form 5
This commit is contained in:
parent
8ba4faf8b1
commit
99e76a04d5
@ -18,7 +18,6 @@
|
||||
"@types/node": "^16.18.36",
|
||||
"@types/react": "^18.2.12",
|
||||
"@types/react-dom": "^18.2.5",
|
||||
"antd": "^5.7.3",
|
||||
"axios": "^1.4.0",
|
||||
"chart.js": "^4.3.0",
|
||||
"chartjs-adapter-date-fns": "^3.0.0",
|
||||
|
||||
@ -10,6 +10,15 @@
|
||||
height: 50px
|
||||
}
|
||||
|
||||
.collapsable-form-style-multiline .MuiInputBase-root {
|
||||
width: 300px !important;
|
||||
margin: 5%;
|
||||
min-height: 100px
|
||||
}
|
||||
.collapsable-form-style-multiline label {
|
||||
padding: 15px;
|
||||
}
|
||||
|
||||
.collapsable-form-style label {
|
||||
padding: 15px;
|
||||
}
|
||||
|
||||
@ -118,9 +118,6 @@ export default function PainAnalysisSection4(){
|
||||
label="Others"
|
||||
/>
|
||||
</FormGroup>
|
||||
{formik.touched.painQuality && formik.errors.painQuality ? (
|
||||
<div>{formik.errors.painQuality}</div>
|
||||
) : null}
|
||||
</FormControl>
|
||||
</Grid>
|
||||
|
||||
@ -200,9 +197,6 @@ export default function PainAnalysisSection4(){
|
||||
<FormControlLabel value="50-75%" control={<Radio />} label="50-75%" />
|
||||
<FormControlLabel value="75-100%" control={<Radio />} label="75-100%" />
|
||||
</RadioGroup>
|
||||
{formik.touched.painDuration && formik.errors.painDuration ? (
|
||||
<div>{formik.errors.painDuration}</div>
|
||||
) : null}
|
||||
</FormControl>
|
||||
</Grid>
|
||||
|
||||
@ -228,9 +222,6 @@ export default function PainAnalysisSection4(){
|
||||
/>
|
||||
|
||||
</FormGroup>
|
||||
{formik.touched.painQuality && formik.errors.painQuality ? (
|
||||
<div>{formik.errors.painQuality}</div>
|
||||
) : null}
|
||||
</FormControl>
|
||||
</Grid>
|
||||
|
||||
@ -266,30 +257,7 @@ export default function PainAnalysisSection4(){
|
||||
onBlur={formik.handleBlur}
|
||||
/>
|
||||
</Grid>
|
||||
{/* <Grid item xs={12}>
|
||||
<TextField
|
||||
label="Current Treatment"
|
||||
name='currentTreatment'
|
||||
onChange={formik.handleChange}
|
||||
value={formik.values.currentTreatment}
|
||||
onBlur={formik.handleBlur}
|
||||
/>
|
||||
{formik.touched.currentTreatment && formik.errors.currentTreatment ? (
|
||||
<div>{formik.errors.currentTreatment}</div>
|
||||
) : null}
|
||||
</Grid>
|
||||
<Grid item xs={12}>
|
||||
<TextField
|
||||
label="Treatment Results"
|
||||
name='treatmentResults'
|
||||
onChange={formik.handleChange}
|
||||
value={formik.values.treatmentResults}
|
||||
onBlur={formik.handleBlur}
|
||||
/>
|
||||
{formik.touched.treatmentResults && formik.errors.treatmentResults ? (
|
||||
<div>{formik.errors.treatmentResults}</div>
|
||||
) : null}
|
||||
</Grid> */}
|
||||
|
||||
</Grid>
|
||||
</form>
|
||||
|
||||
|
||||
253
src/Components/PatientForm/PastTreatment5.tsx
Normal file
253
src/Components/PatientForm/PastTreatment5.tsx
Normal file
@ -0,0 +1,253 @@
|
||||
import { TextField, FormControlLabel,Grid,Checkbox, FormControl, FormLabel, Radio, RadioGroup } from '@mui/material';
|
||||
import * as React from 'react';
|
||||
|
||||
interface FormValues {
|
||||
generalHealth: string;
|
||||
presentProblemBefore: string;
|
||||
ifYespresentProblemBefore:string;
|
||||
ifYestreatmentProvided: string;
|
||||
ifYesOutcome: string;
|
||||
strokeBloodclotting: string;
|
||||
ifYesstrokeBloodclotting: string;
|
||||
dizzinessFetigue: string;
|
||||
ifyesdizzinessFetigue: string;
|
||||
antiColligent: string;
|
||||
injuriesHospitalization: string;
|
||||
supplementsOrDrugs: string;
|
||||
}
|
||||
|
||||
export default function PastTreatment5(){
|
||||
|
||||
const [values, setValues] = React.useState<FormValues>({
|
||||
generalHealth: '',
|
||||
presentProblemBefore: '',
|
||||
ifYespresentProblemBefore:'',
|
||||
ifYestreatmentProvided:'',
|
||||
ifYesOutcome:'',
|
||||
strokeBloodclotting: '',
|
||||
ifYesstrokeBloodclotting: '',
|
||||
dizzinessFetigue: '',
|
||||
ifyesdizzinessFetigue:'',
|
||||
antiColligent: '',
|
||||
injuriesHospitalization: '',
|
||||
supplementsOrDrugs:''
|
||||
});
|
||||
|
||||
console.log("dsfdsfdsfg",values)
|
||||
return(
|
||||
<>
|
||||
<form>
|
||||
<Grid container direction="row">
|
||||
|
||||
<Grid item xs={12} className='collapsable-form-style-radioButtons-fullwidth'>
|
||||
<FormControl>
|
||||
<FormLabel>Overall your General Healgth is:</FormLabel>
|
||||
<RadioGroup
|
||||
name="painDuration"
|
||||
sx={{display:'flex', flexDirection:'row'}}
|
||||
onChange={(event) => {
|
||||
setValues((prevValues) => ({
|
||||
...prevValues,
|
||||
generalHealth: event.target.value,
|
||||
}));
|
||||
}}
|
||||
>
|
||||
<FormControlLabel value="Excellent" control={<Radio />} label="Excellent" />
|
||||
<FormControlLabel value="Very Good" control={<Radio />} label="Very Good" />
|
||||
<FormControlLabel value="Good" control={<Radio />} label="Good" />
|
||||
<FormControlLabel value="Fair" control={<Radio />} label="Fair" />
|
||||
<FormControlLabel value="Poor" control={<Radio />} label="Poor" />
|
||||
</RadioGroup>
|
||||
</FormControl>
|
||||
</Grid>
|
||||
|
||||
<Grid item xs={12} className='collapsable-form-style-radioButtons-fullwidth'>
|
||||
<FormControl>
|
||||
<FormLabel>Have you experienced your present problem before?</FormLabel>
|
||||
<RadioGroup
|
||||
name="painDuration"
|
||||
sx={{display:'flex', flexDirection:'row'}}
|
||||
onChange={(event) => {
|
||||
setValues((prevValues) => ({
|
||||
...prevValues,
|
||||
presentProblemBefore: event.target.value,
|
||||
}));
|
||||
}}
|
||||
>
|
||||
<FormControlLabel value="Yes" control={<Radio />} label="Yes" />
|
||||
<FormControlLabel value="No" control={<Radio />} label="No" />
|
||||
</RadioGroup>
|
||||
</FormControl>
|
||||
</Grid>
|
||||
|
||||
|
||||
<Grid item xs={4} className='collapsable-form-style'>
|
||||
<TextField
|
||||
variant="outlined"
|
||||
label="If yes, when?"
|
||||
name='treatmentGoal'
|
||||
disabled={values.presentProblemBefore!=='Yes'}
|
||||
onChange={(event) => {
|
||||
setValues((prevValues) => ({
|
||||
...prevValues,
|
||||
ifYespresentProblemBefore: event.target.value,
|
||||
}));
|
||||
}}
|
||||
/>
|
||||
</Grid>
|
||||
<Grid item xs={4} className='collapsable-form-style'>
|
||||
<TextField
|
||||
variant="outlined"
|
||||
label="Was treatment provided?If yes, by whom?"
|
||||
name='treatmentGoal'
|
||||
disabled={values.presentProblemBefore!=='Yes'}
|
||||
onChange={(event) => {
|
||||
setValues((prevValues) => ({
|
||||
...prevValues,
|
||||
ifYestreatmentProvided: event.target.value,
|
||||
}));
|
||||
}}
|
||||
/>
|
||||
</Grid>
|
||||
<Grid item xs={4} className='collapsable-form-style'>
|
||||
<TextField
|
||||
variant="outlined"
|
||||
label="Outcome?"
|
||||
name='treatmentGoal'
|
||||
disabled={values.presentProblemBefore!=='Yes'}
|
||||
onChange={(event) => {
|
||||
setValues((prevValues) => ({
|
||||
...prevValues,
|
||||
ifYesOutcome: event.target.value,
|
||||
}));
|
||||
}}
|
||||
/>
|
||||
</Grid>
|
||||
|
||||
|
||||
<Grid item xs={12} className='collapsable-form-style-radioButtons-fullwidth'>
|
||||
<FormControl>
|
||||
<FormLabel>Have you ever had a stroke or issues with blood clotting?</FormLabel>
|
||||
<RadioGroup
|
||||
name="painDuration"
|
||||
sx={{display:'flex', flexDirection:'row'}}
|
||||
onChange={(event) => {
|
||||
setValues((prevValues) => ({
|
||||
...prevValues,
|
||||
strokeBloodclotting: event.target.value,
|
||||
}));
|
||||
}}
|
||||
>
|
||||
<FormControlLabel value="Yes" control={<Radio />} label="Yes" />
|
||||
<FormControlLabel value="No" control={<Radio />} label="No" />
|
||||
</RadioGroup>
|
||||
</FormControl>
|
||||
</Grid>
|
||||
|
||||
<Grid item xs={4} className='collapsable-form-style'>
|
||||
<TextField
|
||||
variant="outlined"
|
||||
label="If yes, when?"
|
||||
name='treatmentGoal'
|
||||
disabled={values.strokeBloodclotting!=='Yes'}
|
||||
onChange={(event) => {
|
||||
setValues((prevValues) => ({
|
||||
...prevValues,
|
||||
ifYesstrokeBloodclotting: event.target.value,
|
||||
}));
|
||||
}}
|
||||
/>
|
||||
</Grid>
|
||||
|
||||
<Grid item xs={12} className='collapsable-form-style-radioButtons-fullwidth'>
|
||||
<FormControl>
|
||||
<FormLabel>Have you recently experienced dizziness, unexplained fatigue, weight loss or blood loss?</FormLabel>
|
||||
<RadioGroup
|
||||
name="painDuration"
|
||||
sx={{display:'flex', flexDirection:'row'}}
|
||||
onChange={(event) => {
|
||||
setValues((prevValues) => ({
|
||||
...prevValues,
|
||||
dizzinessFetigue: event.target.value,
|
||||
}));
|
||||
}}
|
||||
>
|
||||
<FormControlLabel value="Yes" control={<Radio />} label="Yes" />
|
||||
<FormControlLabel value="No" control={<Radio />} label="No" />
|
||||
</RadioGroup>
|
||||
</FormControl>
|
||||
</Grid>
|
||||
|
||||
<Grid item xs={4} className='collapsable-form-style'>
|
||||
<TextField
|
||||
variant="outlined"
|
||||
label="If yes, when?"
|
||||
name='treatmentGoal'
|
||||
disabled={values.dizzinessFetigue!=='Yes'}
|
||||
onChange={(event) => {
|
||||
setValues((prevValues) => ({
|
||||
...prevValues,
|
||||
ifyesdizzinessFetigue: event.target.value,
|
||||
}));
|
||||
}}
|
||||
/>
|
||||
</Grid>
|
||||
|
||||
<Grid item xs={12} className='collapsable-form-style-radioButtons-fullwidth'>
|
||||
<FormControl>
|
||||
<FormLabel>Are you currently taking anti-coagulant or blood thinning medication?</FormLabel>
|
||||
<RadioGroup
|
||||
name="painDuration"
|
||||
sx={{display:'flex', flexDirection:'row'}}
|
||||
onChange={(event) => {
|
||||
setValues((prevValues) => ({
|
||||
...prevValues,
|
||||
antiColligent: event.target.value,
|
||||
}));
|
||||
}}
|
||||
>
|
||||
<FormControlLabel value="Yes" control={<Radio />} label="Yes" />
|
||||
<FormControlLabel value="No" control={<Radio />} label="No" />
|
||||
</RadioGroup>
|
||||
</FormControl>
|
||||
</Grid>
|
||||
|
||||
<Grid item xs={12} className='collapsable-form-style-radioButtons-fullwidth'>
|
||||
<FormControl>
|
||||
<FormLabel>Have you ever had any major illness, injuries, hospitalization or surgeries?</FormLabel>
|
||||
<RadioGroup
|
||||
name="painDuration"
|
||||
sx={{display:'flex', flexDirection:'row'}}
|
||||
onChange={(event) => {
|
||||
setValues((prevValues) => ({
|
||||
...prevValues,
|
||||
injuriesHospitalization: event.target.value,
|
||||
}));
|
||||
}}
|
||||
>
|
||||
<FormControlLabel value="Yes" control={<Radio />} label="Yes" />
|
||||
<FormControlLabel value="No" control={<Radio />} label="No" />
|
||||
</RadioGroup>
|
||||
</FormControl>
|
||||
</Grid>
|
||||
|
||||
<Grid item xs={6} className='collapsable-form-style-multiline'>
|
||||
<FormLabel>Please list current supplements or drugs you may be taking:</FormLabel>
|
||||
<TextField
|
||||
multiline
|
||||
variant="outlined"
|
||||
label=""
|
||||
name='treatmentGoal'
|
||||
onChange={(event) => {
|
||||
setValues((prevValues) => ({
|
||||
...prevValues,
|
||||
supplementsOrDrugs: event.target.value,
|
||||
}));
|
||||
}}
|
||||
/>
|
||||
</Grid>
|
||||
</Grid>
|
||||
</form>
|
||||
</>
|
||||
)
|
||||
}
|
||||
@ -15,6 +15,7 @@ import MuiAccordionDetails from '@mui/material/AccordionDetails';
|
||||
import MedicalHistory from './MedicalHistorySection3';
|
||||
import FamilyFormSection from './FamilyFormSection2';
|
||||
import PainAnalysisSection4 from './PainAnalysisSection4';
|
||||
import PastTreatment5 from './PastTreatment5';
|
||||
|
||||
interface Patient {
|
||||
fullName: string;
|
||||
@ -158,6 +159,16 @@ export default function PatientForm(){
|
||||
</AccordionDetails>
|
||||
</Accordion>
|
||||
|
||||
<Accordion expanded={expanded === 'panel5'} onChange={handleExpandChange('panel5')}>
|
||||
<AccordionSummary aria-controls="panel5d-content" id="panel5d-header">
|
||||
<Typography sx={{fontSize:18}}>Patient's Past Treatment Details</Typography>
|
||||
</AccordionSummary>
|
||||
|
||||
<AccordionDetails>
|
||||
<PastTreatment5/>
|
||||
</AccordionDetails>
|
||||
</Accordion>
|
||||
|
||||
<FormGroup sx={{ marginTop: 3 }}>
|
||||
<FormControlLabel
|
||||
required
|
||||
|
||||
Loading…
x
Reference in New Issue
Block a user