alpaca

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Alpaca provides the easiest and fastest way to generate interactive forms for the web and mobile devices. It runs simply as HTML5 or more elaborately using Bootstrap, jQuery Mobile or jQuery UI. Alpaca uses Handlebars to process JSON schema and provide

github.com/gitana/alpaca

gitana/alpaca

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{ "fields": { "anc_symptoms": { "type": "checkbox", "multiple": true, "optionLabels": [ "Abdominal Pain", "Vaginal Pain", "Vaginal Bleeding", "Loss of Fetal Movement", "Vaginal Leakage of Fluid", "Headache", "Blurred Vision", "Nausea or Vomiting", "Diarrhea", "Constipation", "Fever", "Contractions", "Post-Coital Bleeding" ] }, "anemia_severities": { "type": "select", "optionLabels": [ "<8.5g/dl", ">8.5g/dl" ] }, "birth_comp": { "type": "checkbox", "multiple": true, "optionLabels": [ "PPH", "Eclampsia", "Pre-eclapmsia", "Obstructed labor", "Retained placenta", "Ruptured uterus", "Sepsis/infection", "Tear (Third Degree Tear)", "Other", "Given IV antibiotics", "Given IV anticonvulsants", "Given uterotonics", "Given blood transfusion", "Given IV anticonvulsants", "Placenta removed by hand", "MVA needed" ] }, "cervical_symptoms": { "type": "checkbox", "multiple": true, "optionLabels": [ "Vaginal Discharge", "Post-Coital Bleeding" ] }, "condom_quantities": { "type": "select", "optionLabels": [ "Not Applicable", "1 to 10", "11 to 20", "21 to 30", "31 to 40", "41 to 50", "50+" ] }, "contraceptive_sources": { "type": "select", "optionLabels": [ "Clinic", "Community Based Distribution (CBD)", "Outreach", "Both" ] }, "contraceptives": { "type": "select", "optionLabels": [ "Pills", "Condoms", "IUD", "Remove IUD", "Other Implants", "Depo Provera", "Sterilization", "Natural ways", "Other" ] }, "delivery_mode": { "type": "select", "optionLabels": [ "Vaginal", "C-section", "Vacuum", "Breech", "Other" ] }, "delivery_type": { "type": "select", "optionLabels": [ "Home delivery", "Delivered by traditional birth attendant", "Delivered in clinic", "Delivered on the way to clinic", "Delivered by skilled provider" ] }, "depoprovera_quantities": { "type": "select", "optionLabels": [ "3 Month Dose", "6 Month Dose" ] }, "diseases": { "type": "select", "optionLabels": [ "Acute Flacid Paralysis", "Cholera", "Dysentery", "Measles", "Meningitis", "Neonatal Tetanus", "Plague", "Relapsing Fever (Louse borne typhus)", "Yellow Fever", "Influenza", "Typhoid", "Rabies/Suspected rabies bites", "Trachoma", "Onchocerciasis", "Trypanosomiasis", "Viral haemorrhagic fevers", "Keratoconjuctivitis", "Diarrhea, Acute (< 14 days)", "Diarrhea, Chronic (.> 14 days)", "Malaria", "Blood Slide positive", "mRDT postivie", "Clinical (No Test)", "In Pregnancy", "Schistosomiasis", "STI Genital Discharge Syndrome (GDS)", "STI Genital Ulcer Diseases (GUD)", "STI Pelvic Inflammatory Diseases (PID)", "Sexually Transmitted Infections, Other", "Tuberculosis", "Leprosy", "Intestinal Worms", "Anaemia, Mild / Moderate ", "Anaemia, Severe", "Sickle cell Disease ", "HIV Positive", "HIV Infection, Symptomatic", "Ear Infection, Acute", "Ear Infection, Chronic", "Eye Infection", "Cataract", "Eye Diseases, Other non-infectious", "Skin Infection, Non-Fungal", "Skin Infection, Fungal", "Skin Diseases, Non-infectious", "Fungal Infection, Non-skin", "Osteomyelitis", "Neonatal sepsis", "Low birth weight and Prematurity complications", "Birth asphyxia", "Acute Respiratory Infection (ARI)", "Pneumonia, Non-Severe", "Cerebral palsy", "Pneumonia, Severe", "Upper Respiratory Infections (Pharyngitis, Tonsillitis, Rhinitis)", "Urinary Tract Infections (UTI)", "Gynaecological diseases, Other", "Kwashiokor", "Marasmus", "Marasmic Kwashiokor", "Moderate Malnutrition", "Vitamin A Deficiency", "Other Nutritional Disorders", "Caries", "Periodontal Diseases", "Dental Emergency Care", "Dental Conditions, Other", "Fractures / Dislocations", "Burn", "Poisoning", "Road Traffic Accidents", "Pregnancy complications", "Abortion", "Snake and Insect Bites", "Emergencies, Other", "Surgical conditions, other", "Epilepsy", "Psychoses", "Neurosis", "Mental conditions, Other", "Hypertension", "Rheumatic Fever", "Cardiovascular Diseases, Other", "Bronchial Asthma", "Peptic Ulcers", "GIT Diseases, Other Non-infectious", "Diabetes Mellitus", "Rheumatoid and Joint Diseases", "Thyroid Diseases", "Neoplasms", "Ill Defined Symptoms (No Diagnosis)", "Diagnoses, Other", "Waliopewa Rufaa" ] }, "drug_quantities": { "type": "select", "optionLabels": [ "Not Applicable", "1 Month Supply", "2 Month Supply", "3 Month Supply", "4 Month Supply", "5 Month Supply", "6 Month Supply", "7 Month Supply", "8 Month Supply", "9 Month Supply", "10 Month Supply", "11 Month Supply", "12 Month Supply", "More Than One Year Supply" ] }, "fertility_desires": { "type": "select", "optionLabels": [ "Desires Pregnancy Now", "Desires Contraception Now", "Desires Future Pregnancy" ] }, "fetal_heart_rates": { "type": "select", "optionLabels": [ "Not Checked", "Checked, But Unable To Hear", "110s", "120s", "130s", "140s", "150s", "160s", "170s", "180s" ] }, "fetal_movements": { "type": "select", "optionLabels": [ "Too Early To Be Felt", "Felt By Mother", "Felt By Mother, Noted to be Abnormal", "Not Felt By Mother" ] }, "fetal_stations": { "type": "select", "optionLabels": [ "Not Examined", "High/Unengaged", "-3", "-2", "-1", "0", "1", "2", "3" ] }, "genders": { "type": "select", "optionLabels": [ "Female", "Male", "Unknown" ] }, "histories": { "type": "checkbox", "multiple": true, "optionLabels": [ "Other", "Hypertension", "Diabetes", "Malaria", "Yellow Fever", "Cholera", "Meningitis", "Sickle Cell", "Cancer", "Leprosy" ] }, "hiv_diagnosis_times": { "type": "select", "optionLabels": [ "Unknown", "Less Than 2 Month After Birth", "Between 2-18 Months After Birth", "More Than 18 Months After Birth" ] }, "hiv_risks": { "type": "select", "optionLabels": [ "Patient Known to Have HIV", "Partner or Previous Partner Known to Have HIV", "History of Sexual Assult", "Desires HIV Testing" ] }, "hiv_statuses": { "type": "radio", "optionLabels": [ "Positive", "Negative", "Unknown" ] }, "immunization_effects": { "type": "select", "optionLabels": [ "Shortness of Breath", "Tongue Swelling", "Rash", "Fever", "Swelling at Injection Site", "Nausea or Vomiting", "Other" ] }, "immunizations": { "type": "checkbox", "multiple": true, "optionLabels": [ "BCG", "OPV-0", "OPV-1", "OPV-2", "OPV-3", "DTP-HB", "DPT 1", "DPT 2", "DPT 3", "Measles", "PENTA", "Tentanus Toxoid 1", "Tentanus Toxoid 2", "Tentanus Toxoid 3", "Tentanus Toxoid 4", "Tentanus Toxoid 5", "Vitamin A", "Other" ] }, "immunizations_postnatal": { "type": "checkbox", "multiple": true, "optionLabels": [ "BCG", "OPV-0" ] }, "infant_weights": { "type": "select", "optionLabels": [ "No Previous Delivery", "Unknown", "<1kg", "1kg", "1.5kg", "2kg", "2.5kg", "3kg", "3.5kg", "4kg+" ] }, "injuries": { "type": "select", "optionLabels": [ "Animal Bite (suspected rabies)", "Animal Bite (No rabies)", "Fracture", "Concussion / Head Injury", "Motor Vehicle Accident", "Motorcycle Accident", "Laceration", "Crush injury", "Burn", "Other" ] }, "injury_treatments": { "type": "select", "optionLabels": [ "Wound Washout", "Suture of Laceration", "Topical Treatment of Burn", "Bone Setting/Cast", "Surgery", "Blood Transfusion", "Antibiotics", "Antivenom", "Other" ] }, "leprosy_classifications": { "type": "select", "optionLabels": [ "MB (A)", "MB (C)", "PB (A)", "PB (C)" ] }, "leprosy_diagnoses": { "type": "checkbox", "multiple": true, "optionLabels": [ "TB", "Leprosy" ] }, "leprosy_disabilities": { "type": "select", "optionLabels": [ "Grade 0", "Grade 1", "Grade 2" ] }, "leprosy_results": { "type": "select", "optionLabels": [ "Treatment completed", "Died", "Transferred out", "Defaulter", "Not applicable" ] }, "leprosy_statuses": { "type": "select", "optionLabels": [ "New Patient", "Return after default", "Relapse after MDT", "Relapse after DDS/other" ] }, "marital_statuses": { "type": "select", "optionLabels": [ "Single", "Married", "Divorced", "Separated", "Widowed" ] }, "menses_regularity": { "type": "select", "optionLabels": [ "Irregular Menses", "Regular Menses Monthly" ] }, "milk_types": { "type": "select", "optionLabels": [ "Mother's Milk ONLY", "Mother's Milk + Formula", "Mother's Milk + Other", "Formula ONLY", "Formula + Other", "Other ONLY" ] }, "postnatal_child_diagnoses": { "type": "checkbox", "multiple": true, "optionLabels": [ "Septicemia", "Umbilical cord infection", "Severe anemia (Hb<10)", "Skin infection", "Neonatal death" ] }, "postnatal_mother_diagnoses": { "type": "checkbox", "multiple": true, "optionLabels": [ "Severe anemia (Hb<8.5)", "Mental disorder", "Gaping or infected perineum ", "Fistula" ] }, "pregnancy_complications": { "type": "checkbox", "multiple": true, "optionLabels": [ "Fetal Death", "Neonatal Death", "Neonatal Injury", "Neonatal Tetanus", "Neonatal Sepsis", "Birth Asphyxia", "Shoulder Dystocia", "Obstructed Labor", "TB", "Diabetes", "Hemorrhage", "Intra-uterine Infection", "Cesarean Section", "Seizure", "Forceps/Vacuum", "Sepsis", "Other" ] }, "pregnancy_diseases": { "type": "checkbox", "multiple": true, "optionLabels": [ "Tuberculosis", "Diabetes", "Heart Disease" ] }, "prenatal_prob": { "type": "checkbox", "multiple": true, "optionLabels": [ "APH", "PROM", "High BP", "Eclampsia", "Pre-eclampsia", "Anemia", "Malaria", "HIV", "HIV stage III or stage IV", "Ectopic pregnancy ", "Abortion complications", "Other" ] }, "referral_locations": { "type": "select", "optionLabels": [ "Not Applicable", "Laboratory", "Pharmacy", "Antenatal Clinic", "TB / Leprosy Department", "CTC", "Reproductive Counseling", "Immunization" ] }, "symptoms": { "type": "checkbox", "multiple": true, "optionLabels": [ "Other", "Body Aches", "Chills", "Diarrhea", "Fever", "Headache", "Shortness of Breath", "Nausea or Vomiting", "Rigors", "Night Sweats", "Rash", "Abdominal Pain", "Cough", "Difficultly with Urination", "Weakness", "Weight Loss" ] }, "tb_classifications": { "type": "checkbox", "optionLabels": [ "AFB+", "AFB-", "Extra-pulmonary" ] }, "tb_regimens": { "type": "select", "optionLabels": [ "2RHZE/4RH", "2RHZ/4RH", "2SRHZE/1RHZE/5RH3E3", "2SRHZE/1RHZE/5RHE", "2RHZE/6EH", "Health facility DOT", "Home-based DOT" ] }, "water_sodium_severities": { "type": "select", "optionLabels": [ "Severe", "Mild", "Uncertain" ] }, "one_to_20_plus": { "type": "select", "optionLabels": [ "1", "2", "3", "4", "5", "6", "7", "8", "9", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20+" ] }, "one_to_42_plus": { "type": "select", "optionLabels": [ "1", "2", "3", "4", "5", "6", "7", "8", "9", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "27", "28", "29", "30", "31", "32", "33", "34", "35", "36", "37", "38", "39", "40", "41", "42+" ] }, "breast_symptoms": { "type": "checkbox", "multiple": true, "optionLabels": [ "Lump", "Pain", "Discharge", "Ulcer" ] }, "fundal_heights": { "type": "select", "optionLabels": [ "too early to measure", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "27", "28", "29", "30", "31", "32", "33", "34", "35", "36", "37", "38", "39", "40", "41", "42" ] }, "cervical_dilations": { "type": "select", "optionLabels": [ "not examined", "closed", "finger tip", "1", "2", "3", "4", "5", "6", "7", "8", "9", "10" ] } } }