{ parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-patient-name" as=${html``} />

parent.activateValidation({"message":"This field is required.","emailMessage":"Please enter a valid Email address","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-email" as=${html``} />

<${props.Flatpickr} name="mf-date-of-birth" className="mf-input mf-date-input mf-left-parent " placeholder="${ parent.decodeEntities(`Date of Birth`) } " options=${{"minDate":"","maxDate":"","dateFormat":"m-d-Y","enableTime":"","disable":[],"mode":"single","static":true,"disableMobile":true,"time_24hr":false}} value=${parent.getValue('mf-date-of-birth')} onInput=${parent.handleDateTime} aria-invalid=${validation.errors['mf-date-of-birth'] ? 'true' : 'false'} ref=${el => props.DateWidget( el, '', {"message":"This field is required.","required":false}, register, parent )} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-date-of-birth" as=${html``} />

parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-telephone" as=${html``} />

${ parent.decodeEntities(`Gender :`) } <${validation.ErrorMessage} errors=${validation.errors} name="mf-gender" as=${html``} />

<${props.Select} className=${"mf-input mf-input-select " + ( validation.errors['mf-service'] ? 'mf-invalid' : '' )} classNamePrefix="mf_select" name="mf-service" placeholder="${ parent.decodeEntities(`Select Service`) } " isSearchable=${false} options=${[{"label":"Home Healthcare","value":"Home Healthcare","isDisabled":false},{"label":"Physiotherapy","value":"Physiotherapy","isDisabled":false},{"label":"Medical Treatment","value":"Medical Treatment","isDisabled":false},{"label":"IV Fluid & Vitamin","value":"IV Fluid & Vitamin","isDisabled":false},{"label":"Doctor on call","value":"Doctor on call","isDisabled":false},{"label":"Covid 19 PCR Test","value":"Covid 19 PCR Test","isDisabled":false},{"label":"Wellness Package","value":"Covid 19 PCR Test","isDisabled":false},{"label":"Home Laboratory Test","value":"Home Laboratory Test","isDisabled":false},{"label":"Telemedicine","value":"Telemedicine","isDisabled":false},{"label":"Wound Care","value":"Telemedicine","isDisabled":false},{"label":"General nursing service","value":"Telemedicine","isDisabled":false}]} value=${parent.getValue("mf-service") ? [{"label":"Home Healthcare","value":"Home Healthcare","isDisabled":false},{"label":"Physiotherapy","value":"Physiotherapy","isDisabled":false},{"label":"Medical Treatment","value":"Medical Treatment","isDisabled":false},{"label":"IV Fluid & Vitamin","value":"IV Fluid & Vitamin","isDisabled":false},{"label":"Doctor on call","value":"Doctor on call","isDisabled":false},{"label":"Covid 19 PCR Test","value":"Covid 19 PCR Test","isDisabled":false},{"label":"Wellness Package","value":"Covid 19 PCR Test","isDisabled":false},{"label":"Home Laboratory Test","value":"Home Laboratory Test","isDisabled":false},{"label":"Telemedicine","value":"Telemedicine","isDisabled":false},{"label":"Wound Care","value":"Telemedicine","isDisabled":false},{"label":"General nursing service","value":"Telemedicine","isDisabled":false}].filter(item => item.value === parent.getValue("mf-service"))[0] : []} onChange=${(e)=> parent.handleSelect(e, "mf-service")} ref=${() => { register({ name: "mf-service" }, parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true})); if ( parent.getValue("mf-service") === '' && false ) { parent.setValue( 'mf-service', '', true ); parent.handleChange({ target: { name: 'mf-service', value: '' } }); } }} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-service" as=${html``} />

<${props.Flatpickr} name="mf-date-appointment" className="mf-input mf-date-input mf-left-parent " placeholder="${ parent.decodeEntities(`Select Date`) } " options=${{"minDate":"","maxDate":"","dateFormat":"m-d-Y","enableTime":"","disable":[],"mode":"single","static":true,"disableMobile":true,"time_24hr":false}} value=${parent.getValue('mf-date-appointment')} onInput=${parent.handleDateTime} aria-invalid=${validation.errors['mf-date-appointment'] ? 'true' : 'false'} ref=${el => props.DateWidget( el, '', {"message":"This field is required.","required":true}, register, parent )} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-date-appointment" as=${html``} />

<${props.Flatpickr} name="booking_time" className="mf-input mf-date-input mf-time-input mf-left-parent " placeholder="${ parent.decodeEntities(`Select Time`) } " options=${{"enableTime":true,"dateFormat":"h:i K","noCalendar":true,"time_24hr":false,"static":true}} value=${parent.getValue('booking_time')} onInput=${parent.handleDateTime} aria-invalid=${validation.errors['booking_time'] ? 'true' : 'false'} ref=${ el => { if( el && el.node.nextSibling ) { if( el.props.value.trim().length ) { el.node.nextSibling.classList.add('value-found'); }else { el.node.nextSibling.classList.remove('value-found'); } } register({ name: "booking_time" }, parent.activateValidation({"message":"This field is required.","required":true})) } } /> <${validation.ErrorMessage} errors=${validation.errors} name="booking_time" as=${html``} />

<${props.Select} className=${"mf-input mf-input-select " + ( validation.errors['mf-doctor'] ? 'mf-invalid' : '' )} classNamePrefix="mf_select" name="mf-doctor" placeholder="${ parent.decodeEntities(`Select Doctor`) } " isSearchable=${false} options=${[{"label":"DR VIKRANT PACHISYA","value":"DR MUTAZ AL SHAMANDI","isDisabled":false},{"label":"DR SOHAR","value":"DR SOHAR","isDisabled":false},{"label":"DR EDWARD MESBER","value":"DR EDWARD MESBER","isDisabled":false},{"label":"DR ISA REZAE","value":"DR ISA REZAE","isDisabled":false}]} value=${parent.getValue("mf-doctor") ? [{"label":"DR VIKRANT PACHISYA","value":"DR MUTAZ AL SHAMANDI","isDisabled":false},{"label":"DR SOHAR","value":"DR SOHAR","isDisabled":false},{"label":"DR EDWARD MESBER","value":"DR EDWARD MESBER","isDisabled":false},{"label":"DR ISA REZAE","value":"DR ISA REZAE","isDisabled":false}].filter(item => item.value === parent.getValue("mf-doctor"))[0] : []} onChange=${(e)=> parent.handleSelect(e, "mf-doctor")} ref=${() => { register({ name: "mf-doctor" }, parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false})); if ( parent.getValue("mf-doctor") === '' && false ) { parent.setValue( 'mf-doctor', '', true ); parent.handleChange({ target: { name: 'mf-doctor', value: '' } }); } }} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-doctor" as=${html``} />

parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el)} > <${validation.ErrorMessage} errors=${validation.errors} name="mf-note-to-the-doctor" as=${html``} />

${ parent.decodeEntities(`Confirm and Pay`) }