© 2024 UltraCare Dental. All Rights Reserved. Website by Value Media
{
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-patient-name"
as=${html``}
/>
parent.activateValidation({"message":"This field is required.","emailMessage":"Please enter a valid Email address","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-email"
as=${html``}
/>
<${props.Flatpickr}
name="mf-date-of-birth"
className="mf-input mf-date-input mf-left-parent "
placeholder="${ parent.decodeEntities(`Date of Birth`) } "
options=${{"minDate":"","maxDate":"","dateFormat":"m-d-Y","enableTime":"","disable":[],"mode":"single","static":true,"disableMobile":true,"time_24hr":false}}
value=${parent.getValue('mf-date-of-birth')}
onInput=${parent.handleDateTime}
aria-invalid=${validation.errors['mf-date-of-birth'] ? 'true' : 'false'}
ref=${el => props.DateWidget(
el,
'',
{"message":"This field is required.","required":false},
register,
parent
)}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-date-of-birth"
as=${html``}
/>
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-telephone"
as=${html``}
/>
<${props.Select}
className=${"mf-input mf-input-select " + ( validation.errors['mf-hospital'] ? 'mf-invalid' : '' )}
classNamePrefix="mf_select"
name="mf-hospital"
placeholder="${ parent.decodeEntities(`Select Clinic`) } "
isSearchable=${false}
options=${[{"label":"Livingstone branch","value":"Livingstone branch","isDisabled":false},{"label":"Mazabuka Branch","value":"Mazabuka Branch","isDisabled":false}]}
value=${parent.getValue("mf-hospital") ? [{"label":"Livingstone branch","value":"Livingstone branch","isDisabled":false},{"label":"Mazabuka Branch","value":"Mazabuka Branch","isDisabled":false}].filter(item => item.value === parent.getValue("mf-hospital"))[0] : []}
onChange=${(e)=> parent.handleSelect(e, "mf-hospital")}
ref=${() => {
register({ name: "mf-hospital" }, parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false}));
if ( parent.getValue("mf-hospital") === '' && false ) {
parent.setValue( 'mf-hospital', '', true );
parent.handleChange({
target: {
name: 'mf-hospital',
value: ''
}
});
}
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-hospital"
as=${html``}
/>
<${props.Select}
className=${"mf-input mf-input-select " + ( validation.errors['mf-service'] ? 'mf-invalid' : '' )}
classNamePrefix="mf_select"
name="mf-service"
placeholder="${ parent.decodeEntities(`Reason`) } "
isSearchable=${false}
options=${[{"label":"New Patient Exam","value":"New Patient Exam","isDisabled":false},{"label":"Emergency Appt","value":"Emergency Appt","isDisabled":false},{"label":"Hygiene","value":"Hygiene","isDisabled":false},{"label":"Facial Aesthetics","value":"Facial Aesthetics","isDisabled":false}]}
value=${parent.getValue("mf-service") ? [{"label":"New Patient Exam","value":"New Patient Exam","isDisabled":false},{"label":"Emergency Appt","value":"Emergency Appt","isDisabled":false},{"label":"Hygiene","value":"Hygiene","isDisabled":false},{"label":"Facial Aesthetics","value":"Facial Aesthetics","isDisabled":false}].filter(item => item.value === parent.getValue("mf-service"))[0] : []}
onChange=${(e)=> parent.handleSelect(e, "mf-service")}
ref=${() => {
register({ name: "mf-service" }, parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false}));
if ( parent.getValue("mf-service") === '' && false ) {
parent.setValue( 'mf-service', '', true );
parent.handleChange({
target: {
name: 'mf-service',
value: ''
}
});
}
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-service"
as=${html``}
/>
<${props.Flatpickr}
name="mf-date-appointment"
className="mf-input mf-date-input mf-left-parent "
placeholder="${ parent.decodeEntities(`Select Date`) } "
options=${{"minDate":"today","maxDate":"","dateFormat":"m-d-Y","enableTime":"","disable":[],"mode":"single","static":true,"disableMobile":true,"time_24hr":false}}
value=${parent.getValue('mf-date-appointment')}
onInput=${parent.handleDateTime}
aria-invalid=${validation.errors['mf-date-appointment'] ? 'true' : 'false'}
ref=${el => props.DateWidget(
el,
'',
{"message":"This field is required.","required":true},
register,
parent
)}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-date-appointment"
as=${html``}
/>
<${props.Flatpickr}
name="booking_time"
className="mf-input mf-date-input mf-time-input mf-left-parent "
placeholder="${ parent.decodeEntities(`Select Time`) } "
options=${{"enableTime":true,"dateFormat":"h:i K","noCalendar":true,"time_24hr":false,"static":true}}
value=${parent.getValue('booking_time')}
onInput=${parent.handleDateTime}
aria-invalid=${validation.errors['booking_time'] ? 'true' : 'false'}
ref=${
el => {
if( el && el.node.nextSibling ) {
if( el.props.value.trim().length ) {
el.node.nextSibling.classList.add('value-found');
}else {
el.node.nextSibling.classList.remove('value-found');
}
}
register({ name: "booking_time" }, parent.activateValidation({"message":"This field is required.","required":true}))
}
}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="booking_time"
as=${html``}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-note-to-the-doctor"
as=${html``}
/>