felicity-lims/felicity/templates/static/assets/PatientForm-f3264c82.js

2 lines
14 KiB
JavaScript
Raw Normal View History

import{f as ve,c as z,d as B,M as _e,T as he,r as L,h as c,k as m,x as e,ag as a,u as n,i as r,D as o,F as b,ak as g,y as we,B as be,_ as ge}from"./_plugin-vue_export-helper-3f67fb71.js";import xe from"./vue-multiselect.esm-ea7276db.js";import{u as Ue,a as ye}from"./index-3189f120.js";import{A as Ne,U as Pe}from"./patient.mutations-91559ac2.js";import{B as De,l as ke,k as Me,ab as Se,q as Ve,ao as Be}from"./billing-356772f3.js";import{c as J,d as P,a as _,f as Ce,g as Q,u as Ie,b as d}from"./array-a5aedee5.js";import{v as p,e as Z,b as Ee,d as D,a as ee}from"./runtime-dom.esm-bundler-6e07ef74.js";/* empty css */const Oe={class:"flex whitespace-nowrap w-full"},$e=e("span",{class:"text-gray-700 w-4/12"},"Patient Unique Identifier",-1),qe={class:"w-full"},Fe={class:"text-orange-600 w-4/12"},Ae={class:"flex whitespace-nowrap w-full"},Re=e("span",{class:"text-gray-700 w-4/12"},"First Name",-1),Ye={class:"w-full"},Te={class:"text-orange-600 w-4/12"},je={class:"flex whitespace-nowrap mb-2 w-full"},Le=e("span",{class:"text-gray-700 w-4/12"},"Middle Name",-1),Ke={class:"w-full"},Ge={class:"text-orange-600 w-4/12"},He={class:"flex whitespace-nowrap w-full"},We=e("span",{class:"text-gray-700 w-4/12"},"Last Name",-1),Xe={class:"w-full"},ze={class:"text-orange-600 w-4/12"},Je={class:"flex whitespace-nowrap my-2 w-full"},Qe=e("span",{class:"text-gray-700 w-4/12"},"Age/DOB Estimated?",-1),Ze={class:"w-full flex justify-between items-center"},et={class:"flex justify-start items-center gap-x-2 ml-4"},tt={for:"estimateYears"},st=e("span",{class:"mr-1"},"Years",-1),lt={for:"estimateMonths"},nt=e("span",{class:"mr-1"},"Months",-1),it={for:"estimateDays"},at=e("span",{class:"mr-1"},"Days",-1),ot={class:"text-orange-600 w-4/12"},dt={class:"flex whitespace-nowrap mb-2 w-full"},ut=e("span",{class:"text-gray-700 w-4/12"},"Date of Birth",-1),rt={class:"w-full"},ct=["disabled"],mt={class:"text-orange-600 w-4/12"},pt={class:"flex whitespace-nowrap mb-2 w-full"},ft=e("span",{class:"text-gray-700 w-4/12"},"Age",-1),vt={class:"w-full"},_t={class:"text-orange-600 w-4/12"},ht={class:"flex whitespace-nowrap mb-2 w-full"},wt=e("span",{class:"text-gray-700 w-4/12"},"Gender",-1),bt={class:"w-full"},gt=e("option",null,null,-1),xt=["value"],Ut={class:"text-orange-600 w-4/12"},yt={class:"flex whitespace-nowrap mb-2 w-full"},Nt=e("span",{class:"text-gray-700 w-4/12"},"Mobile Number",-1),Pt={class:"w-full"},Dt={class:"text-orange-600 w-4/12"},kt={class:"flex whitespace-nowrap mb-2 w-full"},Mt=e("span",{class:"text-gray-700 w-4/12"},"Consent to SMS",-1),St={class:"w-full"},Vt={class:"text-orange-600 w-4/12"},Bt={class:"flex whitespace-nowrap mb-2 w-full"},Ct=e("span",{class:"text-gray-700 w-4/12"},"Primary Referrer",-1),It={class:"w-full"},Et={class:"text-orange-600 w-4/12"},Ot={class:"flex whitespace-nowrap mb-2 w-full"},$t={class:"text-gray-700 w-4/12 flex justify-between items-center"},qt=e("span",{class:"mr-4"},"Extra Ids:",-1),Ft={class:"w-full border-gray-200"},At={class:"flex justify-around items-center w-full"},Rt=e("span",null,"Identification",-1),Yt=["onUpdate:modelValue"],Tt=e("option",null,null,-1),jt=["value"],Lt=e("span",null,"Value",-1),Kt=["onUpdate:modelValue"],Gt=["onClick"],Ht=e("hr",{class:"my-2"},null,-1),Wt={class:"grid grid-cols-3 gap-x-4 mb-4"},Xt={class:"col-span-1"},zt={class:"flex gap-x-2 items-center whitespace-nowrap w-full"},Jt=e("span",{class:"text-gray-700 w-4/12"},"Country",-1),Qt=e("option",{value:null},null,-1),Zt=["value"],es={class:"text-orange-600 w-4/12"},ts={class:"col-span-1"},ss={class:"flex gap-x-2 items-center whitespace-nowrap col-span-1 w-full"},ls=e("span",{class:"text-gray-700 w-4/12"},"Province",-1),ns=e("option",{value:null},null,-1),is=["value"],as={class:"text-orange-600 w-4/12"},os={class:"col-span-1"},ds={class:"flex gap-x-2 items-center whitespace-nowrap col-span-1 w-full"},us=e("span",{class:"text-gray-700 w-4/12"},"District",-1),rs=e("option",{value:null},null,-1),cs=["value"],ms={class:"text-orange-600 w-4/12"},ps=e("hr",null,null,-1),fs=e("b