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sonika 2023-09-07 17:08:28 +05:30
parent 81fb560898
commit f27ef0e113
5 changed files with 326 additions and 57 deletions
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94
src/Components/PatientForm/FamilyFormSection2.tsx
View File

@ -101,7 +101,13 @@ export default function FamilyFormSection({handleFormSection2Data,patientDataDip
</Grid>
<Grid item xs={4} className='collapsable-form-style '></Grid>
<Grid item xs={4} className='collapsable-form-style '>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12}
className='collapsable-form-style '>
<TextField
variant="outlined"
@ -119,7 +125,13 @@ export default function FamilyFormSection({handleFormSection2Data,patientDataDip
disabled={type=='display'}
/>
</Grid>
<Grid item xs={4} className='collapsable-form-style '>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12}
className='collapsable-form-style '>
<TextField
// required
variant="outlined"
@ -137,7 +149,13 @@ export default function FamilyFormSection({handleFormSection2Data,patientDataDip
/>
</Grid>
<Grid item xs={4} className='collapsable-form-style '>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12}
className='collapsable-form-style '>
<TextField
variant="outlined"
label="Hours/Week"
@ -155,7 +173,13 @@ export default function FamilyFormSection({handleFormSection2Data,patientDataDip
/>
</Grid>
<Grid item xs={4} className='collapsable-form-style '>
<Grid
xs={2}
xl={3}
lg={4}
md={6}
sm={12}
className='collapsable-form-style '>
<TextField
variant="outlined"
label="Employer"
@ -171,7 +195,13 @@ export default function FamilyFormSection({handleFormSection2Data,patientDataDip
disabled={type=='display'}
/>
</Grid>
<Grid item xs={4} className='collapsable-form-style '>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12}
className='collapsable-form-style '>
<TextField
variant="outlined"
label="Business Phone"
@ -189,13 +219,24 @@ export default function FamilyFormSection({handleFormSection2Data,patientDataDip
/>
</Grid>
<Grid item xs={4} className='collapsable-form-style '></Grid>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12}
className='collapsable-form-style '></Grid>
<Grid item xs={12} className='collapsable-form-style '>
<FormLabel sx={{fontWeight:600}}>Spouse's Information:</FormLabel>
</Grid>
<Grid item xs={4} className='collapsable-form-style '>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style '>
<TextField
variant="outlined"
label="Spouse's Name"
@ -211,7 +252,13 @@ export default function FamilyFormSection({handleFormSection2Data,patientDataDip
disabled={type=='display'}
/>
</Grid>
<Grid item xs={4} className='collapsable-form-style '>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12}
className='collapsable-form-style '>
<TextField
variant="outlined"
label="Spouse's Employer"
@ -227,7 +274,13 @@ export default function FamilyFormSection({handleFormSection2Data,patientDataDip
disabled={type=='display'}
/>
</Grid>
<Grid item xs={4} className='collapsable-form-style '>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12}
className='collapsable-form-style '>
<TextField
variant="outlined"
label="Business Phone"
@ -250,7 +303,13 @@ export default function FamilyFormSection({handleFormSection2Data,patientDataDip
</Grid>
<Grid item xs={4} className='collapsable-form-style '>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12}
className='collapsable-form-style '>
<TextField
variant="outlined"
label="Emergency Contact"
@ -266,7 +325,13 @@ export default function FamilyFormSection({handleFormSection2Data,patientDataDip
disabled={type=='display'}
/>
</Grid>
<Grid item xs={4} className='collapsable-form-style '>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12}
className='collapsable-form-style '>
<TextField
variant="outlined"
label="Relationship"
@ -282,7 +347,12 @@ export default function FamilyFormSection({handleFormSection2Data,patientDataDip
disabled={type=='display'}
/>
</Grid>
<Grid item xs={4} className='collapsable-form-style '>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style '>
<TextField
variant="outlined"
type="number"

70
src/Components/PatientForm/MedicalHistorySection3.tsx
View File

@ -76,7 +76,13 @@ export default function MedicalHistoryForm({handleFormSection3Data,patientDataDi
</Grid>
<Grid container direction="row">
<Grid item xs={4} className='collapsable-form-style'>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12}
className='collapsable-form-style'>
<TextField
variant="outlined"
label="Family physician"
@ -91,7 +97,13 @@ export default function MedicalHistoryForm({handleFormSection3Data,patientDataDi
disabled={type=='display'}
/>
</Grid>
<Grid item xs={4} className='collapsable-form-style'>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12}
className='collapsable-form-style'>
<TextField
variant="outlined"
label="City"
@ -106,7 +118,13 @@ export default function MedicalHistoryForm({handleFormSection3Data,patientDataDi
disabled={type=='display'}
/>
</Grid>
<Grid item xs={4} className='collapsable-form-style'>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12}
className='collapsable-form-style'>
<TextField
variant="outlined"
label="State"
@ -121,7 +139,13 @@ export default function MedicalHistoryForm({handleFormSection3Data,patientDataDi
disabled={type=='display'}
/>
</Grid>
<Grid item xs={4} className='collapsable-form-style'>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12}
className='collapsable-form-style'>
<TextField
variant="outlined"
label="Phone"
@ -138,14 +162,30 @@ export default function MedicalHistoryForm({handleFormSection3Data,patientDataDi
/>
</Grid>
<Grid item xs={4} className='collapsable-form-style'></Grid>
<Grid item xs={4} className='collapsable-form-style'></Grid>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style'></Grid>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style'></Grid>
<Grid item xs={12} className='collapsable-form-style '>
<FormLabel sx={{fontWeight:600}}>Chiropractor Information:</FormLabel>
</Grid>
<Grid item xs={4} sx={{paddingLeft:"14px",marginTop:2}} className='collapsable-form-style-radioButtons'>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12}
sx={{paddingLeft:"14px",marginTop:2}} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Previous Chiropractic Care:</FormLabel>
<RadioGroup
@ -166,7 +206,13 @@ export default function MedicalHistoryForm({handleFormSection3Data,patientDataDi
</FormControl>
</Grid>
<Grid item xs={4} className='collapsable-form-style'>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12}
className='collapsable-form-style'>
<TextField
variant="outlined"
label="Chiropractor's Name"
@ -182,7 +228,13 @@ export default function MedicalHistoryForm({handleFormSection3Data,patientDataDi
/>
</Grid>
<Grid item xs={4} className='collapsable-form-style'>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12}
className='collapsable-form-style'>
<TextField
variant="outlined"
label="City/State"

27
src/Components/PatientForm/PastTreatment5.tsx
View File

@ -121,7 +121,12 @@ export default function PastTreatment5({handleFormSection5Data,patientDataDiplay
</Grid>
<Grid item xs={4} className='collapsable-form-style-form7'>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style-form7'>
<TextField
variant="outlined"
label="If yes, when?"
@ -135,7 +140,12 @@ export default function PastTreatment5({handleFormSection5Data,patientDataDiplay
}}
/>
</Grid>
<Grid item xs={4} className='collapsable-form-style-form7'>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style-form7'>
<TextField
variant="outlined"
label="Was treatment provided?If yes, by whom?"
@ -150,7 +160,12 @@ export default function PastTreatment5({handleFormSection5Data,patientDataDiplay
}}
/>
</Grid>
<Grid item xs={4} className='collapsable-form-style-form7'>
<Grid item
xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style-form7'>
<TextField
variant="outlined"
label="Outcome?"
@ -287,7 +302,11 @@ export default function PastTreatment5({handleFormSection5Data,patientDataDiplay
type={type}/>
</Grid>
<Grid item xs={6} className='collapsable-form-style-multiline'>
<Grid item xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style-multiline'>
<FormLabel>Please list current supplements or drugs you may be taking:</FormLabel>
<TextField
multiline

96
src/Components/PatientForm/RecreationalHobbiesSection7.tsx
View File

@ -136,7 +136,11 @@ export default function RecreationalHobbiesSection7({handleFormSection7Data,pati
</FormControl>
</Grid>
<Grid item xs={6} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
// lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Do you excercise?</FormLabel>
<RadioGroup
@ -156,7 +160,11 @@ export default function RecreationalHobbiesSection7({handleFormSection7Data,pati
</FormControl>
</Grid>
<Grid item xs={6} className='collapsable-form-style-form7'>
<Grid item xs={2}
xl={3}
// lg={4}
md={6}
sm={12} className='collapsable-form-style-form7'>
<TextField
disabled={patient.excercise!=='Yes'||type=='display'}
variant="outlined"
@ -172,7 +180,11 @@ export default function RecreationalHobbiesSection7({handleFormSection7Data,pati
/>
</Grid>
<Grid item xs={6} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
// lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Use tobacco?</FormLabel>
<RadioGroup
@ -192,7 +204,11 @@ export default function RecreationalHobbiesSection7({handleFormSection7Data,pati
</FormControl>
</Grid>
<Grid item xs={6} className='collapsable-form-style-form7'>
<Grid item xs={2}
xl={3}
// lg={4}
md={6}
sm={12} className='collapsable-form-style-form7'>
<TextField
disabled={patient.tobacco!=='Yes'||type=='display'}
value={type=='display'?patientDataDiplay.tobaccoExplanation:patient.tobaccoExplanation}
@ -208,7 +224,11 @@ export default function RecreationalHobbiesSection7({handleFormSection7Data,pati
/>
</Grid>
<Grid item xs={6} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
// lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Consume alcohol?</FormLabel>
<RadioGroup
@ -228,7 +248,11 @@ export default function RecreationalHobbiesSection7({handleFormSection7Data,pati
</FormControl>
</Grid>
<Grid item xs={6} className='collapsable-form-style-form7'>
<Grid item xs={2}
xl={3}
// lg={4}
md={6}
sm={12} className='collapsable-form-style-form7'>
<TextField
disabled={patient.alcohol!=='Yes'||type=='display'}
value={type=='display'?patientDataDiplay.alcoholExplanation:patient.alcoholExplanation}
@ -244,7 +268,11 @@ export default function RecreationalHobbiesSection7({handleFormSection7Data,pati
/>
</Grid>
<Grid item xs={6} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
// lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Have a healthy diet?</FormLabel>
<RadioGroup
@ -264,7 +292,11 @@ export default function RecreationalHobbiesSection7({handleFormSection7Data,pati
</FormControl>
</Grid>
<Grid item xs={6} className='collapsable-form-style-form7'>
<Grid item xs={2}
xl={3}
// lg={4}
md={6}
sm={12} className='collapsable-form-style-form7'>
<TextField
disabled={patient.healthyDiet!=='No'||type=='display'}
value={type=='display'?patientDataDiplay.healthyDietExplanation:patient.healthyDietExplanation}
@ -280,7 +312,11 @@ export default function RecreationalHobbiesSection7({handleFormSection7Data,pati
/>
</Grid>
<Grid item xs={6} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
// lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Get adequate sleep?</FormLabel>
<RadioGroup
@ -300,7 +336,11 @@ export default function RecreationalHobbiesSection7({handleFormSection7Data,pati
</FormControl>
</Grid>
<Grid item xs={6} className='collapsable-form-style-form7'>
<Grid item xs={2}
xl={3}
// lg={4}
md={6}
sm={12} className='collapsable-form-style-form7'>
<TextField
disabled={patient.sleep!=='No'||type=='display'}
value={type=='display'?patientDataDiplay.sleepExplanation:patient.sleepExplanation}
@ -316,7 +356,11 @@ export default function RecreationalHobbiesSection7({handleFormSection7Data,pati
/>
</Grid>
<Grid item xs={6} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
// lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Is Work/School stressful to you?</FormLabel>
<RadioGroup
@ -336,7 +380,11 @@ export default function RecreationalHobbiesSection7({handleFormSection7Data,pati
</FormControl>
</Grid>
<Grid item xs={6} className='collapsable-form-style-form7'>
<Grid item xs={2}
xl={3}
// lg={4}
md={6}
sm={12} className='collapsable-form-style-form7'>
<TextField
disabled={patient.workSchool!=='Yes'||type=='display'}
value={type=='display'?patientDataDiplay.workSchool:patient.workSchool}
@ -352,7 +400,11 @@ export default function RecreationalHobbiesSection7({handleFormSection7Data,pati
/>
</Grid>
<Grid item xs={6} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
// lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Family life stressful to you?</FormLabel>
<RadioGroup
@ -372,7 +424,11 @@ export default function RecreationalHobbiesSection7({handleFormSection7Data,pati
</FormControl>
</Grid>
<Grid item xs={6} className='collapsable-form-style-form7'>
<Grid item xs={2}
xl={3}
// lg={4}
md={6}
sm={12} className='collapsable-form-style-form7'>
<TextField
disabled={patient.familyLife!=='Yes'||type=='display'}
value={type=='display'?patientDataDiplay.familyLifeExplanation:patient.familyLifeExplanation}
@ -388,7 +444,11 @@ export default function RecreationalHobbiesSection7({handleFormSection7Data,pati
/>
</Grid>
<Grid item xs={6} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
// lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Use recreational drugs?</FormLabel>
<RadioGroup
@ -408,7 +468,11 @@ export default function RecreationalHobbiesSection7({handleFormSection7Data,pati
</FormControl>
</Grid>
<Grid item xs={6} className='collapsable-form-style-form7'>
<Grid item xs={2}
xl={3}
// lg={4}
md={6}
sm={12} className='collapsable-form-style-form7'>
<TextField
disabled={patient.drugs!=='Yes'||type=='display'}
value={type=='display'?patientDataDiplay.drugsExplanation:patient.drugsExplanation}

96
src/Components/PatientForm/SyestemReviewSection6.tsx
View File

@ -93,7 +93,11 @@ export default function SystemReviewSection6({handleFormSection6Data,patientData
<FormLabel sx={{fontWeight:600}}>Please choose body areas or systems where you may have problems:</FormLabel>
</Grid>
<Grid container direction="row">
<Grid item xs={3} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Eyes</FormLabel>
<RadioGroup
@ -112,7 +116,11 @@ export default function SystemReviewSection6({handleFormSection6Data,patientData
</RadioGroup>
</FormControl>
</Grid>
<Grid item xs={3} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Intestines/Bowls</FormLabel>
<RadioGroup
@ -131,7 +139,11 @@ export default function SystemReviewSection6({handleFormSection6Data,patientData
</RadioGroup>
</FormControl>
</Grid>
<Grid item xs={3} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Joints/Bones</FormLabel>
<RadioGroup
@ -150,7 +162,11 @@ export default function SystemReviewSection6({handleFormSection6Data,patientData
</RadioGroup>
</FormControl>
</Grid>
<Grid item xs={3} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Allergies</FormLabel>
<RadioGroup
@ -169,7 +185,11 @@ export default function SystemReviewSection6({handleFormSection6Data,patientData
</RadioGroup>
</FormControl>
</Grid>
<Grid item xs={3} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Ears, Nose, Mouth, Throat</FormLabel>
<RadioGroup
@ -188,7 +208,11 @@ export default function SystemReviewSection6({handleFormSection6Data,patientData
</RadioGroup>
</FormControl>
</Grid>
<Grid item xs={3} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Urinary</FormLabel>
<RadioGroup
@ -207,7 +231,11 @@ export default function SystemReviewSection6({handleFormSection6Data,patientData
</RadioGroup>
</FormControl>
</Grid>
<Grid item xs={3} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Skin</FormLabel>
<RadioGroup
@ -226,7 +254,11 @@ export default function SystemReviewSection6({handleFormSection6Data,patientData
</RadioGroup>
</FormControl>
</Grid>
<Grid item xs={3} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Psychological/Emotional</FormLabel>
<RadioGroup
@ -245,7 +277,11 @@ export default function SystemReviewSection6({handleFormSection6Data,patientData
</RadioGroup>
</FormControl>
</Grid>
<Grid item xs={3} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Heart</FormLabel>
<RadioGroup
@ -264,7 +300,11 @@ export default function SystemReviewSection6({handleFormSection6Data,patientData
</RadioGroup>
</FormControl>
</Grid>
<Grid item xs={3} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Muscles</FormLabel>
<RadioGroup
@ -283,7 +323,11 @@ export default function SystemReviewSection6({handleFormSection6Data,patientData
</RadioGroup>
</FormControl>
</Grid>
<Grid item xs={3} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Internal Organs</FormLabel>
<RadioGroup
@ -302,7 +346,11 @@ export default function SystemReviewSection6({handleFormSection6Data,patientData
</RadioGroup>
</FormControl>
</Grid>
<Grid item xs={3} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Gynecological menstrual/Brest</FormLabel>
<RadioGroup
@ -322,7 +370,11 @@ export default function SystemReviewSection6({handleFormSection6Data,patientData
</FormControl>
</Grid>
<Grid item xs={3} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Lungs/Breathing</FormLabel>
<RadioGroup
@ -341,7 +393,11 @@ export default function SystemReviewSection6({handleFormSection6Data,patientData
</RadioGroup>
</FormControl>
</Grid>
<Grid item xs={3} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Nerves</FormLabel>
<RadioGroup
@ -360,7 +416,11 @@ export default function SystemReviewSection6({handleFormSection6Data,patientData
</RadioGroup>
</FormControl>
</Grid>
<Grid item xs={3} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Blood</FormLabel>
<RadioGroup
@ -379,7 +439,11 @@ export default function SystemReviewSection6({handleFormSection6Data,patientData
</RadioGroup>
</FormControl>
</Grid>
<Grid item xs={3} className='collapsable-form-style-radioButtons'>
<Grid item xs={2}
xl={3}
lg={4}
md={6}
sm={12} className='collapsable-form-style-radioButtons'>
<FormControl>
<FormLabel>Prostate/Testicular/Penile</FormLabel>
<RadioGroup