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7 changed files with 847 additions and 427 deletions

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

View File

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

View File

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

View File

@ -507,7 +507,7 @@ export default function PatientForm({ type }: Props) {
id='panel9d-header' id='panel9d-header'
> >
<Typography sx={{ fontSize: 18 }}> <Typography sx={{ fontSize: 18 }}>
Patient's Injury Image Patient's Pain Zone
</Typography> </Typography>
</AccordionSummary> </AccordionSummary>

View File

@ -1,389 +1,540 @@
import * as React from 'react'; import * as React from 'react';
import { Button, FormControl, FormControlLabel, FormLabel, Grid, Paper, Radio, RadioGroup, TextField } from '@mui/material'; import {
Button,
FormControl,
FormControlLabel,
FormLabel,
Grid,
Paper,
Radio,
RadioGroup,
TextField,
} from '@mui/material';
import { LocalizationProvider, DatePicker } from '@mui/x-date-pickers'; import { LocalizationProvider, DatePicker } from '@mui/x-date-pickers';
import { AdapterDayjs } from '@mui/x-date-pickers/AdapterDayjs'; import { AdapterDayjs } from '@mui/x-date-pickers/AdapterDayjs';
import { useEffect } from 'react'; import { useEffect } from 'react';
interface Patient { interface Patient {
fullName: string; fullName: string;
homePhone: string; homePhone: string;
cellPhone: string; cellPhone: string;
email: string; email: string;
age: number | string; age: number | string;
dateOfBirth: string; dateOfBirth: string;
socialSecurityNumber: string; socialSecurityNumber: string;
mailingAddress: string; mailingAddress: string;
city: string; city: string;
state: string; state: string;
zipCode: string; zipCode: string;
gender: string; gender: string;
} }
type Props = { type Props = {
handleFormSection1Data:( handleFormSection1Data: (
fullName?: string|undefined, fullName?: string | undefined,
homePhone?: string|undefined, homePhone?: string | undefined,
cellPhone?: string|undefined, cellPhone?: string | undefined,
email?: string|undefined, email?: string | undefined,
age?: number|undefined|string, age?: number | undefined | string,
dateOfBirth?: string|undefined, dateOfBirth?: string | undefined,
socialSecurityNumber?: string|undefined, socialSecurityNumber?: string | undefined,
mailingAddress?: string|undefined, mailingAddress?: string | undefined,
city?: string|undefined, city?: string | undefined,
state?: string|undefined, state?: string | undefined,
zipCode?: string|undefined, zipCode?: string | undefined,
gender?: string|undefined, gender?: string | undefined
)=> void ) => void;
patientDataDiplay:any; patientDataDiplay: any;
type:string; type: string;
} };
export default function PersonalSection({
export default function PersonalSection({handleFormSection1Data,patientDataDiplay,type}:Props){ handleFormSection1Data,
patientDataDiplay,
const [birthDateValue, setBirthDateValue] = React.useState<any>(); type,
const [patient, setPatient] = React.useState<any>({ }: Props) {
fullName: "", const [birthDateValue, setBirthDateValue] = React.useState<any>();
fullNameError:false, const [patient, setPatient] = React.useState<any>({
homePhone: "", fullName: '',
cellPhone: "", fullNameError: false,
cellPhoneError: false, homePhone: '',
email: "", cellPhone: '',
emailError: false, cellPhoneError: false,
age: "", email: '',
ageError: false, emailError: false,
dateOfBirth: birthDateValue, age: '',
socialSecurityNumber: "", ageError: false,
mailingAddress:"", dateOfBirth: birthDateValue,
mailingAddressFalse:false, socialSecurityNumber: '',
city: "", mailingAddress: '',
state: "", mailingAddressFalse: false,
zipCode: "", city: '',
gender: "male", state: '',
}); zipCode: '',
gender: 'male',
});
useEffect(()=>{
handleFormSection1Data( useEffect(() => {
patient.fullName, handleFormSection1Data(
patient.homePhone, patient.fullName,
patient.cellPhone, patient.homePhone,
patient.email, patient.cellPhone,
patient.age, patient.email,
birthDateValue, patient.age,
patient.socialSecurityNumber, birthDateValue,
patient.mailingAddress, patient.socialSecurityNumber,
patient.city, patient.mailingAddress,
patient.state, patient.city,
patient.zipCode, patient.state,
patient.gender, patient.zipCode,
) patient.gender
},[patient]) );
}, [patient]);
return (
return( <>
<> <Grid container direction='row' className='section1-test-class'>
<Grid container direction="row" className='section1-test-class'> <Grid
<Grid item xs={4} className='collapsable-form-style '> item
<TextField xs={12}
variant="outlined" xl={3}
label="Patient's Full Name" lg={4}
name="fullName" md={6}
placeholder='Please enter your name' sm={12}
value={type=='display'?patientDataDiplay.fullName:patient.fullName} className='collapsable-form-style '
disabled={type=='display'} >
onChange={(e)=>{ <TextField
setPatient((prevValues:any) => ({ variant='outlined'
...prevValues, label="Patient's Full Name"
fullName: e.target.value, name='fullName'
})); placeholder='Please enter your name'
}} value={
onBlur={(e) => { type == 'display' ? patientDataDiplay.fullName : patient.fullName
if (e.target.value === "") { }
setPatient((prevValues:any) => ({ disabled={type == 'display'}
...prevValues, onChange={(e) => {
fullNameError: true, setPatient((prevValues: any) => ({
})); ...prevValues,
} else { fullName: e.target.value,
setPatient((prevValues:any) => ({ }));
...prevValues, }}
fullNameError: false, onBlur={(e) => {
})); if (e.target.value === '') {
} setPatient((prevValues: any) => ({
}} ...prevValues,
required fullNameError: true,
error={patient.fullNameError} }));
helperText={patient.fullNameError ? "Please enter your name" : ""} } else {
/> setPatient((prevValues: any) => ({
</Grid> ...prevValues,
fullNameError: false,
}));
<Grid item xs={4} className='collapsable-form-style'> }
<TextField }}
required required
variant="outlined" error={patient.fullNameError}
label="Phone Number" helperText={patient.fullNameError ? 'Please enter your name' : ''}
name="cellPhone" />
type="number" </Grid>
placeholder='Please enter your cell Phone number'
value={type=='display'?patientDataDiplay.cellPhone:patient.cellPhone} <Grid
disabled={type=='display'} item
onChange={(e)=>{ xs={12}
setPatient((prevValues:any) => ({ xl={3}
...prevValues, lg={4}
cellPhone: e.target.value, md={6}
})); sm={12}
}} className='collapsable-form-style'
onBlur={(e) => { >
if (!(/^\d{10}$/.test(e.target.value))) { <TextField
setPatient((prevValues:any) => ({ required
...prevValues, variant='outlined'
cellPhoneError: true, label='Phone Number'
})); name='cellPhone'
} else { type='number'
setPatient((prevValues:any) => ({ placeholder='Please enter your cell Phone number'
...prevValues, value={
cellPhoneError: false, type == 'display'
})); ? patientDataDiplay.cellPhone
} : patient.cellPhone
}} }
error={patient.cellPhoneError} disabled={type == 'display'}
helperText={patient.cellPhoneError? "Please enter a valid 10-digit phone number" : ""} onChange={(e) => {
/> let value = e.target.value;
</Grid> if (value[0] === '0') {
value = value.slice(1);
<Grid item xs={4} className='collapsable-form-style'> }
<TextField setPatient((prevValues: any) => ({
variant="outlined" ...prevValues,
label="Home Phone Number" cellPhone: value,
name="homePhone" }));
type='number' }}
placeholder='Please enter your home phone' onBlur={(e) => {
value={type=='display'?patientDataDiplay.homePhone:patient.homePhone} if (!/^\d{10}$/.test(e.target.value)) {
disabled={type=='display'} setPatient((prevValues: any) => ({
onChange={(e)=>{ ...prevValues,
setPatient((prevValues:any) => ({ cellPhoneError: true,
...prevValues, }));
homePhone: e.target.value, } else {
})); setPatient((prevValues: any) => ({
}} ...prevValues,
// error={!(/^\d{10}$/.test(patient.homePhone))} cellPhoneError: false,
// helperText={!(/^\d{10}$/.test(patient.homePhone)) ? "Please enter a valid 10-digit phone number" : ""} }));
/> }
</Grid> }}
error={patient.cellPhoneError}
<Grid item xs={4} className='collapsable-form-style'> helperText={
<TextField patient.cellPhoneError
required ? 'Please enter a valid 10-digit phone number'
variant="outlined" : ''
label="Email" }
name="email" />
placeholder='Please enter your email'
value={type=='display'?patientDataDiplay.email:patient.email} </Grid>
disabled={type=='display'}
onChange={(e)=>{ <Grid
setPatient((prevValues:any) => ({ item
...prevValues, xs={12}
email: e.target.value, xl={3}
})); lg={4}
}} md={6}
onBlur={(e) => { sm={12}
if (!(/^\S+@\S+\.\S+$/.test(e.target.value))) { className='collapsable-form-style'
setPatient((prevValues:any) => ({ >
...prevValues, <TextField
emailError: true, variant='outlined'
})); label='Home Phone Number'
} else { name='homePhone'
setPatient((prevValues:any) => ({ type='number'
...prevValues, placeholder='Please enter your home phone'
emailError: false, value={
})); type == 'display'
} ? patientDataDiplay.homePhone
}} : patient.homePhone
error={patient.emailError} }
helperText={patient.emailError? "Please enter a valid email address" : ""} disabled={type == 'display'}
/> onChange={(e) => {
</Grid> setPatient((prevValues: any) => ({
<Grid item xs={4} className='collapsable-form-style'> ...prevValues,
<TextField homePhone: e.target.value,
required }));
variant="outlined" }}
label="Age" // error={!(/^\d{10}$/.test(patient.homePhone))}
name="age" // helperText={!(/^\d{10}$/.test(patient.homePhone)) ? "Please enter a valid 10-digit phone number" : ""}
type="number" />
placeholder='Please enter your age' </Grid>
value={type=='display'?patientDataDiplay.age:patient.age}
disabled={type=='display'} <Grid
onChange={(e)=>{ item
setPatient((prevValues:any) => ({ xs={12}
...prevValues, xl={3}
age: e.target.value, lg={4}
})); md={6}
}} sm={12}
onBlur={(e) => { className='collapsable-form-style'
if (e.target.value === "") { >
setPatient((prevValues:any) => ({ <TextField
...prevValues, required
ageError: true, variant='outlined'
})); label='Email'
} else { name='email'
setPatient((prevValues:any) => ({ placeholder='Please enter your email'
...prevValues, value={type == 'display' ? patientDataDiplay.email : patient.email}
ageError: false, disabled={type == 'display'}
})); onChange={(e) => {
} setPatient((prevValues: any) => ({
}} ...prevValues,
error={patient.ageError} email: e.target.value,
helperText={patient.ageError ? "Please enter your age" : ""} }));
}}
/> onBlur={(e) => {
</Grid> if (!/^\S+@\S+\.\S+$/.test(e.target.value)) {
setPatient((prevValues: any) => ({
<Grid item xs={4} className='collapsable-form-style'> ...prevValues,
<FormControl > emailError: true,
<LocalizationProvider dateAdapter={AdapterDayjs}> }));
<DatePicker } else {
label="Date of Birth" setPatient((prevValues: any) => ({
value={type=='display'?patientDataDiplay.dateOfBirth:birthDateValue} ...prevValues,
disabled={type=='display'} emailError: false,
onChange={(newValue) => { }));
setBirthDateValue(newValue); }
}} }}
renderInput={(params) => <TextField variant="outlined" {...params} />} error={patient.emailError}
/> helperText={
</LocalizationProvider> patient.emailError ? 'Please enter a valid email address' : ''
</FormControl> }
/>
</Grid> </Grid>
<Grid
<Grid item xs={4} className='collapsable-form-style'> item
<TextField xs={12}
variant="outlined" xl={3}
label="Social Security Number" lg={4}
name="socialSecurityNumber" md={6}
value={type=='display'?patientDataDiplay.socialSecurityNumber:patient.socialSecurityNumber} sm={12}
disabled={type=='display'} className='collapsable-form-style'
onChange={(e)=>{ >
setPatient((prevValues:any) => ({ <TextField
...prevValues, required
socialSecurityNumber: e.target.value, variant='outlined'
})); label='Age'
}} name='age'
// onBlur={formik.handleBlur} type='number'
// error={formik.touched.socialSecurityNumber && Boolean(formik.errors.socialSecurityNumber)} placeholder='Please enter your age'
// helperText={formik.touched.socialSecurityNumber && formik.errors.socialSecurityNumber} value={type == 'display' ? patientDataDiplay.age : patient.age}
/> disabled={type == 'display'}
</Grid> onChange={(e) => {
setPatient((prevValues: any) => ({
<Grid item xs={4} className='collapsable-form-style'> ...prevValues,
<TextField age: e.target.value,
required }));
variant="outlined" }}
label="Mailing Address" onBlur={(e) => {
name="mailingAddress" if (e.target.value === '') {
value={type=='display'?patientDataDiplay.mailingAddress:patient.mailingAddress} setPatient((prevValues: any) => ({
disabled={type=='display'} ...prevValues,
onChange={(e)=>{ ageError: true,
setPatient((prevValues:any) => ({ }));
...prevValues, } else {
mailingAddress: e.target.value, setPatient((prevValues: any) => ({
})); ...prevValues,
}} ageError: false,
onBlur={(e) => { }));
if (e.target.value === "") { }
setPatient((prevValues:any) => ({ }}
...prevValues, error={patient.ageError}
mailingAddressError: true, helperText={patient.ageError ? 'Please enter your age' : ''}
})); />
} else { </Grid>
setPatient((prevValues:any) => ({
...prevValues, <Grid
mailingAddressError: false, item
})); xs={12}
} xl={3}
}} lg={4}
error={patient.mailingAddressError} md={6}
helperText={patient.mailingAddressError? "Please enter your mailing address" : ""} sm={12}
/> className='collapsable-form-style'
</Grid> >
<FormControl>
<Grid item xs={4} className='collapsable-form-style'> <LocalizationProvider dateAdapter={AdapterDayjs}>
<TextField <DatePicker
variant="outlined" label='Date of Birth'
label="State" value={
name="state" type == 'display'
value={type=='display'?patientDataDiplay.state:patient.state} ? patientDataDiplay.dateOfBirth
disabled={type=='display'} : birthDateValue
onChange={(e)=>{ }
setPatient((prevValues:any) => ({ disabled={type == 'display'}
...prevValues, onChange={(newValue) => {
state: e.target.value, setBirthDateValue(newValue);
})); }}
}} renderInput={(params) => (
/> <TextField variant='outlined' {...params} />
</Grid> )}
/>
<Grid item xs={4} className='collapsable-form-style'> </LocalizationProvider>
<TextField </FormControl>
variant="outlined" </Grid>
label="City"
name="city" <Grid
value={type=='display'?patientDataDiplay.city:patient.city} item
disabled={type=='display'} xs={12}
onChange={(e)=>{ xl={3}
setPatient((prevValues:any) => ({ lg={4}
...prevValues, md={6}
city: e.target.value, sm={12}
})); className='collapsable-form-style'
}} >
/> <TextField
</Grid> variant='outlined'
label='Social Security Number'
<Grid item xs={4} className='collapsable-form-style'> name='socialSecurityNumber'
<TextField value={
variant="outlined" type == 'display'
label="Zip Code" ? patientDataDiplay.socialSecurityNumber
name="zipCode" : patient.socialSecurityNumber
value={type=='display'?patientDataDiplay.zipCode:patient.zipCode} }
disabled={type=='display'} disabled={type == 'display'}
onChange={(e)=>{ onChange={(e) => {
setPatient((prevValues:any) => ({ setPatient((prevValues: any) => ({
...prevValues, ...prevValues,
zipCode: e.target.value, socialSecurityNumber: e.target.value,
})); }));
}} }}
// onBlur={formik.handleBlur} // onBlur={formik.handleBlur}
// error={formik.touched.zipCode && Boolean(formik.errors.zipCode)} // error={formik.touched.socialSecurityNumber && Boolean(formik.errors.socialSecurityNumber)}
// helperText={formik.touched.zipCode && formik.errors.zipCode} // helperText={formik.touched.socialSecurityNumber && formik.errors.socialSecurityNumber}
/> />
</Grid> </Grid>
<Grid item xs={4} className='collapsable-form-style-radioButtons'> <Grid
<FormControl > item
<FormLabel>Gender</FormLabel> xs={12}
<RadioGroup xl={3}
aria-labelledby="demo-radio-buttons-group-label" lg={4}
defaultValue={type=='display'?patientDataDiplay.gender:patient.gender} md={6}
name="radio-buttons-group" sm={12}
onChange={(e)=>{ className='collapsable-form-style'
setPatient((prevValues:any) => ({ >
...prevValues, <TextField
gender: e.target.value, required
})); variant='outlined'
}} label='Mailing Address'
sx={{display:'flex', flexDirection:'row'}} name='mailingAddress'
> value={
<FormControlLabel type == 'display'
disabled={type=='display'} ? patientDataDiplay.mailingAddress
value="male" control={<Radio />} label="Male" /> : patient.mailingAddress
<FormControlLabel }
disabled={type=='display'} disabled={type == 'display'}
value="female" control={<Radio />} label="Female" /> onChange={(e) => {
</RadioGroup> setPatient((prevValues: any) => ({
</FormControl> ...prevValues,
</Grid> mailingAddress: e.target.value,
</Grid> }));
</> }}
) onBlur={(e) => {
if (e.target.value === '') {
setPatient((prevValues: any) => ({
...prevValues,
mailingAddressError: true,
}));
} else {
setPatient((prevValues: any) => ({
...prevValues,
mailingAddressError: false,
}));
}
}}
error={patient.mailingAddressError}
helperText={
patient.mailingAddressError
? 'Please enter your mailing address'
: ''
}
/>
</Grid>
<Grid
item
xs={12}
xl={3}
lg={4}
md={6}
sm={12}
className='collapsable-form-style'
>
<TextField
variant='outlined'
label='State'
name='state'
value={type == 'display' ? patientDataDiplay.state : patient.state}
disabled={type == 'display'}
onChange={(e) => {
setPatient((prevValues: any) => ({
...prevValues,
state: e.target.value,
}));
}}
/>
</Grid>
<Grid
item
xs={12}
xl={3}
lg={4}
md={6}
sm={12}
className='collapsable-form-style'
>
<TextField
variant='outlined'
label='City'
name='city'
value={type == 'display' ? patientDataDiplay.city : patient.city}
disabled={type == 'display'}
onChange={(e) => {
setPatient((prevValues: any) => ({
...prevValues,
city: e.target.value,
}));
}}
/>
</Grid>
<Grid
item
xs={12}
xl={3}
lg={4}
md={6}
sm={12}
className='collapsable-form-style'
>
<TextField
variant='outlined'
label='Zip Code'
name='zipCode'
value={
type == 'display' ? patientDataDiplay.zipCode : patient.zipCode
}
disabled={type == 'display'}
onChange={(e) => {
setPatient((prevValues: any) => ({
...prevValues,
zipCode: e.target.value,
}));
}}
// onBlur={formik.handleBlur}
// error={formik.touched.zipCode && Boolean(formik.errors.zipCode)}
// helperText={formik.touched.zipCode && formik.errors.zipCode}
/>
</Grid>
<Grid
item
xs={12}
xl={3}
lg={4}
md={6}
sm={12}
className='collapsable-form-style-radioButtons'
>
<FormControl>
<FormLabel>Gender</FormLabel>
<RadioGroup
aria-labelledby='demo-radio-buttons-group-label'
defaultValue={
type == 'display' ? patientDataDiplay.gender : patient.gender
}
name='radio-buttons-group'
onChange={(e) => {
setPatient((prevValues: any) => ({
...prevValues,
gender: e.target.value,
}));
}}
sx={{ display: 'flex', flexDirection: 'row' }}
>
<FormControlLabel
disabled={type == 'display'}
value='male'
control={<Radio />}
label='Male'
/>
<FormControlLabel
disabled={type == 'display'}
value='female'
control={<Radio />}
label='Female'
/>
</RadioGroup>
</FormControl>
</Grid>
</Grid>
</>
);
} }

View File

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

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