import * as React from 'react'; import Typography from '@mui/material/Typography'; import ExpandMoreIcon from '@mui/icons-material/ExpandMore'; import Footer from "../Footer"; import Header from "../Header"; import {Button, Checkbox, FormControlLabel, FormGroup, Grid, Paper, Radio, RadioGroup, TextField } from '@mui/material'; import PersonalSection from './PersonalSection1'; import { styled } from '@mui/material/styles'; import ArrowForwardIosSharpIcon from '@mui/icons-material/ArrowForwardIosSharp'; import MuiAccordion, { AccordionProps } from '@mui/material/Accordion'; import MuiAccordionSummary, { AccordionSummaryProps, } from '@mui/material/AccordionSummary'; import MuiAccordionDetails from '@mui/material/AccordionDetails'; import MedicalHistory from './MedicalHistorySection3'; import FamilyFormSection from './FamilyFormSection2'; import PainAnalysisSection4 from './PainAnalysisSection4'; import PastTreatment5 from './PastTreatment5'; import SystemReviewSection6 from './SyestemReviewSection6'; interface Patient { fullName: string; homePhone: string; cellPhone: string; email: string; age: number; dateOfBirth: string; socialSecurityNumber: string; mailingAddress: string; city: string; state: string; zipCode: string; gender: string; maritalStatus: string; } const Accordion = styled((props: AccordionProps) => ( ))(({ theme }) => ({ border: `1px solid ${theme.palette.divider}`, '&:not(:last-child)': { borderBottom: 0, }, '&:before': { display: 'none', }, })); const AccordionSummary = styled((props: AccordionSummaryProps) => ( } {...props} /> ))(({ theme }) => ({ backgroundColor: theme.palette.mode === 'dark' ? 'rgba(255, 255, 255, .05)' : 'rgba(0, 0, 0, .03)', flexDirection: 'row-reverse', '& .MuiAccordionSummary-expandIconWrapper.Mui-expanded': { transform: 'rotate(90deg)', }, '& .MuiAccordionSummary-content': { marginLeft: theme.spacing(1), }, })); const AccordionDetails = styled(MuiAccordionDetails)(({ theme }) => ({ padding: theme.spacing(2), borderTop: '1px solid rgba(0, 0, 0, .125)', })); export default function PatientForm(){ const [expanded, setExpanded] = React.useState('panel1'); const [isChecked, setIsChecked] = React.useState(false); const [patient, setPatient] = React.useState({ fullName: "", homePhone: "", cellPhone: "", email: "", age: 0, dateOfBirth: "", socialSecurityNumber: "", mailingAddress: "", city: "", state: "", zipCode: "", gender: "", maritalStatus: "", }); const handleSubmit = (event: React.FormEvent) => { event.preventDefault(); }; const handleExpandChange = (panel: string) => (event: React.SyntheticEvent, newExpanded: boolean) => { setExpanded(newExpanded ? panel : false); }; const handleCheckboxChange = (event:any) => { setIsChecked(event.target.checked); }; return( <>
Confidential Patient Information } aria-controls="panel1a-content" id="panel1a-header" > Patient's Personal Information Patient's Family Information Patient's Medical History Information Patient's Injury Details Patient's Past Treatment Details System Review Questions } label="I hereby state that all the information I have provided is complete and truthful and that I have fully disclosed my health history." />