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patient form signature

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sonika 2023-08-30 11:32:44 +05:30
parent 15cc1aea16
commit 2f373e090b
1 changed files with 27 additions and 11 deletions
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36
src/Components/PatientForm/PatientForm.tsx
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@ -3,7 +3,7 @@ import Typography from '@mui/material/Typography';
import ExpandMoreIcon from '@mui/icons-material/ExpandMore'; import ExpandMoreIcon from '@mui/icons-material/ExpandMore';
import Footer from "../Footer"; import Footer from "../Footer";
import Header from "../Header"; import Header from "../Header";
import {Button, Checkbox, FormControlLabel, FormGroup, Grid, Paper, Radio, RadioGroup, TextField } from '@mui/material'; import {Button, Checkbox, FormControlLabel, FormGroup, FormLabel, Grid, Paper, Radio, RadioGroup, TextField } from '@mui/material';
import PersonalSection from './PersonalSection1'; import PersonalSection from './PersonalSection1';
import { styled } from '@mui/material/styles'; import { styled } from '@mui/material/styles';
import ArrowForwardIosSharpIcon from '@mui/icons-material/ArrowForwardIosSharp'; import ArrowForwardIosSharpIcon from '@mui/icons-material/ArrowForwardIosSharp';
@ -75,6 +75,7 @@ interface Patient {
export default function PatientForm(){ export default function PatientForm(){
const [expanded, setExpanded] = React.useState<string | false>('panel1'); const [expanded, setExpanded] = React.useState<string | false>('panel1');
const [isChecked, setIsChecked] = React.useState(false); const [isChecked, setIsChecked] = React.useState(false);
const [signature,setSignature]=React.useState('');
const [patient, setPatient] = React.useState<Patient>({ const [patient, setPatient] = React.useState<Patient>({
fullName: "", fullName: "",
@ -202,27 +203,42 @@ export default function PatientForm(){
</AccordionDetails> </AccordionDetails>
</Accordion> </Accordion>
<FormGroup sx={{ marginTop: 3 }}> <Grid container>
<FormControlLabel
required
control={<Checkbox checked={isChecked} onChange={handleCheckboxChange} />}
label="I hereby state that all the information I have provided is complete and truthful and that I have fully disclosed my health history."
/>
</FormGroup>
<Grid item xs={12} className='collapsable-form-style-multiline'>
<FormGroup sx={{ marginTop: 3 }}>
<FormControlLabel
required
control={<Checkbox checked={isChecked} onChange={handleCheckboxChange} />}
label="I hereby state that all the information I have provided is complete and truthful and that I have fully disclosed my health history."
/>
</FormGroup>
</Grid>
<Grid item xs={6} className='collapsable-form-style'>
<TextField
variant="outlined"
label="SIGNATURE"
name='treatmentGoal'
placeholder='Please type your name'
onChange={(event) => {
setSignature(event.target.value)
}}
/>
</Grid>
</Grid>
<Grid> <Grid>
<Button <Button
type="submit" type="submit"
variant="contained" variant="contained"
color="primary" color="primary"
sx={{ margin: 5, left: '40%', width: '200px' }} sx={{ margin: 5, left: '40%', width: '200px' }}
disabled={isChecked==false} disabled={isChecked==false || signature==''}
> >
Submit Submit
</Button> </Button>
</Grid> </Grid>
</Grid> </Grid>
</form> </form>