patient form signature
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@ -3,7 +3,7 @@ import Typography from '@mui/material/Typography';
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import ExpandMoreIcon from '@mui/icons-material/ExpandMore';
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import Footer from "../Footer";
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import Header from "../Header";
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import {Button, Checkbox, FormControlLabel, FormGroup, Grid, Paper, Radio, RadioGroup, TextField } from '@mui/material';
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import {Button, Checkbox, FormControlLabel, FormGroup, FormLabel, Grid, Paper, Radio, RadioGroup, TextField } from '@mui/material';
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import PersonalSection from './PersonalSection1';
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import { styled } from '@mui/material/styles';
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import ArrowForwardIosSharpIcon from '@mui/icons-material/ArrowForwardIosSharp';
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@ -75,6 +75,7 @@ interface Patient {
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export default function PatientForm(){
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const [expanded, setExpanded] = React.useState<string | false>('panel1');
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const [isChecked, setIsChecked] = React.useState(false);
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const [signature,setSignature]=React.useState('');
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const [patient, setPatient] = React.useState<Patient>({
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fullName: "",
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@ -202,6 +203,9 @@ export default function PatientForm(){
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</AccordionDetails>
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</Accordion>
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<Grid container>
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<Grid item xs={12} className='collapsable-form-style-multiline'>
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<FormGroup sx={{ marginTop: 3 }}>
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<FormControlLabel
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required
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@ -209,20 +213,32 @@ export default function PatientForm(){
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label="I hereby state that all the information I have provided is complete and truthful and that I have fully disclosed my health history."
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/>
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</FormGroup>
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</Grid>
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<Grid item xs={6} className='collapsable-form-style'>
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<TextField
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variant="outlined"
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label="SIGNATURE"
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name='treatmentGoal'
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placeholder='Please type your name'
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onChange={(event) => {
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setSignature(event.target.value)
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}}
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/>
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</Grid>
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</Grid>
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<Grid>
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<Button
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type="submit"
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variant="contained"
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color="primary"
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sx={{ margin: 5, left: '40%', width: '200px' }}
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disabled={isChecked==false}
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disabled={isChecked==false || signature==''}
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>
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Submit
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</Button>
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</Grid>
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</Grid>
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</form>
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