@icap-ethiopia/esm-ethiohri-intake 1.0.0-pre.8 → 1.0.0

package/dist/src_forms_intake-a-form_tsx.js

@@ -0,0 +1,2367 @@
+"use strict";
+(globalThis["webpackChunk_icap_ethiopia_esm_ethiohri_intake"] = globalThis["webpackChunk_icap_ethiopia_esm_ethiohri_intake"] || []).push([["src_forms_intake-a-form_tsx"],{
+
+/***/ "./src/forms/care-giver.tsx":
+/*!**********************************!*\
+  !*** ./src/forms/care-giver.tsx ***!
+  \**********************************/
+/***/ ((__unused_webpack_module, __webpack_exports__, __webpack_require__) => {
+
+__webpack_require__.r(__webpack_exports__);
+/* harmony export */ __webpack_require__.d(__webpack_exports__, {
+/* harmony export */   "default": () => (__WEBPACK_DEFAULT_EXPORT__)
+/* harmony export */ });
+/* harmony import */ var _carbon_react__WEBPACK_IMPORTED_MODULE_0__ = __webpack_require__(/*! @carbon/react */ "./node_modules/@carbon/react/es/index.js");
+/* harmony import */ var react__WEBPACK_IMPORTED_MODULE_1__ = __webpack_require__(/*! react */ "webpack/sharing/consume/default/react/react");
+/* harmony import */ var react__WEBPACK_IMPORTED_MODULE_1___default = /*#__PURE__*/__webpack_require__.n(react__WEBPACK_IMPORTED_MODULE_1__);
+/* harmony import */ var react_hook_form__WEBPACK_IMPORTED_MODULE_5__ = __webpack_require__(/*! react-hook-form */ "./node_modules/react-hook-form/dist/index.esm.mjs");
+/* harmony import */ var _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__ = __webpack_require__(/*! ./intake-form.scss */ "./src/forms/intake-form.scss");
+/* harmony import */ var _api_api__WEBPACK_IMPORTED_MODULE_3__ = __webpack_require__(/*! ../api/api */ "./src/api/api.ts");
+/* harmony import */ var _utils_form_constant__WEBPACK_IMPORTED_MODULE_4__ = __webpack_require__(/*! ./utils/form-constant */ "./src/forms/utils/form-constant.ts");
+function _array_like_to_array(arr, len) {
+    if (len == null || len > arr.length) len = arr.length;
+    for(var i = 0, arr2 = new Array(len); i < len; i++)arr2[i] = arr[i];
+    return arr2;
+}
+function _array_with_holes(arr) {
+    if (Array.isArray(arr)) return arr;
+}
+function _define_property(obj, key, value) {
+    if (key in obj) {
+        Object.defineProperty(obj, key, {
+            value: value,
+            enumerable: true,
+            configurable: true,
+            writable: true
+        });
+    } else {
+        obj[key] = value;
+    }
+    return obj;
+}
+function _iterable_to_array_limit(arr, i) {
+    var _i = arr == null ? null : typeof Symbol !== "undefined" && arr[Symbol.iterator] || arr["@@iterator"];
+    if (_i == null) return;
+    var _arr = [];
+    var _n = true;
+    var _d = false;
+    var _s, _e;
+    try {
+        for(_i = _i.call(arr); !(_n = (_s = _i.next()).done); _n = true){
+            _arr.push(_s.value);
+            if (i && _arr.length === i) break;
+        }
+    } catch (err) {
+        _d = true;
+        _e = err;
+    } finally{
+        try {
+            if (!_n && _i["return"] != null) _i["return"]();
+        } finally{
+            if (_d) throw _e;
+        }
+    }
+    return _arr;
+}
+function _non_iterable_rest() {
+    throw new TypeError("Invalid attempt to destructure non-iterable instance.\\nIn order to be iterable, non-array objects must have a [Symbol.iterator]() method.");
+}
+function _object_spread(target) {
+    for(var i = 1; i < arguments.length; i++){
+        var source = arguments[i] != null ? arguments[i] : {};
+        var ownKeys = Object.keys(source);
+        if (typeof Object.getOwnPropertySymbols === "function") {
+            ownKeys = ownKeys.concat(Object.getOwnPropertySymbols(source).filter(function(sym) {
+                return Object.getOwnPropertyDescriptor(source, sym).enumerable;
+            }));
+        }
+        ownKeys.forEach(function(key) {
+            _define_property(target, key, source[key]);
+        });
+    }
+    return target;
+}
+function ownKeys(object, enumerableOnly) {
+    var keys = Object.keys(object);
+    if (Object.getOwnPropertySymbols) {
+        var symbols = Object.getOwnPropertySymbols(object);
+        if (enumerableOnly) {
+            symbols = symbols.filter(function(sym) {
+                return Object.getOwnPropertyDescriptor(object, sym).enumerable;
+            });
+        }
+        keys.push.apply(keys, symbols);
+    }
+    return keys;
+}
+function _object_spread_props(target, source) {
+    source = source != null ? source : {};
+    if (Object.getOwnPropertyDescriptors) {
+        Object.defineProperties(target, Object.getOwnPropertyDescriptors(source));
+    } else {
+        ownKeys(Object(source)).forEach(function(key) {
+            Object.defineProperty(target, key, Object.getOwnPropertyDescriptor(source, key));
+        });
+    }
+    return target;
+}
+function _sliced_to_array(arr, i) {
+    return _array_with_holes(arr) || _iterable_to_array_limit(arr, i) || _unsupported_iterable_to_array(arr, i) || _non_iterable_rest();
+}
+function _unsupported_iterable_to_array(o, minLen) {
+    if (!o) return;
+    if (typeof o === "string") return _array_like_to_array(o, minLen);
+    var n = Object.prototype.toString.call(o).slice(8, -1);
+    if (n === "Object" && o.constructor) n = o.constructor.name;
+    if (n === "Map" || n === "Set") return Array.from(n);
+    if (n === "Arguments" || /^(?:Ui|I)nt(?:8|16|32)(?:Clamped)?Array$/.test(n)) return _array_like_to_array(o, minLen);
+}
+
+
+
+
+
+
+var CareGiverPersonForm = function(param) {
+    var control = param.control, setValue = param.setValue, watch = param.watch, readonly = param.readonly, intakeAData = param.intakeAData, ControllerIntake = param.ControllerIntake, controlIntake = param.controlIntake, errorsPerson = param.errorsPerson;
+    var _intakeAData;
+    var country = watch("country");
+    var stateProvince = watch("stateProvince");
+    var countyDistrict = watch("countyDistrict");
+    var cityVillage = watch("cityVillage");
+    var _useState = _sliced_to_array((0,react__WEBPACK_IMPORTED_MODULE_1__.useState)({
+        country: [],
+        state: [],
+        county: [],
+        city: []
+    }), 2), options = _useState[0], setOptions = _useState[1];
+    var _useState1 = _sliced_to_array((0,react__WEBPACK_IMPORTED_MODULE_1__.useState)([]), 2), searchOptions = _useState1[0], setSearchOptions = _useState1[1];
+    (0,react__WEBPACK_IMPORTED_MODULE_1__.useEffect)(function() {
+        (0,_api_api__WEBPACK_IMPORTED_MODULE_3__.fetchChildEntries)([]).then(function(data) {
+            return setOptions(function(prev) {
+                return _object_spread_props(_object_spread({}, prev), {
+                    country: data
+                });
+            });
+        });
+    }, []);
+    (0,react__WEBPACK_IMPORTED_MODULE_1__.useEffect)(function() {
+        if (country) {
+            (0,_api_api__WEBPACK_IMPORTED_MODULE_3__.fetchChildEntries)([
+                country
+            ]).then(function(data) {
+                setOptions(function(prev) {
+                    return _object_spread_props(_object_spread({}, prev), {
+                        state: data
+                    });
+                });
+                if (!data.some(function(opt) {
+                    return opt.name === stateProvince;
+                })) {
+                    setValue("stateProvince", "");
+                }
+            });
+        }
+    }, [
+        country,
+        stateProvince,
+        setValue
+    ]);
+    (0,react__WEBPACK_IMPORTED_MODULE_1__.useEffect)(function() {
+        if (country && stateProvince) {
+            (0,_api_api__WEBPACK_IMPORTED_MODULE_3__.fetchChildEntries)([
+                country,
+                stateProvince
+            ]).then(function(data) {
+                setOptions(function(prev) {
+                    return _object_spread_props(_object_spread({}, prev), {
+                        county: data
+                    });
+                });
+                if (!data.some(function(opt) {
+                    return opt.name === countyDistrict;
+                })) {
+                    setValue("countyDistrict", "");
+                }
+            });
+        }
+    }, [
+        country,
+        stateProvince,
+        countyDistrict,
+        setValue
+    ]);
+    (0,react__WEBPACK_IMPORTED_MODULE_1__.useEffect)(function() {
+        if (country && stateProvince && countyDistrict) {
+            (0,_api_api__WEBPACK_IMPORTED_MODULE_3__.fetchChildEntries)([
+                country,
+                stateProvince,
+                countyDistrict
+            ]).then(function(data) {
+                setOptions(function(prev) {
+                    return _object_spread_props(_object_spread({}, prev), {
+                        city: data
+                    });
+                });
+                if (!data.some(function(opt) {
+                    return opt.name === cityVillage;
+                })) {
+                    setValue("cityVillage", "");
+                }
+            });
+        }
+    }, [
+        country,
+        stateProvince,
+        countyDistrict,
+        cityVillage,
+        setValue
+    ]);
+    var filterOptions = function(input, options) {
+        return input ? options.filter(function(opt) {
+            return opt.name.toLowerCase().includes(input.toLowerCase());
+        }) : options;
+    };
+    return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("div", null, intakeAData.careGiverKnown === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement((react__WEBPACK_IMPORTED_MODULE_1___default().Fragment), null, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("div", {
+        className: "fieldWrapper"
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_5__.Controller, {
+        name: "care_giver_first_name",
+        control: control,
+        rules: {
+            required: intakeAData.careGiverKnown === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" ? "care giver first name" : false
+        },
+        render: function(param) {
+            var field = param.field;
+            var _errorsPerson_care_giver_first_name;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_0__.TextInput, _object_spread_props(_object_spread({
+                readOnly: readonly,
+                id: "care_giver_first_name",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, "First Name")
+            }, field), {
+                invalid: !!errorsPerson.care_giver_first_name,
+                invalidText: (_errorsPerson_care_giver_first_name = errorsPerson.care_giver_first_name) === null || _errorsPerson_care_giver_first_name === void 0 ? void 0 : _errorsPerson_care_giver_first_name.message
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("div", {
+        className: "fieldWrapper"
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_5__.Controller, {
+        name: "care_giver_fathers_name",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_0__.TextInput, _object_spread_props(_object_spread({
+                readOnly: readonly,
+                id: "care_giver_fathers_name",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, "Father's Name")
+            }, field), {
+                invalid: false
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("div", {
+        className: "fieldWrapper"
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_5__.Controller, {
+        name: "care_giver_grandfathers_name",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_0__.TextInput, _object_spread_props(_object_spread({
+                readOnly: readonly,
+                id: "care_giver_grandfathers_name",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, "Grandfather's Name")
+            }, field), {
+                invalid: false
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("div", {
+        className: "fieldWrapper"
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_5__.Controller, {
+        name: "careGiverAge",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_0__.NumberInput, _object_spread_props(_object_spread({
+                allowEmpty: true,
+                readOnly: readonly,
+                id: "careGiverAge",
+                onKeyDown: function(e) {
+                    if ([
+                        "e",
+                        "E",
+                        "+",
+                        "-"
+                    ].includes(e.key) || e.key.length === 1 && !/\d/.test(e.key)) {
+                        e.preventDefault();
+                    }
+                },
+                label: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, "Age")
+            }, field), {
+                invalid: false
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("div", {
+        className: "fieldWrapper"
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_5__.Controller, {
+        name: "careGiverGender",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_0__.RadioButtonGroup, _object_spread({
+                readOnly: readonly,
+                orientation: "vertical",
+                id: "careGiverGender",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, "Sex")
+            }, field), _utils_form_constant__WEBPACK_IMPORTED_MODULE_4__.genderOpt.map(function(item) {
+                return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_0__.RadioButton, {
+                    key: item.concept,
+                    value: item.short,
+                    labelText: item.label,
+                    checked: field.value === item.short
+                });
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("div", {
+        className: "fieldWrapper"
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(ControllerIntake, {
+        name: "relationship",
+        control: controlIntake,
+        render: function(param) {
+            var field = param.field;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_0__.Select, _object_spread_props(_object_spread({
+                readOnly: readonly,
+                id: "relationship",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, "Relationship")
+            }, field), {
+                invalid: false
+            }), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_0__.SelectItem, {
+                value: "",
+                text: "Select"
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_4__.relationshipOpt.map(function(item) {
+                return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_0__.SelectItem, {
+                    key: item.concept,
+                    value: item.concept,
+                    text: item.label
+                });
+            }));
+        }
+    })), ((_intakeAData = intakeAData) === null || _intakeAData === void 0 ? void 0 : _intakeAData.relationship) === "5620AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("div", {
+        className: "fieldWrapper"
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(ControllerIntake, {
+        name: "otherRelationship",
+        control: controlIntake,
+        render: function(param) {
+            var field = param.field;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_0__.TextInput, _object_spread_props(_object_spread({
+                readOnly: readonly,
+                id: "otherRelationship",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, "Other Relationship")
+            }, field), {
+                invalid: false
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("div", {
+        className: "fieldWrapper"
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_5__.Controller, {
+        name: "search",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_0__.ComboBox, {
+                id: "search",
+                titleText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, "Address"),
+                placeholder: "Type to search...",
+                readOnly: readonly,
+                items: searchOptions,
+                itemToString: function(item) {
+                    var _item;
+                    return ((_item = item) === null || _item === void 0 ? void 0 : _item.address) || "";
+                },
+                selectedItem: field.value || null,
+                onInputChange: function(input) {
+                    if (input.length >= 2) {
+                        (0,_api_api__WEBPACK_IMPORTED_MODULE_3__.searchSuggestions)(input).then(setSearchOptions);
+                    }
+                },
+                onChange: function(e) {
+                    var _selected;
+                    var selected = e.selectedItem;
+                    field.onChange(selected);
+                    if ((_selected = selected) === null || _selected === void 0 ? void 0 : _selected.address) {
+                        var parts = selected.address.split(">");
+                        setValue("country", parts[0] || "");
+                        setValue("stateProvince", parts[1] || "");
+                        setValue("countyDistrict", parts[2] || "");
+                        setValue("cityVillage", parts[3] || "");
+                    }
+                },
+                allowCustomValue: true
+            });
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("div", {
+        className: "fieldWrapper"
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_5__.Controller, {
+        name: "stateProvince",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_0__.ComboBox, {
+                id: "stateProvince",
+                titleText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, "Region"),
+                readOnly: readonly,
+                items: filterOptions(field.value, options.state),
+                itemToString: function(item) {
+                    var _item;
+                    return ((_item = item) === null || _item === void 0 ? void 0 : _item.name) || "";
+                },
+                selectedItem: options.state.find(function(opt) {
+                    return opt.name === field.value;
+                }) || {
+                    name: field.value
+                },
+                onChange: function(e) {
+                    var _e_selectedItem;
+                    return field.onChange(((_e_selectedItem = e.selectedItem) === null || _e_selectedItem === void 0 ? void 0 : _e_selectedItem.name) || "");
+                },
+                onInputChange: function(input) {
+                    return field.onChange(input);
+                },
+                allowCustomValue: true
+            });
+        }
+    })), " ", /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("div", {
+        className: "fieldWrapper"
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_5__.Controller, {
+        name: "countyDistrict",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_0__.ComboBox, {
+                id: "countyDistrict",
+                readOnly: readonly,
+                titleText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, "Zone/Sub-City"),
+                items: filterOptions(field.value, options.county),
+                itemToString: function(item) {
+                    var _item;
+                    return ((_item = item) === null || _item === void 0 ? void 0 : _item.name) || "";
+                },
+                selectedItem: options.county.find(function(opt) {
+                    return opt.name === field.value;
+                }) || {
+                    name: field.value
+                },
+                onChange: function(e) {
+                    var _e_selectedItem;
+                    return field.onChange(((_e_selectedItem = e.selectedItem) === null || _e_selectedItem === void 0 ? void 0 : _e_selectedItem.name) || "");
+                },
+                onInputChange: function(input) {
+                    return field.onChange(input);
+                },
+                allowCustomValue: true
+            });
+        }
+    })), " ", /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("div", {
+        className: "fieldWrapper"
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_5__.Controller, {
+        name: "cityVillage",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_0__.ComboBox, {
+                id: "cityVillage",
+                titleText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, "Woreda"),
+                readOnly: readonly,
+                items: filterOptions(field.value, options.city),
+                itemToString: function(item) {
+                    var _item;
+                    return ((_item = item) === null || _item === void 0 ? void 0 : _item.name) || "";
+                },
+                selectedItem: options.city.find(function(opt) {
+                    return opt.name === field.value;
+                }) || {
+                    name: field.value
+                },
+                onChange: function(e) {
+                    var _e_selectedItem;
+                    return field.onChange(((_e_selectedItem = e.selectedItem) === null || _e_selectedItem === void 0 ? void 0 : _e_selectedItem.name) || "");
+                },
+                onInputChange: function(input) {
+                    return field.onChange(input);
+                },
+                allowCustomValue: true
+            });
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("div", {
+        className: "fieldWrapper"
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_5__.Controller, {
+        name: "kebele",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_0__.TextInput, _object_spread_props(_object_spread({
+                readOnly: readonly,
+                id: "kebele",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, "Kebele")
+            }, field), {
+                invalid: false
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("div", {
+        className: "fieldWrapper"
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_5__.Controller, {
+        name: "houseNo",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_0__.TextInput, _object_spread_props(_object_spread({
+                readOnly: readonly,
+                id: "houseNo",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, "House No")
+            }, field), {
+                invalid: false
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("div", {
+        className: "fieldWrapper"
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_5__.Controller, {
+        name: "telephoneMobile",
+        control: control,
+        render: function(param) {
+            var field = param.field, fieldState = param.fieldState;
+            var _fieldState_error;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_0__.TextInput, _object_spread_props(_object_spread({
+                readOnly: readonly,
+                id: "telephoneMobile",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, "Mobile Number")
+            }, field), {
+                invalid: !!fieldState.error,
+                invalidText: (_fieldState_error = fieldState.error) === null || _fieldState_error === void 0 ? void 0 : _fieldState_error.message,
+                onChange: function(e) {
+                    var value = e.target.value;
+                    // Allow only numbers and the + sign
+                    if (/^[0-9+/]*$/.test(value)) {
+                        field.onChange(value);
+                    }
+                }
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("div", {
+        className: "fieldWrapper"
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_5__.Controller, {
+        name: "homePhone",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_0__.TextInput, _object_spread_props(_object_spread({
+                readOnly: readonly,
+                id: "homePhone",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, "Home Phone Number")
+            }, field), {
+                invalid: false,
+                onChange: function(e) {
+                    var value = e.target.value;
+                    // Allow only numbers and the + sign
+                    if (/^[0-9+/]*$/.test(value)) {
+                        field.onChange(value);
+                    }
+                }
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("div", {
+        className: "fieldWrapper"
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_5__.Controller, {
+        name: "workPhone",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_0__.TextInput, _object_spread_props(_object_spread({
+                readOnly: readonly,
+                id: "workPhone",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_1___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, "Work Phone Number")
+            }, field), {
+                invalid: false,
+                onChange: function(e) {
+                    var value = e.target.value;
+                    // Allow only numbers and the + sign
+                    if (/^[0-9+/]*$/.test(value)) {
+                        field.onChange(value);
+                    }
+                }
+            }));
+        }
+    }))));
+};
+/* harmony default export */ const __WEBPACK_DEFAULT_EXPORT__ = (CareGiverPersonForm);
+
+
+/***/ }),
+
+/***/ "./src/forms/intake-a-form.tsx":
+/*!*************************************!*\
+  !*** ./src/forms/intake-a-form.tsx ***!
+  \*************************************/
+/***/ ((__unused_webpack_module, __webpack_exports__, __webpack_require__) => {
+
+__webpack_require__.r(__webpack_exports__);
+/* harmony export */ __webpack_require__.d(__webpack_exports__, {
+/* harmony export */   "default": () => (__WEBPACK_DEFAULT_EXPORT__)
+/* harmony export */ });
+/* harmony import */ var react__WEBPACK_IMPORTED_MODULE_0__ = __webpack_require__(/*! react */ "webpack/sharing/consume/default/react/react");
+/* harmony import */ var react__WEBPACK_IMPORTED_MODULE_0___default = /*#__PURE__*/__webpack_require__.n(react__WEBPACK_IMPORTED_MODULE_0__);
+/* harmony import */ var react_hook_form__WEBPACK_IMPORTED_MODULE_14__ = __webpack_require__(/*! react-hook-form */ "./node_modules/react-hook-form/dist/index.esm.mjs");
+/* harmony import */ var _carbon_react__WEBPACK_IMPORTED_MODULE_1__ = __webpack_require__(/*! @carbon/react */ "./node_modules/@carbon/react/es/index.js");
+/* harmony import */ var _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__ = __webpack_require__(/*! ./intake-form.scss */ "./src/forms/intake-form.scss");
+/* harmony import */ var _openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_3__ = __webpack_require__(/*! @openmrs/esm-framework */ "webpack/sharing/consume/default/@openmrs/esm-framework/@openmrs/esm-framework");
+/* harmony import */ var _openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_3___default = /*#__PURE__*/__webpack_require__.n(_openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_3__);
+/* harmony import */ var react_i18next__WEBPACK_IMPORTED_MODULE_4__ = __webpack_require__(/*! react-i18next */ "webpack/sharing/consume/default/react-i18next/react-i18next");
+/* harmony import */ var react_i18next__WEBPACK_IMPORTED_MODULE_4___default = /*#__PURE__*/__webpack_require__.n(react_i18next__WEBPACK_IMPORTED_MODULE_4__);
+/* harmony import */ var _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__ = __webpack_require__(/*! ./utils/form-constant */ "./src/forms/utils/form-constant.ts");
+/* harmony import */ var dayjs__WEBPACK_IMPORTED_MODULE_6__ = __webpack_require__(/*! dayjs */ "webpack/sharing/consume/default/dayjs/dayjs");
+/* harmony import */ var dayjs__WEBPACK_IMPORTED_MODULE_6___default = /*#__PURE__*/__webpack_require__.n(dayjs__WEBPACK_IMPORTED_MODULE_6__);
+/* harmony import */ var _constants__WEBPACK_IMPORTED_MODULE_7__ = __webpack_require__(/*! ../constants */ "./src/constants.ts");
+/* harmony import */ var _utils_data_table_resource__WEBPACK_IMPORTED_MODULE_8__ = __webpack_require__(/*! ../utils/data-table.resource */ "./src/utils/data-table.resource.ts");
+/* harmony import */ var _hooks_defaultValuesFromEncounter__WEBPACK_IMPORTED_MODULE_9__ = __webpack_require__(/*! ./hooks/defaultValuesFromEncounter */ "./src/forms/hooks/defaultValuesFromEncounter.ts");
+/* harmony import */ var _hooks_useFetchLocation__WEBPACK_IMPORTED_MODULE_10__ = __webpack_require__(/*! ./hooks/useFetchLocation */ "./src/forms/hooks/useFetchLocation.ts");
+/* harmony import */ var _care_giver__WEBPACK_IMPORTED_MODULE_11__ = __webpack_require__(/*! ./care-giver */ "./src/forms/care-giver.tsx");
+/* harmony import */ var _api_api__WEBPACK_IMPORTED_MODULE_12__ = __webpack_require__(/*! ../api/api */ "./src/api/api.ts");
+/* harmony import */ var _hooks_createEncounter__WEBPACK_IMPORTED_MODULE_13__ = __webpack_require__(/*! ./hooks/createEncounter */ "./src/forms/hooks/createEncounter.ts");
+function _array_like_to_array(arr, len) {
+    if (len == null || len > arr.length) len = arr.length;
+    for(var i = 0, arr2 = new Array(len); i < len; i++)arr2[i] = arr[i];
+    return arr2;
+}
+function _array_with_holes(arr) {
+    if (Array.isArray(arr)) return arr;
+}
+function asyncGeneratorStep(gen, resolve, reject, _next, _throw, key, arg) {
+    try {
+        var info = gen[key](arg);
+        var value = info.value;
+    } catch (error) {
+        reject(error);
+        return;
+    }
+    if (info.done) {
+        resolve(value);
+    } else {
+        Promise.resolve(value).then(_next, _throw);
+    }
+}
+function _async_to_generator(fn) {
+    return function() {
+        var self = this, args = arguments;
+        return new Promise(function(resolve, reject) {
+            var gen = fn.apply(self, args);
+            function _next(value) {
+                asyncGeneratorStep(gen, resolve, reject, _next, _throw, "next", value);
+            }
+            function _throw(err) {
+                asyncGeneratorStep(gen, resolve, reject, _next, _throw, "throw", err);
+            }
+            _next(undefined);
+        });
+    };
+}
+function _define_property(obj, key, value) {
+    if (key in obj) {
+        Object.defineProperty(obj, key, {
+            value: value,
+            enumerable: true,
+            configurable: true,
+            writable: true
+        });
+    } else {
+        obj[key] = value;
+    }
+    return obj;
+}
+function _iterable_to_array_limit(arr, i) {
+    var _i = arr == null ? null : typeof Symbol !== "undefined" && arr[Symbol.iterator] || arr["@@iterator"];
+    if (_i == null) return;
+    var _arr = [];
+    var _n = true;
+    var _d = false;
+    var _s, _e;
+    try {
+        for(_i = _i.call(arr); !(_n = (_s = _i.next()).done); _n = true){
+            _arr.push(_s.value);
+            if (i && _arr.length === i) break;
+        }
+    } catch (err) {
+        _d = true;
+        _e = err;
+    } finally{
+        try {
+            if (!_n && _i["return"] != null) _i["return"]();
+        } finally{
+            if (_d) throw _e;
+        }
+    }
+    return _arr;
+}
+function _non_iterable_rest() {
+    throw new TypeError("Invalid attempt to destructure non-iterable instance.\\nIn order to be iterable, non-array objects must have a [Symbol.iterator]() method.");
+}
+function _object_spread(target) {
+    for(var i = 1; i < arguments.length; i++){
+        var source = arguments[i] != null ? arguments[i] : {};
+        var ownKeys = Object.keys(source);
+        if (typeof Object.getOwnPropertySymbols === "function") {
+            ownKeys = ownKeys.concat(Object.getOwnPropertySymbols(source).filter(function(sym) {
+                return Object.getOwnPropertyDescriptor(source, sym).enumerable;
+            }));
+        }
+        ownKeys.forEach(function(key) {
+            _define_property(target, key, source[key]);
+        });
+    }
+    return target;
+}
+function ownKeys(object, enumerableOnly) {
+    var keys = Object.keys(object);
+    if (Object.getOwnPropertySymbols) {
+        var symbols = Object.getOwnPropertySymbols(object);
+        if (enumerableOnly) {
+            symbols = symbols.filter(function(sym) {
+                return Object.getOwnPropertyDescriptor(object, sym).enumerable;
+            });
+        }
+        keys.push.apply(keys, symbols);
+    }
+    return keys;
+}
+function _object_spread_props(target, source) {
+    source = source != null ? source : {};
+    if (Object.getOwnPropertyDescriptors) {
+        Object.defineProperties(target, Object.getOwnPropertyDescriptors(source));
+    } else {
+        ownKeys(Object(source)).forEach(function(key) {
+            Object.defineProperty(target, key, Object.getOwnPropertyDescriptor(source, key));
+        });
+    }
+    return target;
+}
+function _sliced_to_array(arr, i) {
+    return _array_with_holes(arr) || _iterable_to_array_limit(arr, i) || _unsupported_iterable_to_array(arr, i) || _non_iterable_rest();
+}
+function _unsupported_iterable_to_array(o, minLen) {
+    if (!o) return;
+    if (typeof o === "string") return _array_like_to_array(o, minLen);
+    var n = Object.prototype.toString.call(o).slice(8, -1);
+    if (n === "Object" && o.constructor) n = o.constructor.name;
+    if (n === "Map" || n === "Set") return Array.from(n);
+    if (n === "Arguments" || /^(?:Ui|I)nt(?:8|16|32)(?:Clamped)?Array$/.test(n)) return _array_like_to_array(o, minLen);
+}
+function _ts_generator(thisArg, body) {
+    var f, y, t, g, _ = {
+        label: 0,
+        sent: function() {
+            if (t[0] & 1) throw t[1];
+            return t[1];
+        },
+        trys: [],
+        ops: []
+    };
+    return(g = {
+        next: verb(0),
+        "throw": verb(1),
+        "return": verb(2)
+    }, typeof Symbol === "function" && (g[Symbol.iterator] = function() {
+        return this;
+    }), g);
+    function verb(n) {
+        return function(v) {
+            return step([
+                n,
+                v
+            ]);
+        };
+    }
+    function step(op) {
+        if (f) throw new TypeError("Generator is already executing.");
+        while(_)try {
+            if (f = 1, y && (t = op[0] & 2 ? y["return"] : op[0] ? y["throw"] || ((t = y["return"]) && t.call(y), 0) : y.next) && !(t = t.call(y, op[1])).done) return t;
+            if (y = 0, t) op = [
+                op[0] & 2,
+                t.value
+            ];
+            switch(op[0]){
+                case 0:
+                case 1:
+                    t = op;
+                    break;
+                case 4:
+                    _.label++;
+                    return {
+                        value: op[1],
+                        done: false
+                    };
+                case 5:
+                    _.label++;
+                    y = op[1];
+                    op = [
+                        0
+                    ];
+                    continue;
+                case 7:
+                    op = _.ops.pop();
+                    _.trys.pop();
+                    continue;
+                default:
+                    if (!(t = _.trys, t = t.length > 0 && t[t.length - 1]) && (op[0] === 6 || op[0] === 2)) {
+                        _ = 0;
+                        continue;
+                    }
+                    if (op[0] === 3 && (!t || op[1] > t[0] && op[1] < t[3])) {
+                        _.label = op[1];
+                        break;
+                    }
+                    if (op[0] === 6 && _.label < t[1]) {
+                        _.label = t[1];
+                        t = op;
+                        break;
+                    }
+                    if (t && _.label < t[2]) {
+                        _.label = t[2];
+                        _.ops.push(op);
+                        break;
+                    }
+                    if (t[2]) _.ops.pop();
+                    _.trys.pop();
+                    continue;
+            }
+            op = body.call(thisArg, _);
+        } catch (e) {
+            op = [
+                6,
+                e
+            ];
+            y = 0;
+        } finally{
+            f = t = 0;
+        }
+        if (op[0] & 5) throw op[1];
+        return {
+            value: op[0] ? op[1] : void 0,
+            done: true
+        };
+    }
+}
+
+
+
+
+
+
+
+
+
+
+
+
+
+
+
+
+var IntakeAForm = function(param) {
+    var encounter = param.encounter, type = param.type, mutateEncounters = param.mutateEncounters;
+    var _patient_patient, _patient, _patient_patient1, _patient1, _patient2, _type, _IntakeAFormData_whoKnows_selectedItems, _IntakeAFormData_whoKnows, _IntakeAFormData, _IntakeAFormData_whoKnows_selectedItems1, _IntakeAFormData_whoKnows1, _IntakeAFormData1, _type1, _type2;
+    var patient = (0,_openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_3__.usePatient)();
+    var session = (0,_openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_3__.useSession)();
+    var t = (0,react_i18next__WEBPACK_IMPORTED_MODULE_4__.useTranslation)().t;
+    var _useState = _sliced_to_array((0,react__WEBPACK_IMPORTED_MODULE_0__.useState)(false), 2), isSubmitting = _useState[0], setIsSubmitting = _useState[1];
+    var encounterDate = new Date().toISOString();
+    var birthDate = dayjs__WEBPACK_IMPORTED_MODULE_6___default()((_patient = patient) === null || _patient === void 0 ? void 0 : (_patient_patient = _patient.patient) === null || _patient_patient === void 0 ? void 0 : _patient_patient.birthDate);
+    var currentAge = dayjs__WEBPACK_IMPORTED_MODULE_6___default()().diff(dayjs__WEBPACK_IMPORTED_MODULE_6___default()((_patient1 = patient) === null || _patient1 === void 0 ? void 0 : (_patient_patient1 = _patient1.patient) === null || _patient_patient1 === void 0 ? void 0 : _patient_patient1.birthDate), "year");
+    var _useState1 = _sliced_to_array((0,react__WEBPACK_IMPORTED_MODULE_0__.useState)({
+        pid: "",
+        relation: ""
+    }), 2), personId = _useState1[0], setPersonId = _useState1[1];
+    var facilityInfo = (0,_hooks_useFetchLocation__WEBPACK_IMPORTED_MODULE_10__.useFetchLocation)().facilityInfo;
+    var _useLatestObs = (0,_utils_data_table_resource__WEBPACK_IMPORTED_MODULE_8__.useLatestObs)(patient.patientUuid, "dadc86a8-1e44-4a6d-91c2-e3b54089b54c", "a0fde61e-f493-4f1f-b709-22aa94f72dc3"), registrationDate = _useLatestObs.latestMatched;
+    var _useForm = (0,react_hook_form__WEBPACK_IMPORTED_MODULE_14__.useForm)({
+        defaultValues: encounter ? (0,_hooks_defaultValuesFromEncounter__WEBPACK_IMPORTED_MODULE_9__.defaultValuesFromEncounter)(encounter, _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.intakeADefault, _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.intakeAConceptsUuid, [
+            "de8937b6-6ebe-4302-a488-2198be481839"
+        ]) : _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.intakeADefault,
+        mode: "all"
+    }), control = _useForm.control, handleSubmit = _useForm.handleSubmit, watch = _useForm.watch, setValue = _useForm.setValue, trigger = _useForm.trigger, _useForm_formState = _useForm.formState, errors = _useForm_formState.errors, touchedFields = _useForm_formState.touchedFields;
+    var _useForm1 = (0,react_hook_form__WEBPACK_IMPORTED_MODULE_14__.useForm)({
+        defaultValues: _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.careGiverDefault,
+        mode: "all"
+    }), controlPerson = _useForm1.control, handleSubmitPerson = _useForm1.handleSubmit, watchPerson = _useForm1.watch, setValuePerson = _useForm1.setValue, getValuesPerson = _useForm1.getValues, resetPerson = _useForm1.reset, triggerPerson = _useForm1.trigger, _useForm_formState1 = _useForm1.formState, errorsPerson = _useForm_formState1.errors, touchedFieldsPerson = _useForm_formState1.touchedFields;
+    var fetchedPatientUuid = (0,react__WEBPACK_IMPORTED_MODULE_0__.useRef)(null);
+    (0,react__WEBPACK_IMPORTED_MODULE_0__.useEffect)(function() {
+        var fetchData = function() {
+            var _ref = _async_to_generator(function() {
+                var _patient, _person_addresses, _person_attributes_find, _person_attributes, _person_attributes_find1, _person_attributes1, _person_attributes_find2, _person_attributes2, _person_attributes_find3, _person_attributes3, _person_names_, _person_names, _person_names_1, _person_names1, _person_names_2, _person_names2, _person_attributes_find4, _person_attributes4, res, relationship, person, _person_addresses_find, preferredAddress, mappedFormValues;
+                return _ts_generator(this, function(_state) {
+                    switch(_state.label){
+                        case 0:
+                            if (!(encounter && ((_patient = patient) === null || _patient === void 0 ? void 0 : _patient.patientUuid) && patient.patientUuid !== fetchedPatientUuid.current)) return [
+                                3,
+                                2
+                            ];
+                            return [
+                                4,
+                                (0,_api_api__WEBPACK_IMPORTED_MODULE_12__.getPersonData)(patient.patientUuid)
+                            ];
+                        case 1:
+                            res = _state.sent();
+                            relationship = res[0];
+                            person = relationship.personB;
+                            setPersonId({
+                                pid: person.uuid,
+                                relation: relationship.uuid
+                            });
+                            preferredAddress = (_person_addresses_find = (_person_addresses = person.addresses) === null || _person_addresses === void 0 ? void 0 : _person_addresses.find(function(addr) {
+                                return addr.preferred;
+                            })) !== null && _person_addresses_find !== void 0 ? _person_addresses_find : {};
+                            mappedFormValues = {
+                                workPhone: ((_person_attributes = person.attributes) === null || _person_attributes === void 0 ? void 0 : (_person_attributes_find = _person_attributes.find(function(attr) {
+                                    var _attr_attributeType;
+                                    return ((_attr_attributeType = attr.attributeType) === null || _attr_attributeType === void 0 ? void 0 : _attr_attributeType.uuid) === "a69aae3d-8c79-4ac5-a218-88889f007163";
+                                })) === null || _person_attributes_find === void 0 ? void 0 : _person_attributes_find.value) || "",
+                                homePhone: ((_person_attributes1 = person.attributes) === null || _person_attributes1 === void 0 ? void 0 : (_person_attributes_find1 = _person_attributes1.find(function(attr) {
+                                    var _attr_attributeType;
+                                    return ((_attr_attributeType = attr.attributeType) === null || _attr_attributeType === void 0 ? void 0 : _attr_attributeType.uuid) === "b3269e45-8e40-44a1-a5f2-bbb2765c6287";
+                                })) === null || _person_attributes_find1 === void 0 ? void 0 : _person_attributes_find1.value) || "",
+                                houseNo: ((_person_attributes2 = person.attributes) === null || _person_attributes2 === void 0 ? void 0 : (_person_attributes_find2 = _person_attributes2.find(function(attr) {
+                                    var _attr_attributeType;
+                                    return ((_attr_attributeType = attr.attributeType) === null || _attr_attributeType === void 0 ? void 0 : _attr_attributeType.uuid) === "553bedc6-4e59-42d3-b80b-d3cf02a792bd";
+                                })) === null || _person_attributes_find2 === void 0 ? void 0 : _person_attributes_find2.value) || "",
+                                kebele: ((_person_attributes3 = person.attributes) === null || _person_attributes3 === void 0 ? void 0 : (_person_attributes_find3 = _person_attributes3.find(function(attr) {
+                                    var _attr_attributeType;
+                                    return ((_attr_attributeType = attr.attributeType) === null || _attr_attributeType === void 0 ? void 0 : _attr_attributeType.uuid) === "e1695908-916d-4c9e-b62b-90b512492da2";
+                                })) === null || _person_attributes_find3 === void 0 ? void 0 : _person_attributes_find3.value) || "",
+                                search: null,
+                                country: preferredAddress.country || "",
+                                stateProvince: preferredAddress.stateProvince || "",
+                                countyDistrict: preferredAddress.countyDistrict || "",
+                                cityVillage: preferredAddress.cityVillage || "",
+                                care_giver_first_name: ((_person_names = person.names) === null || _person_names === void 0 ? void 0 : (_person_names_ = _person_names[0]) === null || _person_names_ === void 0 ? void 0 : _person_names_.givenName) || "",
+                                care_giver_fathers_name: ((_person_names1 = person.names) === null || _person_names1 === void 0 ? void 0 : (_person_names_1 = _person_names1[0]) === null || _person_names_1 === void 0 ? void 0 : _person_names_1.middleName) || "",
+                                care_giver_grandfathers_name: ((_person_names2 = person.names) === null || _person_names2 === void 0 ? void 0 : (_person_names_2 = _person_names2[0]) === null || _person_names_2 === void 0 ? void 0 : _person_names_2.familyName) || "",
+                                careGiverAge: person.age || null,
+                                careGiverGender: person.gender || "",
+                                addressRegion: preferredAddress.address3 || "",
+                                telephoneMobile: ((_person_attributes4 = person.attributes) === null || _person_attributes4 === void 0 ? void 0 : (_person_attributes_find4 = _person_attributes4.find(function(attr) {
+                                    var _attr_attributeType;
+                                    return ((_attr_attributeType = attr.attributeType) === null || _attr_attributeType === void 0 ? void 0 : _attr_attributeType.uuid) === "1794bcad-b2d2-47ae-8e26-1d4ec31ade13";
+                                })) === null || _person_attributes_find4 === void 0 ? void 0 : _person_attributes_find4.value) || ""
+                            };
+                            resetPerson(mappedFormValues);
+                            fetchedPatientUuid.current = patient.patientUuid;
+                            _state.label = 2;
+                        case 2:
+                            return [
+                                2
+                            ];
+                    }
+                });
+            });
+            return function fetchData() {
+                return _ref.apply(this, arguments);
+            };
+        }();
+        fetchData();
+    }, [
+        encounter,
+        (_patient2 = patient) === null || _patient2 === void 0 ? void 0 : _patient2.patientUuid,
+        resetPerson
+    ]);
+    var IntakeAFormData = (0,react_hook_form__WEBPACK_IMPORTED_MODULE_14__.useWatch)({
+        control: control
+    });
+    var visibilityRules = (0,react__WEBPACK_IMPORTED_MODULE_0__.useMemo)(function() {
+        return {
+            otherReligion: function(data) {
+                return data.religion === "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            otherEducation: function(data) {
+                return data.levelOfEducation === "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            regular_followup: function(data) {
+                return data.catchment_area === "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            mothers_name: function() {
+                return currentAge <= 4;
+            },
+            mothers_father_name: function() {
+                return currentAge <= 4;
+            },
+            mothers_grandfather_name: function() {
+                return currentAge <= 4;
+            },
+            placeOfDelivery: function() {
+                return currentAge <= 4;
+            },
+            otherPlaceOfDelivery: function(data) {
+                return currentAge <= 4 && data.placeOfDelivery === "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            modeOfDelivery: function() {
+                return currentAge <= 4;
+            },
+            otherModeOfDelivery: function(data) {
+                return currentAge <= 4 && data.modeOfDelivery === "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            within_the_facility: function(data) {
+                return data.entryPoint === "163266AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            otherEntryPointWithinTheFacility: function(data) {
+                return data.entryPoint === "163266AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && data.within_the_facility === "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            outside_the_facility: function(data) {
+                return data.entryPoint === "164407AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            otherEntryPointOutsideTheFacility: function(data) {
+                return data.entryPoint === "164407AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && data.outside_the_facility === "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            otherRelationship: function(data) {
+                return data.relationship === "5620AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            }
+        };
+    }, [
+        currentAge
+    ]);
+    (0,react__WEBPACK_IMPORTED_MODULE_0__.useEffect)(function() {
+        if (currentAge) {
+            Object.keys(visibilityRules).forEach(function(field) {
+                var isVisible = visibilityRules[field](IntakeAFormData);
+                if (!isVisible && IntakeAFormData[field] !== null && IntakeAFormData[field] !== undefined) {
+                    setValue(field, null, {
+                        shouldValidate: false,
+                        shouldDirty: false
+                    });
+                }
+            });
+        }
+    }, [
+        IntakeAFormData,
+        visibilityRules,
+        setValue,
+        currentAge
+    ]);
+    var onSubmit = function() {
+        var _ref = _async_to_generator(function() {
+            var _encounter, _type, res, relationship, error;
+            return _ts_generator(this, function(_state) {
+                switch(_state.label){
+                    case 0:
+                        setIsSubmitting(true);
+                        _state.label = 1;
+                    case 1:
+                        _state.trys.push([
+                            1,
+                            5,
+                            6,
+                            7
+                        ]);
+                        if (!(Object.keys(touchedFieldsPerson).length !== 0)) return [
+                            3,
+                            3
+                        ];
+                        return [
+                            4,
+                            handleSavePerson()
+                        ];
+                    case 2:
+                        res = _state.sent();
+                        if (!encounter || !personId.pid) {
+                            relationship = handleCreateRelation(res);
+                        }
+                        _state.label = 3;
+                    case 3:
+                        return [
+                            4,
+                            (0,_hooks_createEncounter__WEBPACK_IMPORTED_MODULE_13__.createEncounter)(IntakeAFormData, {
+                                namespace: "rfe-forms",
+                                touchedFields: touchedFields,
+                                encounter: encounter,
+                                conceptsUuid: _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.intakeAConceptsUuid,
+                                encounterType: _constants__WEBPACK_IMPORTED_MODULE_7__.INTAKE_A_ENCOUNTER_TYPE,
+                                formUuid: _constants__WEBPACK_IMPORTED_MODULE_7__.intakeAFormUuid,
+                                encounterDate: encounterDate,
+                                patientUuid: patient.patientUuid,
+                                providerUuid: session.currentProvider.uuid,
+                                locationUuid: facilityInfo.uuid,
+                                visibilityRules: visibilityRules,
+                                context: {
+                                    currentAge: currentAge
+                                },
+                                encounterUuid: (_encounter = encounter) === null || _encounter === void 0 ? void 0 : _encounter.uuid,
+                                mutateEncounters: mutateEncounters,
+                                workspaceName: "intake-a-form-workspace",
+                                editMode: (_type = type) === null || _type === void 0 ? void 0 : _type.edit
+                            })
+                        ];
+                    case 4:
+                        _state.sent();
+                        return [
+                            3,
+                            7
+                        ];
+                    case 5:
+                        error = _state.sent();
+                        console.error("Error submitting form:", error);
+                        return [
+                            3,
+                            7
+                        ];
+                    case 6:
+                        setIsSubmitting(false); // Reset submitting state
+                        return [
+                            7
+                        ];
+                    case 7:
+                        return [
+                            2
+                        ];
+                }
+            });
+        });
+        return function onSubmit() {
+            return _ref.apply(this, arguments);
+        };
+    }();
+    var handleSavePerson = function() {
+        var _ref = _async_to_generator(function() {
+            var values, currentDate, gender, estimatedBirthDate, payload, response;
+            return _ts_generator(this, function(_state) {
+                switch(_state.label){
+                    case 0:
+                        values = getValuesPerson();
+                        currentDate = dayjs__WEBPACK_IMPORTED_MODULE_6___default()();
+                        gender = values.careGiverGender === "Male" ? "M" : values.careGiverGender === "Female" ? "F" : null;
+                        estimatedBirthDate = values.careGiverAge ? currentDate.subtract(values.careGiverAge, "year") : null;
+                        payload = {
+                            gender: values.careGiverGender,
+                            names: [
+                                {
+                                    givenName: values.care_giver_first_name,
+                                    middleName: values.care_giver_fathers_name,
+                                    familyName: values.care_giver_grandfathers_name
+                                }
+                            ],
+                            birthdate: estimatedBirthDate,
+                            birthdateEstimated: values.careGiverAge ? true : false,
+                            addresses: [
+                                {
+                                    cityVillage: values.cityVillage,
+                                    stateProvince: values.stateProvince,
+                                    country: values.country,
+                                    countyDistrict: values.countyDistrict
+                                }
+                            ],
+                            attributes: [
+                                {
+                                    attributeType: "1794bcad-b2d2-47ae-8e26-1d4ec31ade13",
+                                    value: values.telephoneMobile
+                                },
+                                {
+                                    attributeType: "a69aae3d-8c79-4ac5-a218-88889f007163",
+                                    value: values.workPhone
+                                },
+                                {
+                                    attributeType: "b3269e45-8e40-44a1-a5f2-bbb2765c6287",
+                                    value: values.homePhone
+                                },
+                                {
+                                    attributeType: "553bedc6-4e59-42d3-b80b-d3cf02a792bd",
+                                    value: values.houseNo
+                                },
+                                {
+                                    attributeType: "e1695908-916d-4c9e-b62b-90b512492da2",
+                                    value: values.kebele
+                                }
+                            ]
+                        };
+                        return [
+                            4,
+                            (0,_api_api__WEBPACK_IMPORTED_MODULE_12__.createPerson)(new AbortController(), payload, encounter ? personId.pid : null)
+                        ];
+                    case 1:
+                        response = _state.sent();
+                        return [
+                            2,
+                            response.data
+                        ];
+                }
+            });
+        });
+        return function handleSavePerson() {
+            return _ref.apply(this, arguments);
+        };
+    }();
+    var handleCreateRelation = function() {
+        var _ref = _async_to_generator(function(data) {
+            var values, payload, response;
+            return _ts_generator(this, function(_state) {
+                switch(_state.label){
+                    case 0:
+                        values = getValuesPerson();
+                        payload = {
+                            personA: patient.patientUuid,
+                            relationshipType: "61538867-175a-405b-96d8-d02c83917002",
+                            personB: data.uuid
+                        };
+                        return [
+                            4,
+                            (0,_api_api__WEBPACK_IMPORTED_MODULE_12__.relationshipPerson)(new AbortController(), payload)
+                        ];
+                    case 1:
+                        response = _state.sent();
+                        return [
+                            2,
+                            response.data
+                        ];
+                }
+            });
+        });
+        return function handleCreateRelation(data) {
+            return _ref.apply(this, arguments);
+        };
+    }();
+    var handleFormSubmit = function() {
+        var _ref = _async_to_generator(function(e) {
+            var isFormAValid, isFormBValid;
+            return _ts_generator(this, function(_state) {
+                switch(_state.label){
+                    case 0:
+                        e.preventDefault();
+                        return [
+                            4,
+                            trigger()
+                        ];
+                    case 1:
+                        isFormAValid = _state.sent();
+                        return [
+                            4,
+                            triggerPerson()
+                        ];
+                    case 2:
+                        isFormBValid = _state.sent();
+                        if (isFormAValid && isFormBValid) {
+                            onSubmit();
+                        }
+                        return [
+                            2
+                        ];
+                }
+            });
+        });
+        return function handleFormSubmit(e) {
+            return _ref.apply(this, arguments);
+        };
+    }();
+    return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.Form, {
+        onSubmit: handleFormSubmit,
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].formNew
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("h2", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].heading
+    }, "HIV CARE/ART CLINIC INTAKE FORM-A"), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].scrollableContent
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.Stack, {
+        gap: 1,
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].container
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.Accordion, null, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.AccordionItem, {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].formContainer,
+        title: "GENERAL INFORMATION",
+        open: true
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "unit_tb_no",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_unit_tb_no;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "unit_tb_no",
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("unit_tb_no", "Unit TB No"))
+            }, field), {
+                invalid: !!errors.unit_tb_no,
+                invalidText: (_errors_unit_tb_no = errors.unit_tb_no) === null || _errors_unit_tb_no === void 0 ? void 0 : _errors_unit_tb_no.message
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "childsCareGiverMaritalStatus",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.Select, _object_spread({
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                id: "childsCareGiverMaritalStatus",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("childsCareGiverMaritalStatus", "Client (Child's care giver) marital status"))
+            }, field), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.SelectItem, {
+                value: "",
+                text: "Select"
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.maritalStatusOpt.map(function(item) {
+                return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.SelectItem, {
+                    key: item.concept,
+                    value: item.concept,
+                    text: item.label
+                });
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "religion",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.Select, _object_spread({
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                id: "religion",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("religion", "Religion"))
+            }, field), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.SelectItem, {
+                value: "",
+                text: "Select"
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.religionOpt.map(function(item) {
+                return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.SelectItem, {
+                    key: item.concept,
+                    value: item.concept,
+                    text: item.label
+                });
+            }));
+        }
+    })), IntakeAFormData.religion === "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "otherReligion",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_unit_tb_no;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "otherReligion",
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("otherReligion", "Specify other religion"))
+            }, field), {
+                invalid: !!errors.unit_tb_no,
+                invalidText: (_errors_unit_tb_no = errors.unit_tb_no) === null || _errors_unit_tb_no === void 0 ? void 0 : _errors_unit_tb_no.message
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "levelOfEducation",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.Select, _object_spread({
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                id: "levelOfEducation",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("levelOfEducation", "Level of Education"))
+            }, field), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.SelectItem, {
+                value: "",
+                text: "Select"
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.levelOfEducationOpt.map(function(item) {
+                return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.SelectItem, {
+                    key: item.concept,
+                    value: item.concept,
+                    text: item.label
+                });
+            }));
+        }
+    })), IntakeAFormData.levelOfEducation === "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "otherEducation",
+        control: control,
+        rules: {
+            maxLength: {
+                value: 50,
+                message: "Please use a maximum of 50 characters"
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_otherEducation;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "otherEducation",
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("otherEducation", "Specify other level of education"))
+            }, field), {
+                invalid: !!errors.otherEducation,
+                invalidText: (_errors_otherEducation = errors.otherEducation) === null || _errors_otherEducation === void 0 ? void 0 : _errors_otherEducation.message
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "occupation",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_occupation;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "occupation",
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("occupation", "Occupation"))
+            }, field), {
+                invalid: !!errors.occupation,
+                invalidText: (_errors_occupation = errors.occupation) === null || _errors_occupation === void 0 ? void 0 : _errors_occupation.message
+            }));
+        }
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+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "residentialType",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_residentialType;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread(_object_spread_props(_object_spread({
+                orientation: "vertical",
+                id: "residentialType"
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+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("residentialType", "Residential Type"))
+            }), field), {
+                invalid: !!errors.residentialType,
+                invalidText: (_errors_residentialType = errors.residentialType) === null || _errors_residentialType === void 0 ? void 0 : _errors_residentialType.message,
+                onChange: function(value) {
+                    return field.onChange(value);
+                }
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+                return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButton, {
+                    key: item.concept,
+                    value: item.concept,
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+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "catchment_area",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_catchment_area;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread(_object_spread_props(_object_spread({
+                orientation: "vertical",
+                id: "catchment_area"
+            }, field), {
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("catchment_area", "Client reside within the catchments area"))
+            }), field), {
+                invalid: !!errors.catchment_area,
+                invalidText: (_errors_catchment_area = errors.catchment_area) === null || _errors_catchment_area === void 0 ? void 0 : _errors_catchment_area.message,
+                onChange: function(value) {
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+                return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButton, {
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+                    value: item.concept,
+                    labelText: item.label,
+                    checked: field.value === item.concept
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+            }));
+        }
+    })), IntakeAFormData.catchment_area === "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
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+        name: "regular_followup",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _errors_regular_followup;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                id: "regular_followup",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("regular_followup", "Is challenge anticipated to regularly follow in this facility?"))
+            }, field), {
+                invalid: !!errors.regular_followup,
+                invalidText: (_errors_regular_followup = errors.regular_followup) === null || _errors_regular_followup === void 0 ? void 0 : _errors_regular_followup.message,
+                onChange: function(value) {
+                    return field.onChange(value);
+                }
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.yesNoOptions.map(function(item) {
+                return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButton, {
+                    key: item.concept,
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+                    checked: field.value === item.concept
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+        }
+    }))), currentAge <= 4 && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.AccordionItem, {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].formContainer,
+        title: "FOR CHILD <5 YEARS ONLY",
+        open: true
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "mothers_name",
+        control: control,
+        rules: {
+            maxLength: {
+                value: 20,
+                message: "Please use a maximum of 20 characters"
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_mothers_name;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "mothers_name",
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("mothers_name", "Mother's First Name"))
+            }, field), {
+                invalid: !!errors.mothers_name,
+                invalidText: (_errors_mothers_name = errors.mothers_name) === null || _errors_mothers_name === void 0 ? void 0 : _errors_mothers_name.message
+            }));
+        }
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+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "mothers_father_name",
+        control: control,
+        rules: {
+            maxLength: {
+                value: 20,
+                message: "Please use a maximum of 20 characters"
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_mothers_father_name;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "mothers_father_name",
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("mothers_father_name", "Mother's Father's Name"))
+            }, field), {
+                invalid: !!errors.mothers_father_name,
+                invalidText: (_errors_mothers_father_name = errors.mothers_father_name) === null || _errors_mothers_father_name === void 0 ? void 0 : _errors_mothers_father_name.message
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+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "mothers_grandfather_name",
+        control: control,
+        rules: {
+            maxLength: {
+                value: 20,
+                message: "Please use a maximum of 20 characters"
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_mothers_grandfather_name;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "mothers_grandfather_name",
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("mothers_grandfather_name", "Mother's Grand Father's Name"))
+            }, field), {
+                invalid: !!errors.mothers_grandfather_name,
+                invalidText: (_errors_mothers_grandfather_name = errors.mothers_grandfather_name) === null || _errors_mothers_grandfather_name === void 0 ? void 0 : _errors_mothers_grandfather_name.message
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
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+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "placeOfDelivery",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_placeOfDelivery;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                id: "placeOfDelivery",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("placeOfDelivery", "Place of delivery"))
+            }, field), {
+                invalid: !!errors.placeOfDelivery,
+                invalidText: (_errors_placeOfDelivery = errors.placeOfDelivery) === null || _errors_placeOfDelivery === void 0 ? void 0 : _errors_placeOfDelivery.message,
+                onChange: function(value) {
+                    return field.onChange(value);
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+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.placeOfDeliveryOpt.map(function(item) {
+                return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButton, {
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+                    labelText: item.label,
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+    })), IntakeAFormData.placeOfDelivery === "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
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+        name: "otherPlaceOfDelivery",
+        control: control,
+        rules: {
+            maxLength: {
+                value: 50,
+                message: "Please use a maximum of 50 characters"
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_otherPlaceOfDelivery;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                id: "otherPlaceOfDelivery",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("otherPlaceOfDelivery", "Other place of delivery"))
+            }, field), {
+                invalid: !!errors.otherPlaceOfDelivery,
+                invalidText: (_errors_otherPlaceOfDelivery = errors.otherPlaceOfDelivery) === null || _errors_otherPlaceOfDelivery === void 0 ? void 0 : _errors_otherPlaceOfDelivery.message
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
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+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "modeOfDelivery",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_modeOfDelivery;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                id: "modeOfDelivery",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("modeOfDelivery", "Mode of delivery"))
+            }, field), {
+                invalid: !!errors.modeOfDelivery,
+                invalidText: (_errors_modeOfDelivery = errors.modeOfDelivery) === null || _errors_modeOfDelivery === void 0 ? void 0 : _errors_modeOfDelivery.message,
+                onChange: function(value) {
+                    return field.onChange(value);
+                }
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.modeOfDeliveryOpt.map(function(item) {
+                return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButton, {
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+                    value: item.concept,
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+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "otherModeOfDelivery",
+        control: control,
+        rules: {
+            maxLength: {
+                value: 50,
+                message: "Please use a maximum of 50 characters"
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_otherModeOfDelivery;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                id: "otherModeOfDelivery",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("otherModeOfDelivery", "Other mode of delivery"))
+            }, field), {
+                invalid: !!errors.otherModeOfDelivery,
+                invalidText: (_errors_otherModeOfDelivery = errors.otherModeOfDelivery) === null || _errors_otherModeOfDelivery === void 0 ? void 0 : _errors_otherModeOfDelivery.message
+            }));
+        }
+    }))), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.AccordionItem, {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].formContainer,
+        title: "HIV TEST INFORMATION",
+        open: true
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "date_confirmed",
+        control: control,
+        rules: {
+            required: "Date confirmed HIV+ / Retesting is required"
+        },
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_date_confirmed;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_3__.OpenmrsDatePicker, _object_spread_props(_object_spread({
+                isReadOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view
+            }, field), {
+                id: "date_confirmed",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("date_confirmed", "Date confirmed HIV+ / Retesting"), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].required
+                }, "*")),
+                minDate: birthDate,
+                maxDate: encounterDate,
+                invalid: !!errors.date_confirmed,
+                invalidText: (_errors_date_confirmed = errors.date_confirmed) === null || _errors_date_confirmed === void 0 ? void 0 : _errors_date_confirmed.message
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "test_type",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_test_type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                id: "test_type",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("test_type", "Type of HIV test"))
+            }, field), {
+                invalid: !!errors.test_type,
+                invalidText: (_errors_test_type = errors.test_type) === null || _errors_test_type === void 0 ? void 0 : _errors_test_type.message,
+                onChange: function(value) {
+                    return field.onChange(value);
+                }
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.testTypeOpt.map(function(item) {
+                return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButton, {
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+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].formContainer,
+        title: "CLIENT REFERRAL INFORMATION",
+        open: true
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "entryPoint",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_test_type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                id: "entryPoint",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("test_type", "Entry point"))
+            }, field), {
+                invalid: !!errors.test_type,
+                invalidText: (_errors_test_type = errors.test_type) === null || _errors_test_type === void 0 ? void 0 : _errors_test_type.message,
+                onChange: function(value) {
+                    return field.onChange(value);
+                }
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.entryPointOpt.map(function(item) {
+                return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButton, {
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+                    value: item.concept,
+                    labelText: item.label,
+                    checked: field.value === item.concept
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+    })), IntakeAFormData.entryPoint === "163266AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
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+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "within_the_facility",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_within_the_facility;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.Select, _object_spread_props(_object_spread({
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                id: "within_the_facility",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("within_the_facility", "From Within the Health Facility"))
+            }, field), {
+                invalid: !!errors.within_the_facility,
+                invalidText: (_errors_within_the_facility = errors.within_the_facility) === null || _errors_within_the_facility === void 0 ? void 0 : _errors_within_the_facility.message
+            }), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.SelectItem, {
+                value: "",
+                text: "Select"
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.withinInFacilityOpt.map(function(item) {
+                return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.SelectItem, {
+                    key: item.concept,
+                    value: item.concept,
+                    text: item.label
+                });
+            }));
+        }
+    })), IntakeAFormData.within_the_facility === "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "otherEntryPointWithinTheFacility",
+        control: control,
+        rules: {
+            maxLength: {
+                value: 50,
+                message: "Please use a maximum of 50 characters"
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_otherEntryPointWithinTheFacility;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                id: "otherEntryPointWithinTheFacility",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("otherEntryPointWithinTheFacility", "Other entry point within the facility"))
+            }, field), {
+                invalid: !!errors.otherEntryPointWithinTheFacility,
+                invalidText: (_errors_otherEntryPointWithinTheFacility = errors.otherEntryPointWithinTheFacility) === null || _errors_otherEntryPointWithinTheFacility === void 0 ? void 0 : _errors_otherEntryPointWithinTheFacility.message
+            }));
+        }
+    })), IntakeAFormData.entryPoint === "164407AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "outside_the_facility",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_outside_the_facility;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.Select, _object_spread_props(_object_spread({
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                id: "outside_the_facility",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("outside_the_facility", "Outside the Health Facility"))
+            }, field), {
+                invalid: !!errors.outside_the_facility,
+                invalidText: (_errors_outside_the_facility = errors.outside_the_facility) === null || _errors_outside_the_facility === void 0 ? void 0 : _errors_outside_the_facility.message
+            }), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.SelectItem, {
+                value: "",
+                text: "Select"
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.outsideTheFacility.map(function(item) {
+                return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.SelectItem, {
+                    key: item.concept,
+                    value: item.concept,
+                    text: item.label
+                });
+            }));
+        }
+    })), IntakeAFormData.entryPoint === "164407AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && IntakeAFormData.outside_the_facility === "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "otherEntryPointOutsideTheFacility",
+        control: control,
+        rules: {
+            maxLength: {
+                value: 50,
+                message: "Please use a maximum of 50 characters"
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_otherEntryPointOutsideTheFacility;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                id: "otherEntryPointOutsideTheFacility",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("otherEntryPointOutsideTheFacility", "Other entry point outside the facility"))
+            }, field), {
+                invalid: !!errors.otherEntryPointOutsideTheFacility,
+                invalidText: (_errors_otherEntryPointOutsideTheFacility = errors.otherEntryPointOutsideTheFacility) === null || _errors_otherEntryPointOutsideTheFacility === void 0 ? void 0 : _errors_otherEntryPointOutsideTheFacility.message
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "reason_for_referral",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _errors_reason_for_referral;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                readOnly: true,
+                id: "reason_for_referral",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("reason_for_referral", "Reason for referral"))
+            }, field), {
+                invalid: !!errors.reason_for_referral,
+                invalidText: (_errors_reason_for_referral = errors.reason_for_referral) === null || _errors_reason_for_referral === void 0 ? void 0 : _errors_reason_for_referral.message,
+                onChange: function(value) {
+                    return field.onChange(value);
+                }
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.reasonForReferralOpt.map(function(item) {
+                return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButton, {
+                    key: item.concept,
+                    value: item.concept,
+                    labelText: item.label,
+                    checked: field.value === item.concept
+                });
+            }));
+        }
+    }))), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.AccordionItem, {
+        className: "formContainer",
+        title: "CARE GIVER/EMERGENCY CONTACT INFORMATION",
+        open: true
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: "fieldWrapper"
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "careGiverKnown",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_careGiverKnown;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread(_object_spread_props(_object_spread({
+                orientation: "vertical",
+                id: "careGiverKnown"
+            }, field), {
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("careGiverKnown", "Care giver/Emergency contact known?"))
+            }), field), {
+                invalid: !!errors.careGiverKnown,
+                invalidText: (_errors_careGiverKnown = errors.careGiverKnown) === null || _errors_careGiverKnown === void 0 ? void 0 : _errors_careGiverKnown.message
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.yesNoOptions.map(function(item) {
+                return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButton, {
+                    key: item.concept,
+                    value: item.concept,
+                    labelText: item.label,
+                    checked: field.value === item.concept
+                });
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_care_giver__WEBPACK_IMPORTED_MODULE_11__["default"], {
+        control: controlPerson,
+        setValue: setValuePerson,
+        watch: watchPerson,
+        readonly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+        intakeAData: IntakeAFormData,
+        ControllerIntake: react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller,
+        controlIntake: control,
+        errorsPerson: errorsPerson
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.AccordionItem, {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].formContainer,
+        title: "DISCLOSURE AT ENROLLMENT",
+        open: true
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "hasFamilyMember",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _errors_hasFamilyMember;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                readOnly: true,
+                id: "hasFamilyMember",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("hasFamilyMember", "Does the client have family members (spouse/parent and children/siblings) < 15 years old"))
+            }, field), {
+                invalid: !!errors.hasFamilyMember,
+                invalidText: (_errors_hasFamilyMember = errors.hasFamilyMember) === null || _errors_hasFamilyMember === void 0 ? void 0 : _errors_hasFamilyMember.message,
+                onChange: function(value) {
+                    return field.onChange(value);
+                }
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.yesNoOptions.map(function(item) {
+                return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButton, {
+                    key: item.concept,
+                    value: item.concept,
+                    labelText: item.label,
+                    checked: field.value === item.concept
+                });
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "hivDisclosure",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_hivDisclosure;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                id: "hivDisclosure",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("hivDisclosure", "Does anyone else know about your/your child's HIV status"))
+            }, field), {
+                invalid: !!errors.hivDisclosure,
+                invalidText: (_errors_hivDisclosure = errors.hivDisclosure) === null || _errors_hivDisclosure === void 0 ? void 0 : _errors_hivDisclosure.message,
+                onChange: function(value) {
+                    return field.onChange(value);
+                }
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.yesNoOptions.map(function(item) {
+                return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButton, {
+                    key: item.concept,
+                    value: item.concept,
+                    labelText: item.label,
+                    checked: field.value === item.concept
+                });
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "whoKnows",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_whoKnows, _field_value;
+            var initialSelectedItems = _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.whoKnowsOpt.filter(function(item) {
+                var _field_value_selectedItems, _field_value, _field;
+                return (_field = field) === null || _field === void 0 ? void 0 : (_field_value = _field.value) === null || _field_value === void 0 ? void 0 : (_field_value_selectedItems = _field_value.selectedItems) === null || _field_value_selectedItems === void 0 ? void 0 : _field_value_selectedItems.some(function(selected) {
+                    return selected.concept === item.concept;
+                });
+            });
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.MultiSelect, {
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                id: "whoKnows",
+                titleText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, " ", t("whoKnows", "If yes, who knows your/your child's HIV status?")),
+                // label={t('whoKnows', 'who Knows')}
+                initialSelectedItems: initialSelectedItems,
+                items: _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.whoKnowsOpt,
+                itemToString: function(item) {
+                    return item ? item.label : "";
+                },
+                sortItems: function(items) {
+                    return items;
+                },
+                invalid: !!errors.whoKnows,
+                invalidText: (_errors_whoKnows = errors.whoKnows) === null || _errors_whoKnows === void 0 ? void 0 : _errors_whoKnows.message,
+                onChange: function(param) {
+                    var selectedItems = param.selectedItems;
+                    field.onChange({
+                        selectedItems: selectedItems
+                    });
+                    field.onBlur();
+                },
+                onBlur: function() {
+                    return field.onBlur();
+                },
+                value: ((_field_value = field.value) === null || _field_value === void 0 ? void 0 : _field_value.selectedItems) || []
+            });
+        }
+    }), (_IntakeAFormData = IntakeAFormData) === null || _IntakeAFormData === void 0 ? void 0 : (_IntakeAFormData_whoKnows = _IntakeAFormData.whoKnows) === null || _IntakeAFormData_whoKnows === void 0 ? void 0 : (_IntakeAFormData_whoKnows_selectedItems = _IntakeAFormData_whoKnows.selectedItems) === null || _IntakeAFormData_whoKnows_selectedItems === void 0 ? void 0 : _IntakeAFormData_whoKnows_selectedItems.map(function(data) {
+        return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.Tag, {
+            key: data.concept,
+            type: "gray"
+        }, data.label);
+    })), ((_IntakeAFormData1 = IntakeAFormData) === null || _IntakeAFormData1 === void 0 ? void 0 : (_IntakeAFormData_whoKnows1 = _IntakeAFormData1.whoKnows) === null || _IntakeAFormData_whoKnows1 === void 0 ? void 0 : (_IntakeAFormData_whoKnows_selectedItems1 = _IntakeAFormData_whoKnows1.selectedItems) === null || _IntakeAFormData_whoKnows_selectedItems1 === void 0 ? void 0 : _IntakeAFormData_whoKnows_selectedItems1.some(function(item) {
+        return item.concept === "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+    })) && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "otherPersonThatKnows",
+        control: control,
+        rules: {
+            maxLength: {
+                value: 50,
+                message: "Please use a maximum of 50 characters"
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_otherPersonThatKnows;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                id: "otherPersonThatKnows",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("otherPersonThatKnows", "Other person that knows your/your child's HIV positive status"))
+            }, field), {
+                invalid: !!errors.otherPersonThatKnows,
+                invalidText: (_errors_otherPersonThatKnows = errors.otherPersonThatKnows) === null || _errors_otherPersonThatKnows === void 0 ? void 0 : _errors_otherPersonThatKnows.message
+            }));
+        }
+    }))), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.AccordionItem, {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].formContainer,
+        title: "NOTES",
+        open: true
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_14__.Controller, {
+        name: "notes",
+        control: control,
+        rules: {
+            maxLength: {
+                value: 250,
+                message: "Please use a maximum of 250 characters"
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _errors_notes;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextArea, _object_spread_props(_object_spread({
+                id: "notes",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].label
+                }, t("notes", "Notes")),
+                rows: 1
+            }, field), {
+                invalid: !!errors.notes,
+                invalidText: (_errors_notes = errors.notes) === null || _errors_notes === void 0 ? void 0 : _errors_notes.message
+            }));
+        }
+    })))))), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].stickyButtonSet
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.Button, {
+        kind: "secondary",
+        onClick: function() {
+            return (0,_openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_3__.closeWorkspace)("intake-a-form-workspace");
+        },
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].button
+    }, "Discard"), !((_type1 = type) === null || _type1 === void 0 ? void 0 : _type1.view) && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.Button, {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_2__["default"].button,
+        kind: "primary",
+        type: "submit",
+        disabled: isSubmitting
+    }, isSubmitting ? /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.InlineLoading, null) : ((_type2 = type) === null || _type2 === void 0 ? void 0 : _type2.edit) ? "Update" : "Save")));
+};
+/* harmony default export */ const __WEBPACK_DEFAULT_EXPORT__ = (IntakeAForm);
+
+
+/***/ }),
+
+/***/ "./src/utils/data-table.resource.ts":
+/*!******************************************!*\
+  !*** ./src/utils/data-table.resource.ts ***!
+  \******************************************/
+/***/ ((__unused_webpack_module, __webpack_exports__, __webpack_require__) => {
+
+__webpack_require__.r(__webpack_exports__);
+/* harmony export */ __webpack_require__.d(__webpack_exports__, {
+/* harmony export */   useEncounterRows: () => (/* binding */ useEncounterRows),
+/* harmony export */   useEncounters: () => (/* binding */ useEncounters),
+/* harmony export */   useFetchLocation: () => (/* binding */ useFetchLocation),
+/* harmony export */   useLatestObs: () => (/* binding */ useLatestObs),
+/* harmony export */   usePatientDeathStatus: () => (/* binding */ usePatientDeathStatus)
+/* harmony export */ });
+/* harmony import */ var _openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_0__ = __webpack_require__(/*! @openmrs/esm-framework */ "webpack/sharing/consume/default/@openmrs/esm-framework/@openmrs/esm-framework");
+/* harmony import */ var _openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_0___default = /*#__PURE__*/__webpack_require__.n(_openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_0__);
+/* harmony import */ var swr__WEBPACK_IMPORTED_MODULE_1__ = __webpack_require__(/*! swr */ "./node_modules/swr/dist/core/index.mjs");
+/* harmony import */ var _constants__WEBPACK_IMPORTED_MODULE_2__ = __webpack_require__(/*! ../constants */ "./src/constants.ts");
+/* harmony import */ var react__WEBPACK_IMPORTED_MODULE_3__ = __webpack_require__(/*! react */ "webpack/sharing/consume/default/react/react");
+/* harmony import */ var react__WEBPACK_IMPORTED_MODULE_3___default = /*#__PURE__*/__webpack_require__.n(react__WEBPACK_IMPORTED_MODULE_3__);
+function _array_like_to_array(arr, len) {
+    if (len == null || len > arr.length) len = arr.length;
+    for(var i = 0, arr2 = new Array(len); i < len; i++)arr2[i] = arr[i];
+    return arr2;
+}
+function _array_with_holes(arr) {
+    if (Array.isArray(arr)) return arr;
+}
+function _array_without_holes(arr) {
+    if (Array.isArray(arr)) return _array_like_to_array(arr);
+}
+function _iterable_to_array(iter) {
+    if (typeof Symbol !== "undefined" && iter[Symbol.iterator] != null || iter["@@iterator"] != null) return Array.from(iter);
+}
+function _iterable_to_array_limit(arr, i) {
+    var _i = arr == null ? null : typeof Symbol !== "undefined" && arr[Symbol.iterator] || arr["@@iterator"];
+    if (_i == null) return;
+    var _arr = [];
+    var _n = true;
+    var _d = false;
+    var _s, _e;
+    try {
+        for(_i = _i.call(arr); !(_n = (_s = _i.next()).done); _n = true){
+            _arr.push(_s.value);
+            if (i && _arr.length === i) break;
+        }
+    } catch (err) {
+        _d = true;
+        _e = err;
+    } finally{
+        try {
+            if (!_n && _i["return"] != null) _i["return"]();
+        } finally{
+            if (_d) throw _e;
+        }
+    }
+    return _arr;
+}
+function _non_iterable_rest() {
+    throw new TypeError("Invalid attempt to destructure non-iterable instance.\\nIn order to be iterable, non-array objects must have a [Symbol.iterator]() method.");
+}
+function _non_iterable_spread() {
+    throw new TypeError("Invalid attempt to spread non-iterable instance.\\nIn order to be iterable, non-array objects must have a [Symbol.iterator]() method.");
+}
+function _sliced_to_array(arr, i) {
+    return _array_with_holes(arr) || _iterable_to_array_limit(arr, i) || _unsupported_iterable_to_array(arr, i) || _non_iterable_rest();
+}
+function _to_consumable_array(arr) {
+    return _array_without_holes(arr) || _iterable_to_array(arr) || _unsupported_iterable_to_array(arr) || _non_iterable_spread();
+}
+function _unsupported_iterable_to_array(o, minLen) {
+    if (!o) return;
+    if (typeof o === "string") return _array_like_to_array(o, minLen);
+    var n = Object.prototype.toString.call(o).slice(8, -1);
+    if (n === "Object" && o.constructor) n = o.constructor.name;
+    if (n === "Map" || n === "Set") return Array.from(n);
+    if (n === "Arguments" || /^(?:Ui|I)nt(?:8|16|32)(?:Clamped)?Array$/.test(n)) return _array_like_to_array(o, minLen);
+}
+
+
+
+
+
+function useEncounters(patientUuid, encounterType) {
+    var _data;
+    var encountersUrl = "".concat(_openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_0__.restBaseUrl, "/encounter?patient=").concat(patientUuid, "&encounterType=").concat(encounterType, "&v=").concat(_constants__WEBPACK_IMPORTED_MODULE_2__.encounterRepresentation);
+    var _useSWR = (0,swr__WEBPACK_IMPORTED_MODULE_1__["default"])(patientUuid ? encountersUrl : null, _openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_0__.openmrsFetch), data = _useSWR.data, error = _useSWR.error, isLoading = _useSWR.isLoading, isValidating = _useSWR.isValidating, mutate = _useSWR.mutate;
+    return {
+        encounters: data ? (_data = data) === null || _data === void 0 ? void 0 : _data.data.results : [],
+        isError: error,
+        isLoading: isLoading,
+        isValidating: isValidating,
+        mutate: mutate
+    };
+}
+function useEncounterRows(patientUuid, encounterType, pageSize, pageNumber) {
+    var _response_data, _response;
+    var _useState = _sliced_to_array((0,react__WEBPACK_IMPORTED_MODULE_3__.useState)([]), 2), encounters = _useState[0], setEncounters = _useState[1];
+    var startIndex = (pageNumber - 1) * pageSize;
+    var url = "/ws/rest/v1/encounter?encounterType=".concat(encounterType, "&patient=").concat(patientUuid, "&v=").concat(_constants__WEBPACK_IMPORTED_MODULE_2__.encounterRepresentation, "&totalCount=true&limit=").concat(pageSize, "&startIndex=").concat(startIndex);
+    var _useSWR = (0,swr__WEBPACK_IMPORTED_MODULE_1__["default"])(url, _openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_0__.openmrsFetch), response = _useSWR.data, error = _useSWR.error, isLoading = _useSWR.isLoading, mutate = _useSWR.mutate;
+    (0,react__WEBPACK_IMPORTED_MODULE_3__.useEffect)(function() {
+        if (response) {
+            response.data.results.sort(function(a, b) {
+                return new Date(b.encounterDatetime).getTime() - new Date(a.encounterDatetime).getTime();
+            });
+            setEncounters(_to_consumable_array(response.data.results));
+        }
+    }, [
+        response
+    ]);
+    return {
+        encounters: encounters,
+        total: (_response = response) === null || _response === void 0 ? void 0 : (_response_data = _response.data) === null || _response_data === void 0 ? void 0 : _response_data.totalCount,
+        isLoading: isLoading,
+        isError: error,
+        mutate: mutate
+    };
+}
+function usePatientDeathStatus(patientUuid) {
+    var _response_data, _response;
+    var _useSWRImmutable = (0,swr__WEBPACK_IMPORTED_MODULE_1__["default"])("/ws/rest/v1/person/".concat(patientUuid, "?v=custom:(dead)"), _openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_0__.openmrsFetch), response = _useSWRImmutable.data, isLoading = _useSWRImmutable.isLoading, error = _useSWRImmutable.error;
+    return {
+        isDead: !isLoading && !error && response ? (_response = response) === null || _response === void 0 ? void 0 : (_response_data = _response.data) === null || _response_data === void 0 ? void 0 : _response_data.dead : false
+    };
+}
+function useLatestObs(patientUuid, conceptUuid, encounterType) {
+    var _response_data_entry, _response_data, _response, _response_data_entry_, _response_data1, _response1;
+    var searchParams = new URLSearchParams({
+        patient: patientUuid,
+        code: conceptUuid,
+        _sort: "-_lastUpdated",
+        _count: "1"
+    });
+    if (encounterType) {
+        searchParams.append("encounter.type", encounterType);
+    }
+    var url = "".concat(_openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_0__.fhirBaseUrl, "/Observation?").concat(searchParams.toString());
+    var _useSWR = (0,swr__WEBPACK_IMPORTED_MODULE_1__["default"])(url, _openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_0__.openmrsFetch), response = _useSWR.data, error = _useSWR.error, isLoading = _useSWR.isLoading;
+    return {
+        latestMatched: ((_response = response) === null || _response === void 0 ? void 0 : (_response_data = _response.data) === null || _response_data === void 0 ? void 0 : (_response_data_entry = _response_data.entry) === null || _response_data_entry === void 0 ? void 0 : _response_data_entry.length) ? (_response1 = response) === null || _response1 === void 0 ? void 0 : (_response_data1 = _response1.data) === null || _response_data1 === void 0 ? void 0 : (_response_data_entry_ = _response_data1.entry[0]) === null || _response_data_entry_ === void 0 ? void 0 : _response_data_entry_.resource : null,
+        latestLoading: isLoading,
+        latestError: error
+    };
+}
+function useFetchLocation() {
+    var _useState = _sliced_to_array((0,react__WEBPACK_IMPORTED_MODULE_3__.useState)([]), 2), encounters = _useState[0], setEncounters = _useState[1];
+    var url = "".concat(_openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_0__.restBaseUrl, "/location?v=default");
+    var _useSWR = (0,swr__WEBPACK_IMPORTED_MODULE_1__["default"])(url, _openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_0__.openmrsFetch), response = _useSWR.data, error = _useSWR.error, isLoading = _useSWR.isLoading, mutate = _useSWR.mutate;
+    (0,react__WEBPACK_IMPORTED_MODULE_3__.useEffect)(function() {
+        if (response) {
+            response.data.results.sort(function(a, b) {
+                return new Date(b.encounterDatetime).getTime() - new Date(a.encounterDatetime).getTime();
+            });
+            setEncounters(_to_consumable_array(response.data.results));
+        }
+    }, [
+        response
+    ]);
+    return {
+        encounters: encounters,
+        isLoading: isLoading,
+        isError: error
+    };
+}
+
+
+/***/ })
+
+}]);
+//# sourceMappingURL=src_forms_intake-a-form_tsx.js.map