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

package/dist/src_forms_intake-b-form_tsx.js

@@ -0,0 +1,2684 @@
+"use strict";
+(globalThis["webpackChunk_icap_ethiopia_esm_ethiohri_intake"] = globalThis["webpackChunk_icap_ethiopia_esm_ethiohri_intake"] || []).push([["src_forms_intake-b-form_tsx"],{
+
+/***/ "./src/forms/intake-b-form.tsx":
+/*!*************************************!*\
+  !*** ./src/forms/intake-b-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 _carbon_react__WEBPACK_IMPORTED_MODULE_1__ = __webpack_require__(/*! @carbon/react */ "./node_modules/@carbon/react/es/index.js");
+/* harmony import */ var react_hook_form__WEBPACK_IMPORTED_MODULE_12__ = __webpack_require__(/*! react-hook-form */ "./node_modules/react-hook-form/dist/index.esm.mjs");
+/* harmony import */ var _openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_2__ = __webpack_require__(/*! @openmrs/esm-framework */ "webpack/sharing/consume/default/@openmrs/esm-framework/@openmrs/esm-framework");
+/* harmony import */ var _openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_2___default = /*#__PURE__*/__webpack_require__.n(_openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_2__);
+/* harmony import */ var _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__ = __webpack_require__(/*! ./intake-form.scss */ "./src/forms/intake-form.scss");
+/* harmony import */ var dayjs__WEBPACK_IMPORTED_MODULE_4__ = __webpack_require__(/*! dayjs */ "webpack/sharing/consume/default/dayjs/dayjs");
+/* harmony import */ var dayjs__WEBPACK_IMPORTED_MODULE_4___default = /*#__PURE__*/__webpack_require__.n(dayjs__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 _hooks_useFetchLocation__WEBPACK_IMPORTED_MODULE_6__ = __webpack_require__(/*! ./hooks/useFetchLocation */ "./src/forms/hooks/useFetchLocation.ts");
+/* harmony import */ var _hooks_defaultValuesFromEncounter__WEBPACK_IMPORTED_MODULE_7__ = __webpack_require__(/*! ./hooks/defaultValuesFromEncounter */ "./src/forms/hooks/defaultValuesFromEncounter.ts");
+/* harmony import */ var _constants__WEBPACK_IMPORTED_MODULE_8__ = __webpack_require__(/*! ../constants */ "./src/constants.ts");
+/* harmony import */ var react_i18next__WEBPACK_IMPORTED_MODULE_9__ = __webpack_require__(/*! react-i18next */ "webpack/sharing/consume/default/react-i18next/react-i18next");
+/* harmony import */ var react_i18next__WEBPACK_IMPORTED_MODULE_9___default = /*#__PURE__*/__webpack_require__.n(react_i18next__WEBPACK_IMPORTED_MODULE_9__);
+/* harmony import */ var _hooks_createEncounter__WEBPACK_IMPORTED_MODULE_10__ = __webpack_require__(/*! ./hooks/createEncounter */ "./src/forms/hooks/createEncounter.ts");
+/* harmony import */ var _utils_data_table_resource__WEBPACK_IMPORTED_MODULE_11__ = __webpack_require__(/*! ../utils/data-table.resource */ "./src/utils/data-table.resource.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 IntakeBForm = function(param) {
+    var encounter = param.encounter, type = param.type, mutateEncounters = param.mutateEncounters;
+    var _patient_patient, _patient, _patient_patient1, _patient1, _latestMatched, _intakeBFormValues_HIVRelatedOIs_selectedItems, _intakeBFormValues_HIVRelatedOIs, _intakeBFormValues, _intakeBFormValues_HIVRelatedOIs_selectedItems1, _intakeBFormValues_HIVRelatedOIs1, _intakeBFormValues1, _intakeBFormValues_presentingComplaints_selectedItems, _intakeBFormValues_presentingComplaints, _intakeBFormValues2, _intakeBFormValues_presentingComplaints_selectedItems1, _intakeBFormValues_presentingComplaints1, _intakeBFormValues3, _intakeBFormValues_presentingComplaints_selectedItems2, _intakeBFormValues_presentingComplaints2, _intakeBFormValues4, _intakeBFormValues_whoWhy_selectedItems, _intakeBFormValues_whoWhy, _intakeBFormValues5, _intakeBFormValues_whyEligibleForART_selectedItems, _intakeBFormValues_whyEligibleForART, _intakeBFormValues6, _intakeBFormValues_whyEligibleForART_selectedItems1, _intakeBFormValues_whyEligibleForART1, _intakeBFormValues7, _type, _type1;
+    var encounterDate = new Date().toISOString();
+    var _useState = _sliced_to_array((0,react__WEBPACK_IMPORTED_MODULE_0__.useState)(false), 2), isSubmitting = _useState[0], setIsSubmitting = _useState[1];
+    var patient = (0,_openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_2__.usePatient)();
+    var session = (0,_openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_2__.useSession)();
+    var age = dayjs__WEBPACK_IMPORTED_MODULE_4___default()().diff(dayjs__WEBPACK_IMPORTED_MODULE_4___default()((_patient = patient) === null || _patient === void 0 ? void 0 : (_patient_patient = _patient.patient) === null || _patient_patient === void 0 ? void 0 : _patient_patient.birthDate), "year");
+    var sex = (_patient1 = patient) === null || _patient1 === void 0 ? void 0 : (_patient_patient1 = _patient1.patient) === null || _patient_patient1 === void 0 ? void 0 : _patient_patient1.gender;
+    var t = (0,react_i18next__WEBPACK_IMPORTED_MODULE_9__.useTranslation)().t;
+    var facilityInfo = (0,_hooks_useFetchLocation__WEBPACK_IMPORTED_MODULE_6__.useFetchLocation)().facilityInfo;
+    var latestMatched = (0,_utils_data_table_resource__WEBPACK_IMPORTED_MODULE_11__.useLatestObs)(patient.patientUuid, "160753AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", _constants__WEBPACK_IMPORTED_MODULE_8__.INTAKE_A_ENCOUNTER_TYPE).latestMatched;
+    var _latestMatched_valueDateTime;
+    var date_confirmed = (_latestMatched_valueDateTime = (_latestMatched = latestMatched) === null || _latestMatched === void 0 ? void 0 : _latestMatched.valueDateTime) !== null && _latestMatched_valueDateTime !== void 0 ? _latestMatched_valueDateTime : null;
+    var _useForm = (0,react_hook_form__WEBPACK_IMPORTED_MODULE_12__.useForm)({
+        defaultValues: encounter ? (0,_hooks_defaultValuesFromEncounter__WEBPACK_IMPORTED_MODULE_7__.defaultValuesFromEncounter)(encounter, _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.intakeBdefaultValues, _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.intakeBconceptsUuid, [
+            "339d3209-c797-457f-afb8-8d19d99c63b7",
+            "14718b2b-d38a-4f68-8e22-8bc739ae43f7",
+            "3bb2b035-fa5d-4abf-8d47-5f28fb9cf333",
+            "0675742c-ea84-4cab-a85f-54b46eadd1ee"
+        ]) : _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.intakeBdefaultValues,
+        mode: "all"
+    }), control = _useForm.control, handleSubmit = _useForm.handleSubmit, watch = _useForm.watch, setValue = _useForm.setValue, resetField = _useForm.resetField, _useForm_formState = _useForm.formState, errors = _useForm_formState.errors, touchedFields = _useForm_formState.touchedFields;
+    var intakeBFormValues = (0,react_hook_form__WEBPACK_IMPORTED_MODULE_12__.useWatch)({
+        control: control
+    });
+    (0,react__WEBPACK_IMPORTED_MODULE_0__.useEffect)(function() {
+        if (intakeBFormValues.areAllSystemsNormal === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA") {
+            setValue("heentExamination", "1115AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA");
+            setValue("lymphNodesExamination", "1115AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA");
+            setValue("chestExamination", "1115AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA");
+            setValue("heartExamination", "1115AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA");
+            setValue("abdomenExamination", "1115AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA");
+            setValue("genitourinarySystemExamination", "1115AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA");
+            setValue("musculoskeletalSystemExamination", "1115AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA");
+            setValue("skinExamination", "1115AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA");
+            setValue("nervousSystemExamination", "1115AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA");
+        }
+    }, [
+        setValue,
+        intakeBFormValues.areAllSystemsNormal,
+        intakeBFormValues.lymphNodesExamination,
+        intakeBFormValues.chestExamination,
+        intakeBFormValues.heartExamination,
+        intakeBFormValues.abdomenExamination,
+        intakeBFormValues.genitourinarySystemExamination,
+        intakeBFormValues.musculoskeletalSystemExamination,
+        intakeBFormValues.skinExamination,
+        intakeBFormValues.nervousSystemExamination
+    ]);
+    (0,react__WEBPACK_IMPORTED_MODULE_0__.useEffect)(function() {
+        var handleBmi = function() {
+            var height = intakeBFormValues.height;
+            var weight = intakeBFormValues.weight;
+            if (!height || !weight) return true;
+            var heightInMeters = height / 100;
+            var expectedBmi = weight / (heightInMeters * heightInMeters);
+            var roundedExpected = parseFloat(expectedBmi.toFixed(1));
+            setValue("bmi", roundedExpected);
+        };
+        handleBmi();
+    }, [
+        intakeBFormValues.height,
+        intakeBFormValues.weight,
+        setValue
+    ]);
+    var visibilityRules = (0,react__WEBPACK_IMPORTED_MODULE_0__.useMemo)(function() {
+        return {
+            HIVRelatedOIs: function(data) {
+                return data.opportunisticInfectionPresent === "131768AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            otherOpportunisticIllnesses: function(data) {
+                var _data_HIVRelatedOIs_selectedItems, _data_HIVRelatedOIs;
+                return data.opportunisticInfectionPresent === "131768AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && ((_data_HIVRelatedOIs = data.HIVRelatedOIs) === null || _data_HIVRelatedOIs === void 0 ? void 0 : (_data_HIVRelatedOIs_selectedItems = _data_HIVRelatedOIs.selectedItems) === null || _data_HIVRelatedOIs_selectedItems === void 0 ? void 0 : _data_HIVRelatedOIs_selectedItems.some(function(item) {
+                    return item.concept === "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+                }));
+            },
+            healthFacility: function(data) {
+                return data.ARVForPMTCT === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            regimenForMother: function(data) {
+                return data.ARVForPMTCT === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            regimenForBaby: function(data) {
+                return data.ARVForPMTCT === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            Regimen: function(data) {
+                return data.lifelongARTTI === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            artStartDate: function(data) {
+                return data.lifelongARTTI === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            monthsOnART: function(data) {
+                return data.lifelongARTTI === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            stillonTreatment: function(data) {
+                return data.lifelongARTTI === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            headCircumference: function(data) {
+                return age <= 5;
+            },
+            anthropometryInterpretation: function(data) {
+                return age <= 5;
+            },
+            developmentalStatus: function(data) {
+                return age <= 5;
+            },
+            pregnancyAtEnrollment: function(data) {
+                return sex === "female";
+            },
+            lmpDate: function(data) {
+                return sex === "female" && data.pregnancyAtEnrollment === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            eddDate: function(data) {
+                return sex === "female" && data.pregnancyAtEnrollment === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            otherPresentingComplaints: function(data) {
+                var _data_presentingComplaints_selectedItems, _data_presentingComplaints;
+                return (_data_presentingComplaints = data.presentingComplaints) === null || _data_presentingComplaints === void 0 ? void 0 : (_data_presentingComplaints_selectedItems = _data_presentingComplaints.selectedItems) === null || _data_presentingComplaints_selectedItems === void 0 ? void 0 : _data_presentingComplaints_selectedItems.some(function(item) {
+                    return item.concept === "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+                });
+            },
+            percentOfLostBodyWeight: function(data) {
+                var _data_presentingComplaints_selectedItems, _data_presentingComplaints;
+                return (_data_presentingComplaints = data.presentingComplaints) === null || _data_presentingComplaints === void 0 ? void 0 : (_data_presentingComplaints_selectedItems = _data_presentingComplaints.selectedItems) === null || _data_presentingComplaints_selectedItems === void 0 ? void 0 : _data_presentingComplaints_selectedItems.some(function(item) {
+                    return item.concept === "832AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+                });
+            },
+            heentExaminationComment: function(data) {
+                return data.heentExamination === "1116AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            lymphNodesExaminationComment: function(data) {
+                return data.lymphNodesExamination === "1116AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            chestExaminationComment: function(data) {
+                return data.chestExamination === "1116AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            heartExaminationComment: function(data) {
+                return data.heartExamination === "1116AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            abdomenExaminationComment: function(data) {
+                return data.abdomenExamination === "1116AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            genitourinarySystemExaminationComment: function(data) {
+                return data.genitourinarySystemExamination === "1116AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            musculoskeletalSystemExaminationComment: function(data) {
+                return data.musculoskeletalSystemExamination === "1116AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            skinExaminationComment: function(data) {
+                return data.skinExamination === "1116AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            nervousSystemExaminationComment: function(data) {
+                return data.nervousSystemExamination === "1116AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            lymphNodesExamination: function(data) {
+                return data.areAllSystemsNormal === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            chestExamination: function(data) {
+                return data.areAllSystemsNormal === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            heartExamination: function(data) {
+                return data.areAllSystemsNormal === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            abdomenExamination: function(data) {
+                return data.areAllSystemsNormal === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            genitourinarySystemExamination: function(data) {
+                return data.areAllSystemsNormal === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            musculoskeletalSystemExamination: function(data) {
+                return data.areAllSystemsNormal === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            skinExamination: function(data) {
+                return data.areAllSystemsNormal === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            nervousSystemExamination: function(data) {
+                return data.areAllSystemsNormal === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            },
+            heentExamination: function(data) {
+                return data.areAllSystemsNormal === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+            }
+        };
+    }, [
+        sex,
+        age
+    ]);
+    (0,react__WEBPACK_IMPORTED_MODULE_0__.useEffect)(function() {
+        if (sex && age) {
+            Object.keys(visibilityRules).forEach(function(field) {
+                var isVisible = visibilityRules[field](intakeBFormValues);
+                if (!isVisible && intakeBFormValues[field] !== null && intakeBFormValues[field] !== undefined) {
+                    setValue(field, null, {
+                        shouldValidate: false,
+                        shouldDirty: false
+                    });
+                }
+            });
+        }
+    }, [
+        intakeBFormValues,
+        visibilityRules,
+        setValue,
+        sex,
+        age
+    ]);
+    var onSubmit = function() {
+        var _ref = _async_to_generator(function(data) {
+            var _encounter, _type, error;
+            return _ts_generator(this, function(_state) {
+                switch(_state.label){
+                    case 0:
+                        setIsSubmitting(true); // Set submitting state to true
+                        _state.label = 1;
+                    case 1:
+                        _state.trys.push([
+                            1,
+                            3,
+                            4,
+                            5
+                        ]);
+                        return [
+                            4,
+                            (0,_hooks_createEncounter__WEBPACK_IMPORTED_MODULE_10__.createEncounter)(data, {
+                                namespace: "rfe-forms",
+                                touchedFields: touchedFields,
+                                encounter: encounter,
+                                conceptsUuid: _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.intakeBconceptsUuid,
+                                encounterType: _constants__WEBPACK_IMPORTED_MODULE_8__.INTAKE_B_ENCOUNTER_TYPE,
+                                formUuid: _constants__WEBPACK_IMPORTED_MODULE_8__.intakeBFormUuid,
+                                encounterDate: encounterDate,
+                                patientUuid: patient.patientUuid,
+                                providerUuid: session.currentProvider.uuid,
+                                locationUuid: facilityInfo.uuid,
+                                visibilityRules: visibilityRules,
+                                encounterUuid: (_encounter = encounter) === null || _encounter === void 0 ? void 0 : _encounter.uuid,
+                                mutateEncounters: mutateEncounters,
+                                workspaceName: "intake-b-form-workspace",
+                                editMode: (_type = type) === null || _type === void 0 ? void 0 : _type.edit
+                            })
+                        ];
+                    case 2:
+                        _state.sent();
+                        return [
+                            3,
+                            5
+                        ];
+                    case 3:
+                        error = _state.sent();
+                        console.error("Error submitting form:", error);
+                        return [
+                            3,
+                            5
+                        ];
+                    case 4:
+                        setIsSubmitting(false); // Reset submitting state
+                        return [
+                            7
+                        ];
+                    case 5:
+                        return [
+                            2
+                        ];
+                }
+            });
+        });
+        return function onSubmit(data) {
+            return _ref.apply(this, arguments);
+        };
+    }();
+    return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.Form, {
+        onSubmit: handleSubmit(onSubmit),
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].formNEw
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("h2", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].heading
+    }, "HIV CARE/ART CLINIC INTAKE FORM-B"), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["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_3__["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, {
+        open: true,
+        title: "PAST OPPORTUNISTIC ILLNESS(OI), PROPHYLAXIS AND TREATMENT",
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].formContainer
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "opportunisticInfectionPresent",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_opportunisticInfectionPresent;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Past Opportunistic Illnesses(OIs) present")
+            }, field), {
+                disabled: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.opportunisticInfectionPresent,
+                invalidText: (_errors_opportunisticInfectionPresent = errors.opportunisticInfectionPresent) === null || _errors_opportunisticInfectionPresent === void 0 ? void 0 : _errors_opportunisticInfectionPresent.message
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.opportunisticInfectionPresentOpt.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
+                });
+            }));
+        }
+    })), intakeBFormValues.opportunisticInfectionPresent === "131768AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement((react__WEBPACK_IMPORTED_MODULE_0___default().Fragment), null, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "HIVRelatedOIs",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_HIVRelatedOIs, _field_value;
+            var initialSelectedItems = _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.HIVRelatedOIsOpt.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: "HIVRelatedOIs",
+                // label={
+                //   <span className={styles.label}>
+                //     {t('HIVRelatedOIs', 'Past Opportunistic Illnesses(OIs)')}
+                //   </span>
+                // }
+                titleText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, t("HIVRelatedOIs", "Past Opportunistic Illnesses(OIs)")),
+                initialSelectedItems: initialSelectedItems,
+                items: _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.HIVRelatedOIsOpt,
+                sortItems: function(items) {
+                    return items;
+                },
+                invalid: !!errors.HIVRelatedOIs,
+                invalidText: (_errors_HIVRelatedOIs = errors.HIVRelatedOIs) === null || _errors_HIVRelatedOIs === void 0 ? void 0 : _errors_HIVRelatedOIs.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) || []
+            });
+        }
+    }), (_intakeBFormValues = intakeBFormValues) === null || _intakeBFormValues === void 0 ? void 0 : (_intakeBFormValues_HIVRelatedOIs = _intakeBFormValues.HIVRelatedOIs) === null || _intakeBFormValues_HIVRelatedOIs === void 0 ? void 0 : (_intakeBFormValues_HIVRelatedOIs_selectedItems = _intakeBFormValues_HIVRelatedOIs.selectedItems) === null || _intakeBFormValues_HIVRelatedOIs_selectedItems === void 0 ? void 0 : _intakeBFormValues_HIVRelatedOIs_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);
+    })), ((_intakeBFormValues1 = intakeBFormValues) === null || _intakeBFormValues1 === void 0 ? void 0 : (_intakeBFormValues_HIVRelatedOIs1 = _intakeBFormValues1.HIVRelatedOIs) === null || _intakeBFormValues_HIVRelatedOIs1 === void 0 ? void 0 : (_intakeBFormValues_HIVRelatedOIs_selectedItems1 = _intakeBFormValues_HIVRelatedOIs1.selectedItems) === null || _intakeBFormValues_HIVRelatedOIs_selectedItems1 === void 0 ? void 0 : _intakeBFormValues_HIVRelatedOIs_selectedItems1.some(function(item) {
+        return item.concept === "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+    })) && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "otherOpportunisticIllnesses",
+        control: control,
+        rules: {
+            maxLength: {
+                value: 50,
+                message: "Please use a maximum of 50 characters"
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_otherOpportunisticIllnesses;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "otherOpportunisticIllnesses",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Other opportunistic illnesses")
+            }, field), {
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.otherOpportunisticIllnesses,
+                invalidText: (_errors_otherOpportunisticIllnesses = errors.otherOpportunisticIllnesses) === null || _errors_otherOpportunisticIllnesses === void 0 ? void 0 : _errors_otherOpportunisticIllnesses.message
+            }));
+        }
+    }))))), /*#__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, {
+        open: true,
+        title: "PAST PROPHYLAXIS/TREATMENT",
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].formContainer
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "cotrimoxazoleDateStarted",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _errors_cotrimoxazoleDateStarted, _type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_2__.OpenmrsDatePicker, {
+                id: "cotrimoxazoleDateStarted",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Cotrimoxazole started date"),
+                value: field.value,
+                maxDate: encounterDate,
+                onChange: function(date) {
+                    field.onChange(date);
+                    field.onBlur();
+                },
+                onBlur: function() {
+                    return field.onBlur();
+                },
+                invalid: !!errors.cotrimoxazoleDateStarted,
+                invalidText: (_errors_cotrimoxazoleDateStarted = errors.cotrimoxazoleDateStarted) === null || _errors_cotrimoxazoleDateStarted === void 0 ? void 0 : _errors_cotrimoxazoleDateStarted.message,
+                isReadOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view
+            });
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "cotrimoxazoleDateStopped",
+        control: control,
+        rules: {
+            validate: function(value) {
+                return !value || !intakeBFormValues.cotrimoxazoleDateStarted || new Date(value) > new Date(intakeBFormValues.cotrimoxazoleDateStarted) || "Cotrimoxazole stopped date should not be earlier than started date";
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _errors_cotrimoxazoleDateStopped, _type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_2__.OpenmrsDatePicker, {
+                id: "cotrimoxazoleDateStopped",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Cotrimoxazole stopped date"),
+                value: field.value,
+                maxDate: encounterDate,
+                onChange: function(date) {
+                    field.onChange(date);
+                    field.onBlur();
+                },
+                onBlur: function() {
+                    return field.onBlur();
+                },
+                invalid: !!errors.cotrimoxazoleDateStopped,
+                invalidText: (_errors_cotrimoxazoleDateStopped = errors.cotrimoxazoleDateStopped) === null || _errors_cotrimoxazoleDateStopped === void 0 ? void 0 : _errors_cotrimoxazoleDateStopped.message,
+                isReadOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view
+            });
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "TBProphylaxisType",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_TBProphylaxisType;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "TB prophylaxis type")
+            }, field), {
+                disabled: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.TBProphylaxisType,
+                invalidText: (_errors_TBProphylaxisType = errors.TBProphylaxisType) === null || _errors_TBProphylaxisType === void 0 ? void 0 : _errors_TBProphylaxisType.message
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.tbProphylaxisTypeOpt.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_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "inhStartedDate",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _errors_inhStartedDate, _type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_2__.OpenmrsDatePicker, {
+                id: "inhStartedDate",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "TPT started date"),
+                value: field.value,
+                maxDate: encounterDate,
+                onChange: function(date) {
+                    field.onChange(date);
+                    field.onBlur();
+                },
+                onBlur: function() {
+                    return field.onBlur();
+                },
+                invalid: !!errors.inhStartedDate,
+                invalidText: (_errors_inhStartedDate = errors.inhStartedDate) === null || _errors_inhStartedDate === void 0 ? void 0 : _errors_inhStartedDate.message,
+                isReadOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view
+            });
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "inhCompletedDate",
+        control: control,
+        rules: {
+            validate: function(value) {
+                return !value || !intakeBFormValues.inhStartedDate || new Date(value) > new Date(intakeBFormValues.inhStartedDate) || "TPT completed date should not be earlier than started date";
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _errors_inhCompletedDate, _type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_2__.OpenmrsDatePicker, {
+                id: "inhCompletedDate",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "TPT completed date"),
+                value: field.value,
+                maxDate: encounterDate,
+                onChange: function(date) {
+                    field.onChange(date);
+                    field.onBlur();
+                },
+                onBlur: function() {
+                    return field.onBlur();
+                },
+                invalid: !!errors.inhCompletedDate,
+                invalidText: (_errors_inhCompletedDate = errors.inhCompletedDate) === null || _errors_inhCompletedDate === void 0 ? void 0 : _errors_inhCompletedDate.message,
+                isReadOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view
+            });
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "fluconazolePreventiveTherapyDateStarted",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _errors_fluconazolePreventiveTherapyDateStarted, _type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_2__.OpenmrsDatePicker, {
+                id: "fluconazolePreventiveTherapyDateStarted",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Fluconazole Preventive Therapy (FPT) started date"),
+                value: field.value,
+                maxDate: encounterDate,
+                onChange: function(date) {
+                    field.onChange(date);
+                    field.onBlur();
+                },
+                onBlur: function() {
+                    return field.onBlur();
+                },
+                invalid: !!errors.fluconazolePreventiveTherapyDateStarted,
+                invalidText: (_errors_fluconazolePreventiveTherapyDateStarted = errors.fluconazolePreventiveTherapyDateStarted) === null || _errors_fluconazolePreventiveTherapyDateStarted === void 0 ? void 0 : _errors_fluconazolePreventiveTherapyDateStarted.message,
+                isReadOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view
+            });
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "fluconazolePreventiveTherapyDateCompleted",
+        control: control,
+        rules: {
+            validate: function(value) {
+                return !value || !intakeBFormValues.fluconazolePreventiveTherapyDateStarted || new Date(value) > new Date(intakeBFormValues.fluconazolePreventiveTherapyDateStarted) || "Fluconazole completed date should not be earlier than started date";
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _errors_fluconazolePreventiveTherapyDateCompleted, _type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_2__.OpenmrsDatePicker, {
+                id: "fluconazolePreventiveTherapyDateCompleted",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Fluconazole Preventive Therapy (FPT) completed date"),
+                value: field.value,
+                maxDate: encounterDate,
+                onChange: function(date) {
+                    field.onChange(date);
+                    field.onBlur();
+                },
+                onBlur: function() {
+                    return field.onBlur();
+                },
+                invalid: !!errors.fluconazolePreventiveTherapyDateCompleted,
+                invalidText: (_errors_fluconazolePreventiveTherapyDateCompleted = errors.fluconazolePreventiveTherapyDateCompleted) === null || _errors_fluconazolePreventiveTherapyDateCompleted === void 0 ? void 0 : _errors_fluconazolePreventiveTherapyDateCompleted.message,
+                isReadOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view
+            });
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "lifelongARTTI",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_lifelongARTTI;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Lifelong ART/TI")
+            }, field), {
+                disabled: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.lifelongARTTI,
+                invalidText: (_errors_lifelongARTTI = errors.lifelongARTTI) === null || _errors_lifelongARTTI === void 0 ? void 0 : _errors_lifelongARTTI.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
+                });
+            }));
+        }
+    })), intakeBFormValues.lifelongARTTI === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement((react__WEBPACK_IMPORTED_MODULE_0___default().Fragment), null, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "Regimen",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_Regimen;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.Select, _object_spread_props(_object_spread({
+                id: "Regimen",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Regimens")
+            }, field), {
+                disabled: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.Regimen,
+                invalidText: (_errors_Regimen = errors.Regimen) === null || _errors_Regimen === void 0 ? void 0 : _errors_Regimen.message,
+                helperText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].helperText
+                }, field.value === "2798d3bc-2e0a-459c-b249-9516b380a69e" || field.value === "3495d89f-4d46-44d8-b1c9-d101bc9f15d4" || field.value === "ae0dc59c-eb3d-421b-913b-ee5a06ec6182" || field.value === "c5995b5c-19bb-42f6-895b-0b4627bc9dd1" || field.value === "a9da3e97-3916-4834-854c-6bcbc5142aca" || field.value === "8b727274-4a3c-4a81-ae50-9f759a87358d" || field.value === "71ecf102-8d3d-4a2a-b799-30773ad5d447" || field.value === "a87d9674-11af-4440-afd0-d097d84d0393" || field.value === "82e23d8c-4c9d-4b18-a960-9f8890b86f2f" || field.value === "cf29c24b-b796-4536-aaa5-8303f45bb5f8" || field.value === "2e84a82a-8b93-40fc-a556-2028d39f5710" || field.value === "c33efc4a-734f-4e89-92a4-71b259a5e547" || field.value === "7bbee32a-31a8-4199-a8a2-2d15c748d80a" || field.value === "756b4487-f358-4817-b248-9c05080bad67" || field.value === "fcafc964-f018-41c8-9dc9-343a2f4a94b5" || field.value === "7c30ed1a-a770-4b74-8704-82077427128d" || field.value === "18c78c5f-082c-4acc-a121-62fa334f34d3" || field.value === "5c9424e6-4f18-44e1-a074-e561643a7d91" || field.value === "2e58ef33-d019-4bd9-97b8-553e39e12646" || field.value === "8feb33db-71db-4fd0-a0e7-c02f81fcc76f" || field.value === "5415f1b1-a680-4870-89c5-3324d42da408" || field.value === "3e7d018b-9669-4f48-9298-d7c633f86b0f" ? "Warning: This Regimen is retired." : "")
+            }), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.SelectItem, {
+                text: "Select",
+                value: ""
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.regimenOpt.map(function(option) {
+                return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.SelectItem, {
+                    key: option.concept,
+                    text: option.label,
+                    value: option.concept
+                });
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "artStartDate",
+        control: control,
+        rules: {
+            validate: function(value) {
+                if (!value || !date_confirmed) return true;
+                return new Date(value) >= new Date(date_confirmed) ? true : "ART start date should not be before HIV confirmed date in Intake A";
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _errors_artStartDate, _type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_2__.OpenmrsDatePicker, {
+                id: "artStartDate",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "ART Start date"),
+                value: field.value,
+                maxDate: encounterDate,
+                onChange: function(date) {
+                    field.onChange(date);
+                    field.onBlur();
+                },
+                onBlur: function() {
+                    return field.onBlur();
+                },
+                invalid: !!errors.artStartDate,
+                invalidText: (_errors_artStartDate = errors.artStartDate) === null || _errors_artStartDate === void 0 ? void 0 : _errors_artStartDate.message,
+                isReadOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view
+            });
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "monthsOnART",
+        control: control,
+        rules: {
+            pattern: {
+                value: /^\d{1,3}$/,
+                message: "Months on ART should not be more than three digits long"
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_monthsOnART;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "monthsOnART",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Months on ART")
+            }, field), {
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.monthsOnART,
+                invalidText: (_errors_monthsOnART = errors.monthsOnART) === null || _errors_monthsOnART === void 0 ? void 0 : _errors_monthsOnART.message
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "stillonTreatment",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_stillonTreatment;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Still on Treatment")
+            }, field), {
+                disabled: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.stillonTreatment,
+                invalidText: (_errors_stillonTreatment = errors.stillonTreatment) === null || _errors_stillonTreatment === void 0 ? void 0 : _errors_stillonTreatment.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("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "ARVForPMTCT",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_ARVForPMTCT;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "ARV For PMTCT")
+            }, field), {
+                disabled: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.ARVForPMTCT,
+                invalidText: (_errors_ARVForPMTCT = errors.ARVForPMTCT) === null || _errors_ARVForPMTCT === void 0 ? void 0 : _errors_ARVForPMTCT.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
+                });
+            }));
+        }
+    })), intakeBFormValues.ARVForPMTCT === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement((react__WEBPACK_IMPORTED_MODULE_0___default().Fragment), null, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "healthFacility",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_healthFacility;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "healthFacility",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Health Facility")
+            }, field), {
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.healthFacility,
+                invalidText: (_errors_healthFacility = errors.healthFacility) === null || _errors_healthFacility === void 0 ? void 0 : _errors_healthFacility.message
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "regimenForMother",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_regimenForMother;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.Select, _object_spread_props(_object_spread({
+                id: "regimenForMother",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Regimen for Mother")
+            }, field), {
+                disabled: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.regimenForMother,
+                invalidText: (_errors_regimenForMother = errors.regimenForMother) === null || _errors_regimenForMother === void 0 ? void 0 : _errors_regimenForMother.message,
+                helperText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].helperText
+                }, field.value === "2798d3bc-2e0a-459c-b249-9516b380a69e" || field.value === "3495d89f-4d46-44d8-b1c9-d101bc9f15d4" || field.value === "ae0dc59c-eb3d-421b-913b-ee5a06ec6182" || field.value === "c5995b5c-19bb-42f6-895b-0b4627bc9dd1" || field.value === "a9da3e97-3916-4834-854c-6bcbc5142aca" || field.value === "8b727274-4a3c-4a81-ae50-9f759a87358d" || field.value === "a664a63f-57f5-4cfc-80c0-4a8456725c2a" || field.value === "71ecf102-8d3d-4a2a-b799-30773ad5d447" || field.value === "a87d9674-11af-4440-afd0-d097d84d0393" || field.value === "82e23d8c-4c9d-4b18-a960-9f8890b86f2f" || field.value === "cf29c24b-b796-4536-aaa5-8303f45bb5f8" || field.value === "2e84a82a-8b93-40fc-a556-2028d39f5710" ? "Warning: This Regimen is retired." : "")
+            }), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.SelectItem, {
+                text: "Select",
+                value: ""
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.regimenForMotherOpt.map(function(option) {
+                return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.SelectItem, {
+                    key: option.concept,
+                    text: option.label,
+                    value: option.concept
+                });
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "regimenForBaby",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_regimenForBaby;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.Select, _object_spread_props(_object_spread({
+                id: "regimenForBaby",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Regimen for Baby")
+            }, field), {
+                disabled: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.regimenForBaby,
+                invalidText: (_errors_regimenForBaby = errors.regimenForBaby) === null || _errors_regimenForBaby === void 0 ? void 0 : _errors_regimenForBaby.message,
+                helperText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].helperText
+                }, field.value === "c33efc4a-734f-4e89-92a4-71b259a5e547" || field.value === "7bbee32a-31a8-4199-a8a2-2d15c748d80a" || field.value === "756b4487-f358-4817-b248-9c05080bad67" || field.value === "fcafc964-f018-41c8-9dc9-343a2f4a94b5" || field.value === "7c30ed1a-a770-4b74-8704-82077427128d" || field.value === "18c78c5f-082c-4acc-a121-62fa334f34d3" || field.value === "5c9424e6-4f18-44e1-a074-e561643a7d91" || field.value === "2e58ef33-d019-4bd9-97b8-553e39e12646" || field.value === "8feb33db-71db-4fd0-a0e7-c02f81fcc76f" || field.value === "5415f1b1-a680-4870-89c5-3324d42da408" || field.value === "3e7d018b-9669-4f48-9298-d7c633f86b0f" ? "Warning: This Regimen is retired." : "")
+            }), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.SelectItem, {
+                text: "Select",
+                value: ""
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.regimenForBabyOpt.map(function(option) {
+                return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.SelectItem, {
+                    key: option.concept,
+                    text: option.label,
+                    value: option.concept
+                });
+            }));
+        }
+    })))))), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("h2", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].heading
+    }, "CLIENT STATUS AT ENROLLMENT"), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.Stack, {
+        gap: 1,
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["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, {
+        open: true,
+        title: "VITAL SIGNS",
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].formContainer
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "temperature",
+        control: control,
+        rules: {
+            validate: function(value) {
+                if (value === null || typeof value === "undefined") {
+                    return true; // Allow empty
+                }
+                var num = Number(value);
+                if (isNaN(num)) {
+                    return "Temperature should be a valid number";
+                }
+                if (num < 25 || num > 50) {
+                    return "Temperature should be between 25 and 50";
+                }
+                return true;
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _errors_temperature, _type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.NumberInput, {
+                id: "temperature",
+                allowEmpty: true,
+                label: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Temperature (in degree Celsius)"),
+                value: field.value,
+                onChange: function(_, param) {
+                    var value = param.value;
+                    field.onChange(value !== "" ? Number(value) : null);
+                    field.onBlur();
+                },
+                onKeyDown: function(e) {
+                    if ([
+                        "e",
+                        "E",
+                        "+",
+                        "-"
+                    ].includes(e.key)) {
+                        e.preventDefault();
+                    }
+                },
+                invalid: !!errors.temperature,
+                invalidText: (_errors_temperature = errors.temperature) === null || _errors_temperature === void 0 ? void 0 : _errors_temperature.message,
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view
+            });
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "heartRate",
+        control: control,
+        rules: {
+            validate: function(value) {
+                if (value === null || typeof value === "undefined") {
+                    return true; // Allow empty
+                }
+                var num = Number(value);
+                if (isNaN(num)) {
+                    return "Heart Rate should be a valid number";
+                }
+                if (num < 25 || num > 300) {
+                    return "Heart Rate should be between 25 and 300";
+                }
+                return true;
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _errors_heartRate, _type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.NumberInput, {
+                id: "heartRate",
+                allowEmpty: true,
+                label: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "PULSE/Heart Rate (per minute)"),
+                value: field.value,
+                onChange: function(_, param) {
+                    var value = param.value;
+                    field.onChange(value !== "" ? Number(value) : null);
+                    field.onBlur();
+                },
+                onKeyDown: function(e) {
+                    if ([
+                        "e",
+                        "E",
+                        "+",
+                        "-"
+                    ].includes(e.key) || e.key.length === 1 && !/\d/.test(e.key)) {
+                        e.preventDefault();
+                    }
+                },
+                invalid: !!errors.heartRate,
+                invalidText: (_errors_heartRate = errors.heartRate) === null || _errors_heartRate === void 0 ? void 0 : _errors_heartRate.message,
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view
+            });
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "systolicBloodPressure",
+        control: control,
+        rules: {
+            validate: function(value) {
+                if (value === null || typeof value === "undefined") {
+                    return true; // Allow empty
+                }
+                var num = Number(value);
+                if (isNaN(num)) {
+                    return "Blood Pressure should be a valid number";
+                }
+                if (num < 50 || num > 300) {
+                    return "Blood Pressure should be between 50 and 300";
+                }
+                return true;
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _errors_systolicBloodPressure, _type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.NumberInput, {
+                allowEmpty: true,
+                id: "systolicBloodPressure",
+                label: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Systolic Blood Pressure (in mmHg)"),
+                value: field.value,
+                onChange: function(_, param) {
+                    var value = param.value;
+                    field.onChange(value !== "" ? Number(value) : null);
+                    field.onBlur();
+                },
+                onKeyDown: function(e) {
+                    if ([
+                        "e",
+                        "E",
+                        "+",
+                        "-"
+                    ].includes(e.key) || e.key.length === 1 && !/\d/.test(e.key)) {
+                        e.preventDefault();
+                    }
+                },
+                invalid: !!errors.systolicBloodPressure,
+                invalidText: (_errors_systolicBloodPressure = errors.systolicBloodPressure) === null || _errors_systolicBloodPressure === void 0 ? void 0 : _errors_systolicBloodPressure.message,
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view
+            });
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "diastolicBloodPressure",
+        control: control,
+        rules: {
+            validate: function(value) {
+                if (value === null || typeof value === "undefined") {
+                    return true; // Allow empty
+                }
+                var num = Number(value);
+                if (isNaN(num)) {
+                    return "Diastolic Blood Pressure should be a valid number";
+                }
+                if (num < 40 || num > 300) {
+                    return "Diastolic Blood Pressure should be between 40 and 300";
+                }
+                return true;
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _errors_diastolicBloodPressure, _type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.NumberInput, {
+                allowEmpty: true,
+                id: "diastolicBloodPressure",
+                label: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Diastolic Blood Pressure (in mmHg)"),
+                value: field.value,
+                onChange: function(_, param) {
+                    var value = param.value;
+                    field.onChange(value !== "" ? Number(value) : null);
+                    field.onBlur();
+                },
+                onKeyDown: function(e) {
+                    if ([
+                        "e",
+                        "E",
+                        "+",
+                        "-"
+                    ].includes(e.key) || e.key.length === 1 && !/\d/.test(e.key)) {
+                        e.preventDefault();
+                    }
+                },
+                invalid: !!errors.diastolicBloodPressure,
+                invalidText: (_errors_diastolicBloodPressure = errors.diastolicBloodPressure) === null || _errors_diastolicBloodPressure === void 0 ? void 0 : _errors_diastolicBloodPressure.message,
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view
+            });
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "rr",
+        control: control,
+        rules: {
+            validate: function(value) {
+                if (value === null || typeof value === "undefined") {
+                    return true; // Allow empty
+                }
+                var num = Number(value);
+                if (isNaN(num)) {
+                    return "Respiratory Rate should be a valid number";
+                }
+                if (num < 4 || num > 45) {
+                    return "Respiratory Rate should be between 4 and 45";
+                }
+                return true;
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _errors_rr, _type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.NumberInput, {
+                id: "rr",
+                allowEmpty: true,
+                label: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Respiratory Rate/RR (R/min)"),
+                value: field.value,
+                onChange: function(_, param) {
+                    var value = param.value;
+                    field.onChange(value !== "" ? Number(value) : null);
+                    field.onBlur();
+                },
+                onKeyDown: function(e) {
+                    if ([
+                        "e",
+                        "E",
+                        "+",
+                        "-"
+                    ].includes(e.key) || e.key.length === 1 && !/\d/.test(e.key)) {
+                        e.preventDefault();
+                    }
+                },
+                invalid: !!errors.rr,
+                invalidText: (_errors_rr = errors.rr) === null || _errors_rr === void 0 ? void 0 : _errors_rr.message,
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view
+            });
+        }
+    })))), /*#__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, {
+        open: true,
+        title: "ANTHROPOMETRY",
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].formContainer
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "height",
+        control: control,
+        rules: {
+            validate: function(value) {
+                if (value === null || typeof value === "undefined") {
+                    return true; // Allow empty
+                }
+                var num = Number(value);
+                if (isNaN(num)) {
+                    return "height should be a valid number";
+                }
+                if (num < 0 || num > 300) {
+                    return "height should be between 40 and 300";
+                }
+                return true;
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _errors_height, _type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.NumberInput, {
+                allowEmpty: true,
+                id: "height",
+                label: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Height (in cm)"),
+                value: field.value,
+                onChange: function(_, param) {
+                    var value = param.value;
+                    field.onChange(value !== "" ? Number(value) : null);
+                    field.onBlur();
+                },
+                onKeyDown: function(e) {
+                    if ([
+                        "e",
+                        "E",
+                        "+",
+                        "-"
+                    ].includes(e.key) || e.key.length === 1 && !/\d/.test(e.key)) {
+                        e.preventDefault();
+                    }
+                },
+                invalid: !!errors.height,
+                invalidText: (_errors_height = errors.height) === null || _errors_height === void 0 ? void 0 : _errors_height.message,
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view
+            });
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "weight",
+        control: control,
+        rules: {
+            validate: function(value) {
+                if (value === null || typeof value === "undefined") {
+                    return true; // Allow empty
+                }
+                var num = Number(value);
+                if (isNaN(num)) {
+                    return "weight should be a valid number";
+                }
+                if (num < 0 || num > 500) {
+                    return "weight should be between 0 and 500";
+                }
+                return true;
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _errors_weight, _type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.NumberInput, {
+                id: "weight",
+                allowEmpty: true,
+                label: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Weight (in kg)"),
+                value: field.value,
+                onChange: function(_, param) {
+                    var value = param.value;
+                    field.onChange(value !== "" ? Number(value) : null);
+                    field.onBlur();
+                },
+                onKeyDown: function(e) {
+                    if ([
+                        "e",
+                        "E",
+                        "+",
+                        "-"
+                    ].includes(e.key)) {
+                        e.preventDefault();
+                    }
+                },
+                invalid: !!errors.weight,
+                invalidText: (_errors_weight = errors.weight) === null || _errors_weight === void 0 ? void 0 : _errors_weight.message,
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view
+            });
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "bmi",
+        control: control,
+        // rules={{
+        //   pattern: {
+        //     value: /^(0|[1-9]\d*)(\.\d+)?$/,
+        //     message: 'BMI should be a numeric value',
+        //   },
+        //   validate: (value) => {
+        //     const height = intakeBFormValues.height;
+        //     const weight = intakeBFormValues.weight;
+        //     if (!height || !weight) return true; // skip if height or weight not filled yet
+        //     const heightInMeters = height / 100;
+        //     const expectedBmi = parseFloat(weight) / (heightInMeters * heightInMeters);
+        //     const bmiValue = parseFloat(value);
+        //     const roundedExpected = parseFloat(expectedBmi.toFixed(1));
+        //     const roundedInput = parseFloat(bmiValue.toFixed(1));
+        //     return roundedExpected === roundedInput || `Calculated BMI should be ${roundedExpected}`;
+        //   },
+        // }}
+        render: function(param) {
+            var field = param.field;
+            var _errors_bmi;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "bmi",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "BMI (kg/m\xb2)")
+            }, field), {
+                readOnly: true,
+                invalid: !!errors.bmi,
+                invalidText: (_errors_bmi = errors.bmi) === null || _errors_bmi === void 0 ? void 0 : _errors_bmi.message
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "patientFunctionalStatus",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_patientFunctionalStatus;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Functional Status")
+            }, field), {
+                disabled: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.patientFunctionalStatus,
+                invalidText: (_errors_patientFunctionalStatus = errors.patientFunctionalStatus) === null || _errors_patientFunctionalStatus === void 0 ? void 0 : _errors_patientFunctionalStatus.message
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.patientFunctionalStatusOpt.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
+                });
+            }));
+        }
+    })))), age <= 5 && /*#__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, {
+        open: true,
+        title: "FOR CHILD ONLY",
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].formContainer
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "headCircumference",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _errors_headCircumference, _type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.NumberInput, {
+                id: "headCircumference",
+                allowEmpty: true,
+                label: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Head Circumference (in cm)"),
+                min: 0,
+                max: 99999999,
+                value: field.value,
+                onChange: function(_, param) {
+                    var value = param.value;
+                    field.onChange(Number(value));
+                    field.onBlur();
+                },
+                onKeyDown: function(e) {
+                    if ([
+                        "e",
+                        "E",
+                        "+",
+                        "-"
+                    ].includes(e.key) || e.key.length === 1 && !/\d/.test(e.key)) {
+                        e.preventDefault();
+                    }
+                },
+                invalid: !!errors.headCircumference,
+                invalidText: (_errors_headCircumference = errors.headCircumference) === null || _errors_headCircumference === void 0 ? void 0 : _errors_headCircumference.message,
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view
+            });
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "anthropometryInterpretation",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_anthropometryInterpretation;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Anthropometry interpretation")
+            }, field), {
+                disabled: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.anthropometryInterpretation,
+                invalidText: (_errors_anthropometryInterpretation = errors.anthropometryInterpretation) === null || _errors_anthropometryInterpretation === void 0 ? void 0 : _errors_anthropometryInterpretation.message
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.anthropometryInterpretationOpt.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_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "developmentalStatus",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_developmentalStatus;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Developmental Status (for a child < 5)")
+            }, field), {
+                disabled: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.developmentalStatus,
+                invalidText: (_errors_developmentalStatus = errors.developmentalStatus) === null || _errors_developmentalStatus === void 0 ? void 0 : _errors_developmentalStatus.message
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.developmentalStatusOpt.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
+                });
+            }));
+        }
+    })))), sex === "female" && /*#__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, {
+        open: true,
+        title: "PREGNANCY STATUS",
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].formContainer
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "pregnancyAtEnrollment",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_pregnancyAtEnrollment;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Client's Pregnancy at Enrollment")
+            }, field), {
+                disabled: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.pregnancyAtEnrollment,
+                invalidText: (_errors_pregnancyAtEnrollment = errors.pregnancyAtEnrollment) === null || _errors_pregnancyAtEnrollment === void 0 ? void 0 : _errors_pregnancyAtEnrollment.message
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.yesNoNotApplicableOpt.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
+                });
+            }));
+        }
+    })), intakeBFormValues.pregnancyAtEnrollment === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement((react__WEBPACK_IMPORTED_MODULE_0___default().Fragment), null, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "lmpDate",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _errors_lmpDate, _type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_2__.OpenmrsDatePicker, {
+                id: "lmpDate",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "LMP"),
+                value: field.value,
+                maxDate: encounterDate,
+                onChange: function(date) {
+                    field.onChange(date);
+                    field.onBlur();
+                },
+                onBlur: function() {
+                    return field.onBlur();
+                },
+                invalid: !!errors.lmpDate,
+                invalidText: (_errors_lmpDate = errors.lmpDate) === null || _errors_lmpDate === void 0 ? void 0 : _errors_lmpDate.message,
+                isReadOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view
+            });
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "eddDate",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _errors_eddDate, _type;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_openmrs_esm_framework__WEBPACK_IMPORTED_MODULE_2__.OpenmrsDatePicker, {
+                id: "eddDate",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "EDD"),
+                value: field.value,
+                onChange: function(date) {
+                    field.onChange(date);
+                    field.onBlur();
+                },
+                onBlur: function() {
+                    return field.onBlur();
+                },
+                invalid: !!errors.eddDate,
+                invalidText: (_errors_eddDate = errors.eddDate) === null || _errors_eddDate === void 0 ? void 0 : _errors_eddDate.message,
+                isReadOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view
+            });
+        }
+    }), " ")))), /*#__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, {
+        open: true,
+        title: "PRESENTING SYMPTOMT",
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].formContainer
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "presentingComplaints",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_presentingComplaints, _field_value;
+            var initialSelectedItems = _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.presentingComplaintsOpt.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, _object_spread_props(_object_spread({
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                id: "presentingComplaints",
+                // label={
+                //   <span className={styles.label}>{t('presentingComplaints', 'Presenting Complaints')}</span>
+                // }
+                titleText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, t("presentingComplaints", "Presenting Complaints"))
+            }, field), {
+                initialSelectedItems: initialSelectedItems,
+                items: _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.presentingComplaintsOpt,
+                invalid: !!errors.presentingComplaints,
+                sortItems: function(items) {
+                    return items;
+                },
+                invalidText: (_errors_presentingComplaints = errors.presentingComplaints) === null || _errors_presentingComplaints === void 0 ? void 0 : _errors_presentingComplaints.message,
+                onChange: function(param) {
+                    var selectedItems = param.selectedItems;
+                    field.onChange({
+                        selectedItems: selectedItems
+                    });
+                    field.onBlur();
+                },
+                value: ((_field_value = field.value) === null || _field_value === void 0 ? void 0 : _field_value.selectedItems) || []
+            }));
+        }
+    }), (_intakeBFormValues2 = intakeBFormValues) === null || _intakeBFormValues2 === void 0 ? void 0 : (_intakeBFormValues_presentingComplaints = _intakeBFormValues2.presentingComplaints) === null || _intakeBFormValues_presentingComplaints === void 0 ? void 0 : (_intakeBFormValues_presentingComplaints_selectedItems = _intakeBFormValues_presentingComplaints.selectedItems) === null || _intakeBFormValues_presentingComplaints_selectedItems === void 0 ? void 0 : _intakeBFormValues_presentingComplaints_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);
+    })), ((_intakeBFormValues3 = intakeBFormValues) === null || _intakeBFormValues3 === void 0 ? void 0 : (_intakeBFormValues_presentingComplaints1 = _intakeBFormValues3.presentingComplaints) === null || _intakeBFormValues_presentingComplaints1 === void 0 ? void 0 : (_intakeBFormValues_presentingComplaints_selectedItems1 = _intakeBFormValues_presentingComplaints1.selectedItems) === null || _intakeBFormValues_presentingComplaints_selectedItems1 === void 0 ? void 0 : _intakeBFormValues_presentingComplaints_selectedItems1.some(function(item) {
+        return item.concept === "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+    })) && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "otherPresentingComplaints",
+        control: control,
+        rules: {
+            maxLength: {
+                value: 50,
+                message: "Please use a maximum of 50 characters"
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_otherPresentingComplaints;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "otherPresentingComplaints",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Other presenting complaints")
+            }, field), {
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.otherPresentingComplaints,
+                invalidText: (_errors_otherPresentingComplaints = errors.otherPresentingComplaints) === null || _errors_otherPresentingComplaints === void 0 ? void 0 : _errors_otherPresentingComplaints.message
+            }));
+        }
+    })), ((_intakeBFormValues4 = intakeBFormValues) === null || _intakeBFormValues4 === void 0 ? void 0 : (_intakeBFormValues_presentingComplaints2 = _intakeBFormValues4.presentingComplaints) === null || _intakeBFormValues_presentingComplaints2 === void 0 ? void 0 : (_intakeBFormValues_presentingComplaints_selectedItems2 = _intakeBFormValues_presentingComplaints2.selectedItems) === null || _intakeBFormValues_presentingComplaints_selectedItems2 === void 0 ? void 0 : _intakeBFormValues_presentingComplaints_selectedItems2.some(function(item) {
+        return item.concept === "832AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+    })) && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "percentOfLostBodyWeight",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_percentOfLostBodyWeight;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "percentOfLostBodyWeight",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Percent (%) of lost body weight")
+            }, field), {
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.percentOfLostBodyWeight,
+                invalidText: (_errors_percentOfLostBodyWeight = errors.percentOfLostBodyWeight) === null || _errors_percentOfLostBodyWeight === void 0 ? void 0 : _errors_percentOfLostBodyWeight.message
+            }));
+        }
+    })))), /*#__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, {
+        open: true,
+        title: "GENERAL APPEARANCE AT ENROLLMENT",
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].formContainer
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "generalAppearance",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_generalAppearance;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "generalAppearance",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "General Appearance")
+            }, field), {
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.generalAppearance,
+                invalidText: (_errors_generalAppearance = errors.generalAppearance) === null || _errors_generalAppearance === void 0 ? void 0 : _errors_generalAppearance.message
+            }));
+        }
+    })))), /*#__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, {
+        open: true,
+        title: "PHYSICAL EXAMINATION BY SYSTEM",
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].formContainer
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "areAllSystemsNormal",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_areAllSystemsNormal;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Are all systems normal")
+            }, field), {
+                disabled: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.areAllSystemsNormal,
+                invalidText: (_errors_areAllSystemsNormal = errors.areAllSystemsNormal) === null || _errors_areAllSystemsNormal === void 0 ? void 0 : _errors_areAllSystemsNormal.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("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "heentExamination",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_heentExamination;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "HEENT examination")
+            }, field), {
+                disabled: ((_type = type) === null || _type === void 0 ? void 0 : _type.view) || intakeBFormValues.areAllSystemsNormal === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
+                invalid: !!errors.heentExamination,
+                invalidText: (_errors_heentExamination = errors.heentExamination) === null || _errors_heentExamination === void 0 ? void 0 : _errors_heentExamination.message
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.heentExaminationOpt.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
+                });
+            }));
+        }
+    })), intakeBFormValues.heentExamination === "1116AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "heentExaminationComment",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _type1, _errors_heentExaminationComment;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "heentExaminationComment",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Specify Abnormal Finding of HEENT")
+            }, field), {
+                disabled: ((_type = type) === null || _type === void 0 ? void 0 : _type.view) || intakeBFormValues.areAllSystemsNormal === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
+                readOnly: (_type1 = type) === null || _type1 === void 0 ? void 0 : _type1.view,
+                invalid: !!errors.heentExaminationComment,
+                invalidText: (_errors_heentExaminationComment = errors.heentExaminationComment) === null || _errors_heentExaminationComment === void 0 ? void 0 : _errors_heentExaminationComment.message
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "lymphNodesExamination",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_lymphNodesExamination;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Lymph nodes examination")
+            }, field), {
+                disabled: ((_type = type) === null || _type === void 0 ? void 0 : _type.view) || intakeBFormValues.areAllSystemsNormal === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
+                invalid: !!errors.lymphNodesExamination,
+                invalidText: (_errors_lymphNodesExamination = errors.lymphNodesExamination) === null || _errors_lymphNodesExamination === void 0 ? void 0 : _errors_lymphNodesExamination.message
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.heentExaminationOpt.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
+                });
+            }));
+        }
+    })), intakeBFormValues.lymphNodesExamination === "1116AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "lymphNodesExaminationComment",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_lymphNodesExaminationComment;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "lymphNodesExaminationComment",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Specify Abnormal Finding of Lymph nodes")
+            }, field), {
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.lymphNodesExaminationComment,
+                invalidText: (_errors_lymphNodesExaminationComment = errors.lymphNodesExaminationComment) === null || _errors_lymphNodesExaminationComment === void 0 ? void 0 : _errors_lymphNodesExaminationComment.message
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "chestExamination",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_chestExamination;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Chest examination")
+            }, field), {
+                disabled: ((_type = type) === null || _type === void 0 ? void 0 : _type.view) || intakeBFormValues.areAllSystemsNormal === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
+                invalid: !!errors.chestExamination,
+                invalidText: (_errors_chestExamination = errors.chestExamination) === null || _errors_chestExamination === void 0 ? void 0 : _errors_chestExamination.message
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.heentExaminationOpt.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
+                });
+            }));
+        }
+    })), intakeBFormValues.chestExamination === "1116AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "chestExaminationComment",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_chestExaminationComment;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "chestExaminationComment",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Specify Abnormal Finding of Chest")
+            }, field), {
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.chestExaminationComment,
+                invalidText: (_errors_chestExaminationComment = errors.chestExaminationComment) === null || _errors_chestExaminationComment === void 0 ? void 0 : _errors_chestExaminationComment.message
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "heartExamination",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_heartExamination;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Heart examination")
+            }, field), {
+                disabled: ((_type = type) === null || _type === void 0 ? void 0 : _type.view) || intakeBFormValues.areAllSystemsNormal === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
+                invalid: !!errors.heartExamination,
+                invalidText: (_errors_heartExamination = errors.heartExamination) === null || _errors_heartExamination === void 0 ? void 0 : _errors_heartExamination.message
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.heentExaminationOpt.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
+                });
+            }));
+        }
+    })), intakeBFormValues.heartExamination === "1116AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "heartExaminationComment",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_heartExaminationComment;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "heartExaminationComment",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Specify Abnormal Finding of Heart")
+            }, field), {
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.heartExaminationComment,
+                invalidText: (_errors_heartExaminationComment = errors.heartExaminationComment) === null || _errors_heartExaminationComment === void 0 ? void 0 : _errors_heartExaminationComment.message
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "abdomenExamination",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_abdomenExamination;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Abdomen examination")
+            }, field), {
+                disabled: ((_type = type) === null || _type === void 0 ? void 0 : _type.view) || intakeBFormValues.areAllSystemsNormal === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
+                invalid: !!errors.abdomenExamination,
+                invalidText: (_errors_abdomenExamination = errors.abdomenExamination) === null || _errors_abdomenExamination === void 0 ? void 0 : _errors_abdomenExamination.message
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.heentExaminationOpt.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
+                });
+            }));
+        }
+    })), intakeBFormValues.abdomenExamination === "1116AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "abdomenExaminationComment",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_abdomenExaminationComment;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "abdomenExaminationComment",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Specify Abnormal Finding of Abdomen")
+            }, field), {
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.abdomenExaminationComment,
+                invalidText: (_errors_abdomenExaminationComment = errors.abdomenExaminationComment) === null || _errors_abdomenExaminationComment === void 0 ? void 0 : _errors_abdomenExaminationComment.message
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "genitourinarySystemExamination",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_genitourinarySystemExamination;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Genitourinary system examination")
+            }, field), {
+                disabled: ((_type = type) === null || _type === void 0 ? void 0 : _type.view) || intakeBFormValues.areAllSystemsNormal === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
+                invalid: !!errors.genitourinarySystemExamination,
+                invalidText: (_errors_genitourinarySystemExamination = errors.genitourinarySystemExamination) === null || _errors_genitourinarySystemExamination === void 0 ? void 0 : _errors_genitourinarySystemExamination.message
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.heentExaminationOpt.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
+                });
+            }));
+        }
+    })), intakeBFormValues.genitourinarySystemExamination === "1116AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "genitourinarySystemExaminationComment",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_genitourinarySystemExaminationComment;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "genitourinarySystemExaminationComment",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Specify Abnormal Finding of Genitourinary System")
+            }, field), {
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.genitourinarySystemExaminationComment,
+                invalidText: (_errors_genitourinarySystemExaminationComment = errors.genitourinarySystemExaminationComment) === null || _errors_genitourinarySystemExaminationComment === void 0 ? void 0 : _errors_genitourinarySystemExaminationComment.message
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "musculoskeletalSystemExamination",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_musculoskeletalSystemExamination;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Musculoskeletal system examination")
+            }, field), {
+                disabled: ((_type = type) === null || _type === void 0 ? void 0 : _type.view) || intakeBFormValues.areAllSystemsNormal === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
+                invalid: !!errors.musculoskeletalSystemExamination,
+                invalidText: (_errors_musculoskeletalSystemExamination = errors.musculoskeletalSystemExamination) === null || _errors_musculoskeletalSystemExamination === void 0 ? void 0 : _errors_musculoskeletalSystemExamination.message
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.heentExaminationOpt.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
+                });
+            }));
+        }
+    })), intakeBFormValues.musculoskeletalSystemExamination === "1116AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "musculoskeletalSystemExaminationComment",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_musculoskeletalSystemExaminationComment;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "musculoskeletalSystemExaminationComment",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Specify Abnormal Finding of Musculoskeletal System")
+            }, field), {
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.musculoskeletalSystemExaminationComment,
+                invalidText: (_errors_musculoskeletalSystemExaminationComment = errors.musculoskeletalSystemExaminationComment) === null || _errors_musculoskeletalSystemExaminationComment === void 0 ? void 0 : _errors_musculoskeletalSystemExaminationComment.message
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "skinExamination",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_skinExamination;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Skin examination")
+            }, field), {
+                disabled: ((_type = type) === null || _type === void 0 ? void 0 : _type.view) || intakeBFormValues.areAllSystemsNormal === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
+                invalid: !!errors.skinExamination,
+                invalidText: (_errors_skinExamination = errors.skinExamination) === null || _errors_skinExamination === void 0 ? void 0 : _errors_skinExamination.message
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.heentExaminationOpt.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
+                });
+            }));
+        }
+    })), intakeBFormValues.skinExamination === "1116AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "skinExaminationComment",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_skinExaminationComment;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "skinExaminationComment",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Specify Abnormal Finding of Skin")
+            }, field), {
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.skinExaminationComment,
+                invalidText: (_errors_skinExaminationComment = errors.skinExaminationComment) === null || _errors_skinExaminationComment === void 0 ? void 0 : _errors_skinExaminationComment.message
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "nervousSystemExamination",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_nervousSystemExamination;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Nervous system examination")
+            }, field), {
+                disabled: ((_type = type) === null || _type === void 0 ? void 0 : _type.view) || intakeBFormValues.areAllSystemsNormal === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
+                invalid: !!errors.nervousSystemExamination,
+                invalidText: (_errors_nervousSystemExamination = errors.nervousSystemExamination) === null || _errors_nervousSystemExamination === void 0 ? void 0 : _errors_nervousSystemExamination.message
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.heentExaminationOpt.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
+                });
+            }));
+        }
+    })), intakeBFormValues.nervousSystemExamination === "1116AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "nervousSystemExaminationComment",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_nervousSystemExaminationComment;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "nervousSystemExaminationComment",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Specify Abnormal Finding of Nervous System")
+            }, field), {
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.nervousSystemExaminationComment,
+                invalidText: (_errors_nervousSystemExaminationComment = errors.nervousSystemExaminationComment) === null || _errors_nervousSystemExaminationComment === void 0 ? void 0 : _errors_nervousSystemExaminationComment.message
+            }));
+        }
+    })), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "otherPhysicalExaminationFindings",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_otherPhysicalExaminationFindings;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "otherPhysicalExaminationFindings",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Other Physical Examination Findings")
+            }, field), {
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.otherPhysicalExaminationFindings,
+                invalidText: (_errors_otherPhysicalExaminationFindings = errors.otherPhysicalExaminationFindings) === null || _errors_otherPhysicalExaminationFindings === void 0 ? void 0 : _errors_otherPhysicalExaminationFindings.message
+            }));
+        }
+    })))), /*#__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, {
+        open: true,
+        title: "WHO STAGING",
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].formContainer
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "WHOStaging",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_WHOStaging;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "WHO Staging")
+            }, field), {
+                disabled: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.WHOStaging,
+                invalidText: (_errors_WHOStaging = errors.WHOStaging) === null || _errors_WHOStaging === void 0 ? void 0 : _errors_WHOStaging.message
+            }), _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.whoStagingOpt.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_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "whoWhy",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_whoWhy, _field_value;
+            var initialSelectedItems = _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.HIVRelatedOIsOpt.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: "whoWhy",
+                // label={<span className={styles.label}>{t('whoWhy', 'Reasons for WHO Staging')}</span>}
+                titleText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, t("whoWhy", "Reasons for WHO Staging")),
+                initialSelectedItems: initialSelectedItems,
+                items: _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.HIVRelatedOIsOpt,
+                sortItems: function(items) {
+                    return items;
+                },
+                invalid: !!errors.whoWhy,
+                invalidText: (_errors_whoWhy = errors.whoWhy) === null || _errors_whoWhy === void 0 ? void 0 : _errors_whoWhy.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) || []
+            });
+        }
+    })), (_intakeBFormValues5 = intakeBFormValues) === null || _intakeBFormValues5 === void 0 ? void 0 : (_intakeBFormValues_whoWhy = _intakeBFormValues5.whoWhy) === null || _intakeBFormValues_whoWhy === void 0 ? void 0 : (_intakeBFormValues_whoWhy_selectedItems = _intakeBFormValues_whoWhy.selectedItems) === null || _intakeBFormValues_whoWhy_selectedItems === void 0 ? void 0 : _intakeBFormValues_whoWhy_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);
+    }))), /*#__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, {
+        open: true,
+        title: "INTAKE NOTES",
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].formContainer
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "intakeNotes",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _type, _errors_intakeNotes;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextArea, _object_spread_props(_object_spread({
+                id: "intakeNotes",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Intake Notes")
+            }, field), {
+                rows: 1,
+                readOnly: (_type = type) === null || _type === void 0 ? void 0 : _type.view,
+                invalid: !!errors.intakeNotes,
+                invalidText: (_errors_intakeNotes = errors.intakeNotes) === null || _errors_intakeNotes === void 0 ? void 0 : _errors_intakeNotes.message
+            }));
+        }
+    })))), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("h2", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].heading
+    }, "ART ELIGIBILITY"), /*#__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, {
+        open: true,
+        title: "ART ELIGIBILITY ASSESSMENT AND PLAN",
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].formContainer
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "eligibileForART",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _errors_eligibileForART;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.RadioButtonGroup, _object_spread_props(_object_spread({
+                orientation: "vertical",
+                legendText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Eligible for ART")
+            }, field), {
+                disabled: true,
+                invalid: !!errors.eligibileForART,
+                invalidText: (_errors_eligibileForART = errors.eligibileForART) === null || _errors_eligibileForART === void 0 ? void 0 : _errors_eligibileForART.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
+                });
+            }));
+        }
+    }), " "), intakeBFormValues.eligibileForART === "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement((react__WEBPACK_IMPORTED_MODULE_0___default().Fragment), null, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "whyEligibleForART",
+        control: control,
+        render: function(param) {
+            var field = param.field;
+            var _errors_whyEligibleForART, _field_value;
+            var initialSelectedItems = _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.whyEligibleForARTOpt.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: true,
+                id: "whyEligibleForART",
+                // label={
+                //   <span className={styles.label}>{t('whyEligibleForART', 'Why eligible for ART')}</span>
+                // }
+                titleText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, t("whyEligibleForART", "Why eligible for ART")),
+                initialSelectedItems: initialSelectedItems,
+                items: _utils_form_constant__WEBPACK_IMPORTED_MODULE_5__.whyEligibleForARTOpt,
+                invalid: !!errors.whyEligibleForART,
+                sortItems: function(items) {
+                    return items;
+                },
+                invalidText: (_errors_whyEligibleForART = errors.whyEligibleForART) === null || _errors_whyEligibleForART === void 0 ? void 0 : _errors_whyEligibleForART.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) || []
+            });
+        }
+    }), " "), (_intakeBFormValues6 = intakeBFormValues) === null || _intakeBFormValues6 === void 0 ? void 0 : (_intakeBFormValues_whyEligibleForART = _intakeBFormValues6.whyEligibleForART) === null || _intakeBFormValues_whyEligibleForART === void 0 ? void 0 : (_intakeBFormValues_whyEligibleForART_selectedItems = _intakeBFormValues_whyEligibleForART.selectedItems) === null || _intakeBFormValues_whyEligibleForART_selectedItems === void 0 ? void 0 : _intakeBFormValues_whyEligibleForART_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);
+    }), ((_intakeBFormValues7 = intakeBFormValues) === null || _intakeBFormValues7 === void 0 ? void 0 : (_intakeBFormValues_whyEligibleForART1 = _intakeBFormValues7.whyEligibleForART) === null || _intakeBFormValues_whyEligibleForART1 === void 0 ? void 0 : (_intakeBFormValues_whyEligibleForART_selectedItems1 = _intakeBFormValues_whyEligibleForART1.selectedItems) === null || _intakeBFormValues_whyEligibleForART_selectedItems1 === void 0 ? void 0 : _intakeBFormValues_whyEligibleForART_selectedItems1.some(function(item) {
+        return item.concept === "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA";
+    })) && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].fieldWrapper
+    }, /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(react_hook_form__WEBPACK_IMPORTED_MODULE_12__.Controller, {
+        name: "otherReasonWhyEligible",
+        control: control,
+        rules: {
+            maxLength: {
+                value: 50,
+                message: "Please use a maximum of 50 characters"
+            }
+        },
+        render: function(param) {
+            var field = param.field;
+            var _errors_otherReasonWhyEligible;
+            return /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.TextInput, _object_spread_props(_object_spread({
+                id: "otherReasonWhyEligible",
+                labelText: /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("span", {
+                    className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].label
+                }, "Other reasons for ART eligibility")
+            }, field), {
+                readOnly: true,
+                invalid: !!errors.otherReasonWhyEligible,
+                invalidText: (_errors_otherReasonWhyEligible = errors.otherReasonWhyEligible) === null || _errors_otherReasonWhyEligible === void 0 ? void 0 : _errors_otherReasonWhyEligible.message
+            }));
+        }
+    }), " ")))))), /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement("div", {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["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_2__.closeWorkspace)("intake-b-form-workspace");
+        },
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["default"].button
+    }, "Cancel"), !((_type = type) === null || _type === void 0 ? void 0 : _type.view) && /*#__PURE__*/ react__WEBPACK_IMPORTED_MODULE_0___default().createElement(_carbon_react__WEBPACK_IMPORTED_MODULE_1__.Button, {
+        className: _intake_form_scss__WEBPACK_IMPORTED_MODULE_3__["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) : ((_type1 = type) === null || _type1 === void 0 ? void 0 : _type1.edit) ? "Update" : "Save")));
+};
+/* harmony default export */ const __WEBPACK_DEFAULT_EXPORT__ = (IntakeBForm);
+
+
+/***/ }),
+
+/***/ "./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-b-form_tsx.js.map