alpaca
Version:
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
224 lines • 6.34 kB
JSON
{
"fields": {
"last_menstrual_period": {
"label": "Last Menstrual Period:",
"type": "date",
"dateFormat": "yy-mm-dd",
"datepicker": {
"hideIfNoPrevNextType": true,
"yearRange": "2010:+10",
"changeMonth": true,
"changeYear": true
}
},
"menstrual_history": {
"label": "Menstrual History:",
"type": "select"
},
"number_pregnancy": {
"label": "Total Number of Pregnancies",
"type": "select"
},
"number_full_term_delivery": {
"label": "Number of Full Term Deliveries",
"type": "select"
},
"number_pre_term_delivery": {
"label": "Number of Preterm Deliveries",
"type": "select"
},
"number_miscarriage_or_abortion": {
"label": "Number of Miscarriages or Abortions",
"type": "select"
},
"number_live_birth": {
"label": "Number of Live Births",
"type": "select"
},
"pregnancy_complication": {
"label": "Pregnancy Complications, Check All That Apply:",
"type": "checkbox"
},
"pregnancy_complication_other": {
"label": "If Other Pregnancy Complication, Describe:"
},
"marital_status": {
"label": "Marital Status:",
"type": "select"
},
"contraception_previous": {
"label": "Previous Contraception:",
"type": "select"
},
"contraception_current": {
"label": "Current Contraception:",
"type": "select"
},
"contraception_source": {
"label": "Source of Contraception",
"type": "select"
},
"fertility_desire": {
"label": "Fertility Desires:",
"type": "select"
},
"hiv_risk": {
"label": "HIV Risks:",
"type": "select"
},
"hiv_status": {
"label": "HIV Status",
"type": "select"
},
"hiv_tested": {
"label": "Tested for HIV?",
"type": "radio",
"enum": [
"Yes",
"No"
],
"removeDefaultNone": true
},
"hiv_partner_test": {
"label": "Partner tested for HIV?",
"type": "radio",
"enum": [
"Yes",
"No"
],
"removeDefaultNone": true
},
"hiv_positive_test": {
"label": "Tested positive for HIV?",
"type": "radio",
"enum": [
"Yes",
"No"
],
"removeDefaultNone": true
},
"hiv_partner_positive_test": {
"label": "Partner tested positive for HIV?",
"type": "radio",
"enum": [
"Yes",
"No"
],
"removeDefaultNone": true
},
"hiv_counseling": {
"label": "HIV counseling given?",
"type": "radio",
"enum": [
"Yes",
"No"
],
"removeDefaultNone": true
},
"hiv_partner_counseling": {
"label": "HIV counseling given to partner?",
"type": "radio",
"enum": [
"Yes",
"No"
],
"removeDefaultNone": true
},
"hiv_discordant": {
"label": "HIV discordant couple?",
"type": "radio",
"enum": [
"Yes",
"No"
],
"removeDefaultNone": true
},
"referred_ctc": {
"label": "Referred to CTC?",
"type": "radio",
"enum": [
"Yes",
"No"
],
"removeDefaultNone": true
},
"post_test_counseling": {
"label": "Post-test HIV counseling given?",
"type": "radio",
"enum": [
"Yes",
"No"
],
"removeDefaultNone": true
},
"implant_removed": {
"label": "Implant removed?",
"type": "radio",
"enum": [
"Yes",
"No"
],
"removeDefaultNone": true
},
"contraception_after_miscarriage": {
"label": "Contraception given after recent miscarriage?",
"type": "radio",
"enum": [
"Yes",
"No"
],
"removeDefaultNone": true
},
"delivery_in_42_days": {
"label": "Delivery within 42 days?",
"type": "radio",
"enum": [
"Yes",
"No"
],
"removeDefaultNone": true
},
"contraception_in_42_days": {
"label": "Contraception given within 42 days of delivery?",
"type": "radio",
"enum": [
"Yes",
"No"
],
"removeDefaultNone": true
},
"contraception_dispensed": {
"label": "Contraception Dispensed:",
"type": "select"
},
"quantity_pills_dispensed": {
"label": "Quantity of Pills Dispensed:",
"type": "select"
},
"quantity_condoms_dispensed": {
"label": "Quantity of Condoms Dispensed:",
"type": "select"
},
"quantity_depo_provera": {
"label": "Dose of Depo Provera:",
"type": "select"
},
"condom_education": {
"label": "Condom Use Education Preformed",
"type": "radio",
"enum": [
"Yes",
"No"
],
"removeDefaultNone": true
},
"cervical_symptom": {
"label": "Cervical Symptoms:",
"type": "checkbox"
},
"breast_symptom": {
"label": "Breast Symptoms:",
"type": "checkbox"
}
}
}