list current supplements or drugs you may be taking:</FormLabel>
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<TextField
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<TextField
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@ -249,11 +253,6 @@ export default function PastTreatment5(){
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/>
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/>
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</Grid>
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</Grid>
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<Grid item xs={12} >
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<Table />
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</Grid>
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</Grid>
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</Grid>
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</form>
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</form>
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</>
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</>
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@ -25,14 +25,14 @@ interface Patient {
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fullName: yup.string().required("Full name is required"),
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fullName: yup.string().required("Full name is required"),
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homePhone: yup.string().matches(/^\d{10}$/, "Home phone must be 10 digits"),
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homePhone: yup.string().matches(/^\d{10}$/, "Home phone must be 10 digits"),
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cellPhone: yup.string().required("Phone number is required").matches(/^\d{10}$/, "Cell phone must be 10 digits"),
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cellPhone: yup.string().required("Phone number is required").matches(/^\d{10}$/, "Cell phone must be 10 digits"),
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email: yup.string().email("Invalid email format").required("Email is required"),
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email: yup.string().required("Email is required"),
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age: yup.number().positive().integer("Age must be a positive integer").required("Age is required"),
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age: yup.number().positive().integer("Age must be a positive integer").required("Age is required"),
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dateOfBirth: yup.date().required("Date of birth is required"),
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dateOfBirth: yup.date().required("Date of birth is required"),
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socialSecurityNumber: yup.string().matches(/^\d{9}$/, "Social security number must be 9 digits"),
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socialSecurityNumber: yup.string().matches(/^\d{9}$/, "Social security number must be 9 digits"),
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mailingAddress: yup.string().required("Mailing address is required"),
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mailingAddress: yup.string().required("Mailing address is required"),
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city: yup.string().required("City is required"),
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city: yup.string().required("City is required"),
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state: yup.string().required("State is required"),
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state: yup.string().required("State is required"),
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zipCode: yup.string().matches(/^\d{5}$/, "Zip code must be 6 digits").required("Zip code is required")
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zipCode: yup.string().matches(/^\d{6}$/, "Zip code must be 6 digits").required("Zip code is required")
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});
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});
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export default function PersonalSection(){
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export default function PersonalSection(){
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@ -78,6 +78,7 @@ export default function PersonalSection(){
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});
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});
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const handleChange = (event: React.ChangeEvent<HTMLInputElement>) => {
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const handleChange = (event: React.ChangeEvent<HTMLInputElement>) => {
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console.log("dsfsdfsdf",event.target.value)
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const { name, value } = event.target;
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const { name, value } = event.target;
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setPatient((prevPatient) => ({
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setPatient((prevPatient) => ({
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...prevPatient,
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...prevPatient,
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@ -134,7 +135,6 @@ export default function PersonalSection(){
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<Grid item xs={4} className='collapsable-form-style'>
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<Grid item xs={4} className='collapsable-form-style'>
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<TextField
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<TextField
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required
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variant="outlined"
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variant="outlined"
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label="Email"
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label="Email"
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name="email"
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name="email"
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@ -142,8 +142,8 @@ export default function PersonalSection(){
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value={formik.values.email}
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value={formik.values.email}
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onChange={handleChange}
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onChange={handleChange}
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onBlur={formik.handleBlur}
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onBlur={formik.handleBlur}
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error={formik.touched.email && Boolean(formik.errors.email)}
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// error={formik.touched.email && Boolean(formik.errors.email)}
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helperText={formik.touched.email && formik.errors.email}
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// helperText={formik.touched.email && formik.errors.email}
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/>
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/>
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</Grid>
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</Grid>
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<Grid item xs={4} className='collapsable-form-style'>
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<Grid item xs={4} className='collapsable-form-style'>
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@ -212,8 +212,8 @@ export default function PersonalSection(){
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value={formik.values.state}
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value={formik.values.state}
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onChange={formik.handleChange}
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onChange={formik.handleChange}
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onBlur={formik.handleBlur}
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onBlur={formik.handleBlur}
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error={formik.touched.state && Boolean(formik.errors.state)}
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// error={formik.touched.state && Boolean(formik.errors.state)}
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helperText={formik.touched.state && formik.errors.state}
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// helperText={formik.touched.state && formik.errors.state}
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/>
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/>
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</Grid>
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</Grid>
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@ -47,7 +47,7 @@ export default function RecreationalHobbiesSection7(){
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<>
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<>
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<Grid container direction="row">
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<Grid container direction="row">
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<Grid item xs={6} className='collapsable-form-style-multiline'>
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<Grid item xs={12} className='collapsable-form-style-multiline'>
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<FormLabel>Recreational Activities/Hobbies:</FormLabel><br></br>
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<FormLabel>Recreational Activities/Hobbies:</FormLabel><br></br>
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<TextField
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<TextField
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multiline
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multiline
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@ -84,7 +84,7 @@ export default function RecreationalHobbiesSection7(){
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</FormControl>
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</FormControl>
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</Grid>
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</Grid>
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<Grid item xs={12} className='collapsable-form-style-radioButtons'>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormControl>
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<FormControl>
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<FormLabel>Do you excercise?</FormLabel>
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<FormLabel>Do you excercise?</FormLabel>
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<RadioGroup
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<RadioGroup
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@ -118,7 +118,7 @@ export default function RecreationalHobbiesSection7(){
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/>
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/>
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</Grid>
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</Grid>
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<Grid item xs={12} className='collapsable-form-style-radioButtons'>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormControl>
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<FormControl>
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<FormLabel>Use tobacco?</FormLabel>
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<FormLabel>Use tobacco?</FormLabel>
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<RadioGroup
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<RadioGroup
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@ -152,7 +152,7 @@ export default function RecreationalHobbiesSection7(){
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/>
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/>
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</Grid>
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</Grid>
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<Grid item xs={12} className='collapsable-form-style-radioButtons'>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormControl>
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<FormControl>
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<FormLabel>Consume alcohol?</FormLabel>
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<FormLabel>Consume alcohol?</FormLabel>
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<RadioGroup
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<RadioGroup
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/>
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/>
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</Grid>
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</Grid>
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<Grid item xs={12} className='collapsable-form-style-radioButtons'>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormControl>
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<FormControl>
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<FormLabel>Have a healthy diet?</FormLabel>
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<FormLabel>Have a healthy diet?</FormLabel>
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<RadioGroup
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<RadioGroup
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@ -220,7 +220,7 @@ export default function RecreationalHobbiesSection7(){
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/>
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/>
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</Grid>
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</Grid>
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<Grid item xs={12} className='collapsable-form-style-radioButtons'>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormControl>
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<FormControl>
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<FormLabel>Get adequate sleep?</FormLabel>
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<FormLabel>Get adequate sleep?</FormLabel>
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<RadioGroup
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<RadioGroup
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@ -254,7 +254,7 @@ export default function RecreationalHobbiesSection7(){
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/>
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/>
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</Grid>
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</Grid>
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<Grid item xs={12} className='collapsable-form-style-radioButtons'>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormControl>
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<FormControl>
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<FormLabel>Is Work/School stressful to you?</FormLabel>
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<FormLabel>Is Work/School stressful to you?</FormLabel>
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<RadioGroup
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<RadioGroup
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@ -288,7 +288,7 @@ export default function RecreationalHobbiesSection7(){
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/>
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/>
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</Grid>
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</Grid>
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<Grid item xs={12} className='collapsable-form-style-radioButtons'>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormControl>
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<FormControl>
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<FormLabel>Family life stressful to you?</FormLabel>
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<FormLabel>Family life stressful to you?</FormLabel>
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<RadioGroup
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<RadioGroup
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@ -322,7 +322,7 @@ export default function RecreationalHobbiesSection7(){
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/>
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/>
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</Grid>
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</Grid>
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<Grid item xs={12} className='collapsable-form-style-radioButtons'>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormControl>
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<FormControl>
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<FormLabel>Use recreational drugs?</FormLabel>
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<FormLabel>Use recreational drugs?</FormLabel>
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<RadioGroup
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<RadioGroup
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