step 7 : onchange dob and set tahun, bulan, hari done

2024-05-31 18:23:24 +07:00
parent 011d2c8857
commit 5680dccd8c
6 changed files with 560 additions and 21 deletions
--- a/handlers/dev/md.doctor.handlers.go
+++ b/handlers/dev/md.doctor.handlers.go
@@ -30,6 +30,7 @@ type MdDoctorServices interface {
 	GetJenisKelamin() ([]models.HardCodeDropdownV0, error)
 	GetKewarganegaraan() ([]models.HardCodeRadioButtonV0, error)
 	GetListMdSpesialis() ([]models.SpecialistV0, error)
+	GetDateNow() (string, error)
 }

 func NewMdDoctorHandler(us MdDoctorServices) *MdDoctorHandler {
@@ -221,6 +222,91 @@ func (lh *MdDoctorHandler) HandleShowMdDoctorScreen(c echo.Context) error {
 		return err
 	}

+	// listItem Pendidikan
+	dataResultPend, err := services.GetTerminologyList(
+		models.TerminologyParamv0{
+			AttributePath: "Person.education",
+			CodeSystem:    "xhis.code.education.level",
+		},
+	)
+	fmt.Println(dataResultPend)
+	fmt.Println(err)
+	if err != nil {
+		defer logger.Sync()
+		logger.Info("ERROR BREADCRUMB DEV",
+			zap.Any("error", err),
+		)
+		fmt.Println(dataResultPend)
+		return err
+	}
+
+	// listItem Identitas
+	dataResultIdentitas, err := services.GetTerminologyList(
+		models.TerminologyParamv0{
+			AttributePath: "Person.identifier.type",
+			CodeSystem:    "http://terminology.hl7.org/CodeSystem/v2-0203",
+		},
+	)
+	fmt.Println(dataResultIdentitas)
+	fmt.Println(err)
+	if err != nil {
+		defer logger.Sync()
+		logger.Info("ERROR BREADCRUMB DEV",
+			zap.Any("error", err),
+		)
+		fmt.Println(dataResultIdentitas)
+		return err
+	}
+
+	// listItem dataResultBloodRhesus
+	dataResultBloodRhesus, err := services.GetTerminologyList(
+		models.TerminologyParamv0{
+			AttributePath: "Person.blood.rhesus",
+			CodeSystem:    "http://snomed.info/sct",
+		},
+	)
+	fmt.Println(dataResultBloodRhesus)
+	fmt.Println(err)
+	if err != nil {
+		defer logger.Sync()
+		logger.Info("ERROR BREADCRUMB DEV",
+			zap.Any("error", err),
+		)
+		fmt.Println(dataResultBloodRhesus)
+		return err
+	}
+
+	// listItem dataResultEtnis
+	dataResultEtnis, err := services.GetTerminologyList(
+		models.TerminologyParamv0{
+			AttributePath: "Person.etnicity",
+			CodeSystem:    "xhis.code.etnicity",
+		},
+	)
+	fmt.Println(dataResultEtnis)
+	fmt.Println(err)
+	if err != nil {
+		defer logger.Sync()
+		logger.Info("ERROR BREADCRUMB DEV",
+			zap.Any("error", err),
+		)
+		fmt.Println(dataResultEtnis)
+		return err
+	}
+
+	// tanggal sekarang
+	dataTglNow, err := lh.MdDoctorServices.GetDateNow()
+	fmt.Println(dataTglNow)
+	fmt.Println(err)
+	if err != nil {
+		defer logger.Sync()
+		logger.Info("ERROR BREADCRUMB DEV",
+			zap.Any("error", err),
+		)
+		fmt.Println(dataTglNow)
+		return err
+	}
+
 	defer logger.Sync()
 	logger.Info("LOAD BREADCRUMB DEV",
 		zap.Any("data", dataBreadCrumb),
@@ -244,6 +330,30 @@ func (lh *MdDoctorHandler) HandleShowMdDoctorScreen(c echo.Context) error {
 	// Component Dropdown MCU
 	listItemResultSpesialisComponent := dev_mddoctorview.ItemDropdownSpesialis(dataResultSpecialist, 0, "Pilih Spesialis")

+	// Component Dropdown Pendidikan Terakhir
+	listItemResultPendComponent := dev_mddoctorview.ItemDropdownTerminology(dataResultPend,
+		models.TerminologySelectedV0{},
+		"Pendidikan Terakhir",
+	)
+
+	// Component Dropdown Identitas
+	listItemResultIdentitasComponent := dev_mddoctorview.ItemDropdownTerminology(dataResultIdentitas,
+		models.TerminologySelectedV0{},
+		"Pilih Identitas",
+	)
+
+	// Component Dropdown Rhesus
+	listItemResultBloodRhesusComponent := dev_mddoctorview.ItemDropdownTerminology(dataResultBloodRhesus,
+		models.TerminologySelectedV0{},
+		"Rhesus",
+	)
+
+	// Component Dropdown Etnis
+	listItemResultEtnisComponent := dev_mddoctorview.ItemDropdownTerminology(dataResultEtnis,
+		models.TerminologySelectedV0{},
+		"Etnis",
+	)
+
 	//modal add form
 	dialogAddBodyCmp := dev_mddoctorview.BodyFormDoctor(
 		models.CustomTextFieldv2Prm{
@@ -253,6 +363,14 @@ func (lh *MdDoctorHandler) HandleShowMdDoctorScreen(c echo.Context) error {
 			Type:        "hidden",
 			ID:          "doctorid",
 		},
+		models.CustomTextFieldv2Prm{
+			Label:       "Tgl Sekarang",
+			Name:        "doctortglnow",
+			Placeholder: "Tgl Sekarang",
+			Type:        "hidden",
+			ID:          "doctortglnow",
+			Value:       dataTglNow,
+		},
 		models.CustomDropdownv1Prm{
 			Label: "Sapaan",
 			Name:  "doctorsapaan",
@@ -304,6 +422,93 @@ func (lh *MdDoctorHandler) HandleShowMdDoctorScreen(c echo.Context) error {
 			ID:    "doctorspesialis",
 		},
 		listItemResultSpesialisComponent,
+		models.CustomTextFieldv2Prm{
+			Label:       "Imbuhan Akhir 1",
+			Name:        "doctorimbuhanakhir1",
+			Placeholder: "Akhir 1",
+			Type:        "text",
+			ID:          "doctorimbuhanakhir1",
+		},
+		models.CustomTextFieldv2Prm{
+			Label:       "Imbuhan Akhir 2",
+			Name:        "doctorimbuhanakhir2",
+			Placeholder: "Akhir 2",
+			Type:        "text",
+			ID:          "doctorimbuhanakhir2",
+		},
+		models.CustomTextFieldv2Prm{
+			Label:       "Tahun",
+			Name:        "doctorimbuhantahun",
+			Placeholder: "Tahun",
+			Type:        "text",
+			ID:          "doctorimbuhantahun",
+		},
+		models.CustomTextFieldv2Prm{
+			Label:       "Bulan",
+			Name:        "doctorimbuhanbulan",
+			Placeholder: "Bulan",
+			Type:        "text",
+			ID:          "doctorimbuhanbulan",
+		},
+		models.CustomTextFieldv2Prm{
+			Label:       "Hari",
+			Name:        "doctorimbuhanhari",
+			Placeholder: "Hari",
+			Type:        "text",
+			ID:          "doctorimbuhanhari",
+		},
+		models.CustomDropdownv1Prm{
+			Label: "Pendidikan Terakhir",
+			Name:  "doctorpendidikanterakhir",
+			ID:    "doctorpendidikanterakhir",
+		},
+		listItemResultPendComponent,
+		models.CustomDropdownv1Prm{
+			Label: "Identitas",
+			Name:  "doctoridentitas",
+			ID:    "doctoridentitas",
+		},
+		listItemResultIdentitasComponent,
+		models.CustomTextFieldv2Prm{
+			Label:       "Email",
+			Name:        "doctorimbuhanemail",
+			Placeholder: "Email",
+			Type:        "text",
+			ID:          "doctorimbuhanemail",
+		},
+		models.CustomTextFieldv2Prm{
+			Label:       "Nama",
+			Name:        "doctorimbuhannama",
+			Placeholder: "Nama",
+			Type:        "text",
+			ID:          "doctorimbuhannama",
+		},
+		models.CustomTextFieldv2Prm{
+			Label:       "Tanggal Lahir",
+			Name:        "doctorimbuhantanggallahir",
+			Placeholder: "Tanggal Lahir",
+			Type:        "date",
+			ID:          "doctorimbuhantanggallahir",
+		},
+		models.CustomDropdownv1Prm{
+			Label: "Rhesus",
+			Name:  "doctorgolonganbloodrhesus",
+			ID:    "doctorgolonganbloodrhesus",
+		},
+		listItemResultBloodRhesusComponent,
+		models.CustomDropdownv1Prm{
+			Label: "Ernis",
+			Name:  "doctorgolonganetnis",
+			ID:    "doctorgolonganetnis",
+		},
+		listItemResultEtnisComponent,
+		models.CustomTextFieldv2Prm{
+			Label:       "Nomor HP",
+			Name:        "doctorimbuhannohp",
+			Placeholder: "Nomor HP",
+			Type:        "text",
+			ID:          "doctorimbuhannohp",
+		},
 		dialogAddBodyID, dev_mddoctorview.JsHideModalDoctor(""))

 	modalActioAddCmp := dev_mddoctorview.ActionFormDoctor(
--- a/services/dev/md.doctor.services.go
+++ b/services/dev/md.doctor.services.go
@@ -690,6 +690,28 @@ func (su *ServicesMdDoctor) GetListMdSpesialis() ([]models.SpecialistV0, error)
 	return sapaanList, nil
 }

+// tanggal sekarang
+func (su *ServicesMdDoctor) GetDateNow() (string, error) {
+	var stringDateNow string
+
+	logger, _ := zap.NewProduction()
+	defer logger.Sync()
+
+	query := `
+		SELECT CURRENT_DATE() as tglSekarang
+	`
+
+	logger.Info("QUERY SEARCH INITIAL",
+		zap.String("query search", query),
+	)
+
+	if err := dbx.Handlex.Get(&stringDateNow, query); err != nil {
+		return "", fmt.Errorf("error querying database: %v", err)
+	}
+
+	return stringDateNow, nil
+}
+
 // LISTING, SEARCH, PAGINATION
 func (su *ServicesMdDoctor) GetListMdDoctor(search string, currentPage int, rowPerPage int) ([]models.DoctorV1, int, error) {
 	var doctorList []models.DoctorV1
--- a/views/dev/mddoctor/mddoctor.templ
+++ b/views/dev/mddoctor/mddoctor.templ
@@ -157,7 +157,7 @@ templ ItemDropdownTerminology(dataDropdown []models.TerminologyV0, selectedItem

 // for item radiobutton kewarganegaraan
 templ ItemRadioButtonKewarganegaraan(data []models.HardCodeRadioButtonV0, selectedRadioButton int) {
-	<div style="display: flex; gap: 20px">
+	<div style="display: flex; gap: 20px" class="mt-6">
 		for _, v := range data {
 			if (selectedRadioButton == v.ID) {
 				<label style="display: flex; align-items: center; gap: 5px">
--- a/views/dev/mddoctor/mddoctor_templ.go
+++ b/views/dev/mddoctor/mddoctor_templ.go
@@ -538,7 +538,7 @@ func ItemRadioButtonKewarganegaraan(data []models.HardCodeRadioButtonV0, selecte
 			templ_7745c5c3_Var22 = templ.NopComponent
 		}
 		ctx = templ.ClearChildren(ctx)
-		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString("<div style=\"display: flex; gap: 20px\">")
+		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString("<div style=\"display: flex; gap: 20px\" class=\"mt-6\">")
 		if templ_7745c5c3_Err != nil {
 			return templ_7745c5c3_Err
 		}
--- a/views/dev/mddoctor/mddoctorformmodal.templ
+++ b/views/dev/mddoctor/mddoctorformmodal.templ
@@ -60,7 +60,9 @@ script HandleFormAfterRequest() {
 	}
 }

-templ BodyFormDoctor(inputId models.CustomTextFieldv2Prm,
+templ BodyFormDoctor(
+	inputId models.CustomTextFieldv2Prm,
+	inputTglNow models.CustomTextFieldv2Prm,
 	dropdownDoctorSapaan models.CustomDropdownv1Prm,
 	listItemSapaan templ.Component,
 	InputImbuhanAwal1 models.CustomTextFieldv2Prm,
@@ -74,6 +76,23 @@ templ BodyFormDoctor(inputId models.CustomTextFieldv2Prm,
 	InputNomorIdentitas models.CustomTextFieldv2Prm,
 	dropdownDoctorSpesialis models.CustomDropdownv1Prm,
 	listItemSpesialis templ.Component,
+	InputImbuhanAkhir1 models.CustomTextFieldv2Prm,
+	InputImbuhanAkhir2 models.CustomTextFieldv2Prm,
+	InputTahun models.CustomTextFieldv2Prm,
+	InputBulan models.CustomTextFieldv2Prm,
+	InputHari models.CustomTextFieldv2Prm,
+	dropdownDoctorPend models.CustomDropdownv1Prm,
+	listItemPend templ.Component,
+	dropdownDoctorIdentitas models.CustomDropdownv1Prm,
+	listItemIdentitas templ.Component,
+	InputEmail models.CustomTextFieldv2Prm,
+	InputNama models.CustomTextFieldv2Prm,
+	InputTanggalLahir models.CustomTextFieldv2Prm,
+	dropdownDoctorBloodRhesus models.CustomDropdownv1Prm,
+	listItemBloodRhesus templ.Component,
+	dropdownDoctorEtnis models.CustomDropdownv1Prm,
+	listItemEtnis templ.Component,
+	InputNomorHP models.CustomTextFieldv2Prm,
 	componentID string,
 	hxOnLoad templ.ComponentScript) {
 	<div id={ componentID } hx-on::load={ hxOnLoad }>
@@ -100,6 +119,8 @@ templ BodyFormDoctor(inputId models.CustomTextFieldv2Prm,
 			<!-- person.png end -->
 			@customtextfield.CustomTextFieldv2(
 				inputId)
+			@customtextfield.CustomTextFieldv2(
+				inputTglNow)
 			<div class="row mt-5">
 				<!-- col 1 start -->
 				<div class="col-4">
@@ -146,7 +167,7 @@ templ BodyFormDoctor(inputId models.CustomTextFieldv2Prm,
 					</div>
 					<!-- Kewarganegaraan -->
 					<!-- Nomor identitas start -->
-					<div class="form-row mt-0">
+					<div class="form-row mt-8">
 						@customtextfield.CustomTextFieldv2(
 							InputNomorIdentitas)
 					</div>
@@ -160,6 +181,110 @@ templ BodyFormDoctor(inputId models.CustomTextFieldv2Prm,
 					<!-- spesialis -->
 				</div>
 				<!-- col 1 end -->
+				<!-- col 2 start -->
+				<div class="col-4">
+					<div class="form-row">
+						<!-- Nama start -->
+						<div class="col">
+							@customtextfield.CustomTextFieldv2(
+								InputNama)
+						</div>
+						<!-- Nama end -->
+					</div>
+					<div class="form-row">
+						<!-- TanggalLahir start -->
+						<div class="col">
+							@customtextfield.CustomTextFieldv2(
+								InputTanggalLahir)
+						</div>
+						<!-- TanggalLahir end -->
+					</div>
+					<div class="form-row">
+						<!-- BloodRhesus start -->
+						<div class="col">
+							@customdropdown.MainCustomDropdownInputV0(
+								dropdownDoctorBloodRhesus,
+								listItemBloodRhesus)
+						</div>
+						<!-- BloodRhesus end -->
+					</div>
+					<div class="form-row">
+						<!-- Etnis start -->
+						<div class="col">
+							@customdropdown.MainCustomDropdownInputV0(
+								dropdownDoctorEtnis,
+								listItemEtnis)
+						</div>
+						<!-- Etnis end -->
+					</div>
+					<div class="form-row mt-0">
+						<!-- Nomor HP start -->
+						<div class="col">
+							@customtextfield.CustomTextFieldv2(
+								InputNomorHP)
+						</div>
+						<!-- Nomor HP end -->
+					</div>
+				</div>
+				<!-- col 2 start -->
+				<!-- col 3 start -->
+				<div class="col-4">
+					<div class="form-row">
+						<!-- Imbuhan akhir 1 start -->
+						<div class="col">
+							@customtextfield.CustomTextFieldv2(
+								InputImbuhanAkhir1)
+						</div>
+						<!-- Imbuhan akhir 1 end -->
+						<!-- Imbuhan akhir 2 start -->
+						<div class="col">
+							@customtextfield.CustomTextFieldv2(
+								InputImbuhanAkhir2)
+						</div>
+						<!-- Imbuhan akhir 2 end -->
+					</div>
+					<div class="form-row mt-0">
+						<!-- Tahun start -->
+						<div class="col">
+							@customtextfield.CustomTextFieldv2(
+								InputTahun)
+						</div>
+						<!-- Tahun end -->
+						<!-- Bulan start -->
+						<div class="col">
+							@customtextfield.CustomTextFieldv2(
+								InputBulan)
+						</div>
+						<!-- Bulan end -->
+						<!-- Hari -->
+						<div class="col">
+							@customtextfield.CustomTextFieldv2(
+								InputHari)
+						</div>
+						<!-- Hari -->
+					</div>
+					<!-- pendidikan -->
+					<div class="form-row mt-0">
+						@customdropdown.MainCustomDropdownInputV0(
+							dropdownDoctorPend,
+							listItemPend)
+					</div>
+					<!-- pendidikan -->
+					<!-- Identitas -->
+					<div class="form-row mt-0">
+						@customdropdown.MainCustomDropdownInputV0(
+							dropdownDoctorIdentitas,
+							listItemIdentitas)
+					</div>
+					<!-- Identitas -->
+					<!-- email -->
+					<div class="form-row mt-0">
+						@customtextfield.CustomTextFieldv2(
+							InputEmail)
+					</div>
+					<!-- email -->
+				</div>
+				<!-- col 3 start -->
 			</div>
 		</div>
 	</div>
@@ -168,6 +293,48 @@ templ BodyFormDoctor(inputId models.CustomTextFieldv2Prm,
        // Reinitialize selectpicker after HTMX content swap
        $('.selectpicker').selectpicker('refresh');
    });
+
+	document.addEventListener('DOMContentLoaded', function() {
+		document.getElementById('doctorimbuhantahun').setAttribute('disabled',true)
+		document.getElementById('doctorimbuhanbulan').setAttribute('disabled',true)
+		document.getElementById('doctorimbuhanhari').setAttribute('disabled',true)
+
+		// onchange date picker
+		var birthdateInput = document.querySelector("#doctorimbuhantanggallahir");
+    	var invalidFeedback = birthdateInput.closest(".form-group").querySelector(".invalid-feedback");
+
+    	var birthdateValue = birthdateInput.value;
+
+		var todayInput = document.querySelector("#doctortglnow");
+	
+		birthdateInput.addEventListener('change', function() {
+			var birthdateValue = new Date(birthdateInput.value);
+			if (!isNaN(birthdateValue)) {
+				var today = new Date(todayInput.value);
+				
+				var years = today.getFullYear() - birthdateValue.getFullYear();
+				var months = today.getMonth() - birthdateValue.getMonth();
+				var days = today.getDate() - birthdateValue.getDate();
+				
+				if (days < 0) {
+					months--;
+					days += new Date(today.getFullYear(), today.getMonth(), 0).getDate();
+				}
+				
+				if (months < 0) {
+					years--;
+					months += 12;
+				}
+
+				document.querySelector("[name='doctorimbuhantahun']").value = years + ' Tahun';
+				document.querySelector("[name='doctorimbuhanbulan']").value = months + ' Bulan';
+				document.querySelector("[name='doctorimbuhanhari']").value = days + ' Hari';
+			} else{
+				birthdateInput.classList.add('is-invalid');
+				invalidFeedback.textContent = 'Tanggal lahir tidak valid.';
+			}
+		})
+	});
    </script>
 }

--- a/views/dev/mddoctor/mddoctorformmodal_templ.go
+++ b/views/dev/mddoctor/mddoctorformmodal_templ.go
@@ -187,7 +187,9 @@ func HandleFormAfterRequest() templ.ComponentScript {
 	}
 }

-func BodyFormDoctor(inputId models.CustomTextFieldv2Prm,
+func BodyFormDoctor(
+	inputId models.CustomTextFieldv2Prm,
+	inputTglNow models.CustomTextFieldv2Prm,
 	dropdownDoctorSapaan models.CustomDropdownv1Prm,
 	listItemSapaan templ.Component,
 	InputImbuhanAwal1 models.CustomTextFieldv2Prm,
@@ -201,6 +203,23 @@ func BodyFormDoctor(inputId models.CustomTextFieldv2Prm,
 	InputNomorIdentitas models.CustomTextFieldv2Prm,
 	dropdownDoctorSpesialis models.CustomDropdownv1Prm,
 	listItemSpesialis templ.Component,
+	InputImbuhanAkhir1 models.CustomTextFieldv2Prm,
+	InputImbuhanAkhir2 models.CustomTextFieldv2Prm,
+	InputTahun models.CustomTextFieldv2Prm,
+	InputBulan models.CustomTextFieldv2Prm,
+	InputHari models.CustomTextFieldv2Prm,
+	dropdownDoctorPend models.CustomDropdownv1Prm,
+	listItemPend templ.Component,
+	dropdownDoctorIdentitas models.CustomDropdownv1Prm,
+	listItemIdentitas templ.Component,
+	InputEmail models.CustomTextFieldv2Prm,
+	InputNama models.CustomTextFieldv2Prm,
+	InputTanggalLahir models.CustomTextFieldv2Prm,
+	dropdownDoctorBloodRhesus models.CustomDropdownv1Prm,
+	listItemBloodRhesus templ.Component,
+	dropdownDoctorEtnis models.CustomDropdownv1Prm,
+	listItemEtnis templ.Component,
+	InputNomorHP models.CustomTextFieldv2Prm,
 	componentID string,
 	hxOnLoad templ.ComponentScript) templ.Component {
 	return templ.ComponentFunc(func(ctx context.Context, templ_7745c5c3_W io.Writer) (templ_7745c5c3_Err error) {
@@ -226,7 +245,7 @@ func BodyFormDoctor(inputId models.CustomTextFieldv2Prm,
 		var templ_7745c5c3_Var10 string
 		templ_7745c5c3_Var10, templ_7745c5c3_Err = templ.JoinStringErrs(componentID)
 		if templ_7745c5c3_Err != nil {
-			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 79, Col: 22}
+			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 98, Col: 22}
 		}
 		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString(templ.EscapeString(templ_7745c5c3_Var10))
 		if templ_7745c5c3_Err != nil {
@@ -250,6 +269,11 @@ func BodyFormDoctor(inputId models.CustomTextFieldv2Prm,
 		if templ_7745c5c3_Err != nil {
 			return templ_7745c5c3_Err
 		}
+		templ_7745c5c3_Err = customtextfield.CustomTextFieldv2(
+			inputTglNow).Render(ctx, templ_7745c5c3_Buffer)
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
 		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString("<div class=\"row mt-5\"><!-- col 1 start --><div class=\"col-4\"><div class=\"form-row\"><!-- sapaan start --><div class=\"col\">")
 		if templ_7745c5c3_Err != nil {
 			return templ_7745c5c3_Err
@@ -308,7 +332,7 @@ func BodyFormDoctor(inputId models.CustomTextFieldv2Prm,
 		if templ_7745c5c3_Err != nil {
 			return templ_7745c5c3_Err
 		}
-		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString("</div><!-- Kewarganegaraan --><!-- Nomor identitas start --><div class=\"form-row mt-0\">")
+		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString("</div><!-- Kewarganegaraan --><!-- Nomor identitas start --><div class=\"form-row mt-8\">")
 		if templ_7745c5c3_Err != nil {
 			return templ_7745c5c3_Err
 		}
@@ -327,7 +351,128 @@ func BodyFormDoctor(inputId models.CustomTextFieldv2Prm,
 		if templ_7745c5c3_Err != nil {
 			return templ_7745c5c3_Err
 		}
-		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString("</div><!-- spesialis --></div><!-- col 1 end --></div></div></div><script>\r\n    document.addEventListener('htmx:afterSwap', function(event) {\r\n        // Reinitialize selectpicker after HTMX content swap\r\n        $('.selectpicker').selectpicker('refresh');\r\n    });\r\n    </script>")
+		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString("</div><!-- spesialis --></div><!-- col 1 end --><!-- col 2 start --><div class=\"col-4\"><div class=\"form-row\"><!-- Nama start --><div class=\"col\">")
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		templ_7745c5c3_Err = customtextfield.CustomTextFieldv2(
+			InputNama).Render(ctx, templ_7745c5c3_Buffer)
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString("</div><!-- Nama end --></div><div class=\"form-row\"><!-- TanggalLahir start --><div class=\"col\">")
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		templ_7745c5c3_Err = customtextfield.CustomTextFieldv2(
+			InputTanggalLahir).Render(ctx, templ_7745c5c3_Buffer)
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString("</div><!-- TanggalLahir end --></div><div class=\"form-row\"><!-- BloodRhesus start --><div class=\"col\">")
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		templ_7745c5c3_Err = customdropdown.MainCustomDropdownInputV0(
+			dropdownDoctorBloodRhesus,
+			listItemBloodRhesus).Render(ctx, templ_7745c5c3_Buffer)
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString("</div><!-- BloodRhesus end --></div><div class=\"form-row\"><!-- Etnis start --><div class=\"col\">")
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		templ_7745c5c3_Err = customdropdown.MainCustomDropdownInputV0(
+			dropdownDoctorEtnis,
+			listItemEtnis).Render(ctx, templ_7745c5c3_Buffer)
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString("</div><!-- Etnis end --></div><div class=\"form-row mt-0\"><!-- Nomor HP start --><div class=\"col\">")
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		templ_7745c5c3_Err = customtextfield.CustomTextFieldv2(
+			InputNomorHP).Render(ctx, templ_7745c5c3_Buffer)
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString("</div><!-- Nomor HP end --></div></div><!-- col 2 start --><!-- col 3 start --><div class=\"col-4\"><div class=\"form-row\"><!-- Imbuhan akhir 1 start --><div class=\"col\">")
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		templ_7745c5c3_Err = customtextfield.CustomTextFieldv2(
+			InputImbuhanAkhir1).Render(ctx, templ_7745c5c3_Buffer)
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString("</div><!-- Imbuhan akhir 1 end --><!-- Imbuhan akhir 2 start --><div class=\"col\">")
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		templ_7745c5c3_Err = customtextfield.CustomTextFieldv2(
+			InputImbuhanAkhir2).Render(ctx, templ_7745c5c3_Buffer)
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString("</div><!-- Imbuhan akhir 2 end --></div><div class=\"form-row mt-0\"><!-- Tahun start --><div class=\"col\">")
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		templ_7745c5c3_Err = customtextfield.CustomTextFieldv2(
+			InputTahun).Render(ctx, templ_7745c5c3_Buffer)
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString("</div><!-- Tahun end --><!-- Bulan start --><div class=\"col\">")
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		templ_7745c5c3_Err = customtextfield.CustomTextFieldv2(
+			InputBulan).Render(ctx, templ_7745c5c3_Buffer)
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString("</div><!-- Bulan end --><!-- Hari --><div class=\"col\">")
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		templ_7745c5c3_Err = customtextfield.CustomTextFieldv2(
+			InputHari).Render(ctx, templ_7745c5c3_Buffer)
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString("</div><!-- Hari --></div><!-- pendidikan --><div class=\"form-row mt-0\">")
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		templ_7745c5c3_Err = customdropdown.MainCustomDropdownInputV0(
+			dropdownDoctorPend,
+			listItemPend).Render(ctx, templ_7745c5c3_Buffer)
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString("</div><!-- pendidikan --><!-- Identitas --><div class=\"form-row mt-0\">")
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		templ_7745c5c3_Err = customdropdown.MainCustomDropdownInputV0(
+			dropdownDoctorIdentitas,
+			listItemIdentitas).Render(ctx, templ_7745c5c3_Buffer)
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString("</div><!-- Identitas --><!-- email --><div class=\"form-row mt-0\">")
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		templ_7745c5c3_Err = customtextfield.CustomTextFieldv2(
+			InputEmail).Render(ctx, templ_7745c5c3_Buffer)
+		if templ_7745c5c3_Err != nil {
+			return templ_7745c5c3_Err
+		}
+		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString("</div><!-- email --></div><!-- col 3 start --></div></div></div><script>\r\n    document.addEventListener('htmx:afterSwap', function(event) {\r\n        // Reinitialize selectpicker after HTMX content swap\r\n        $('.selectpicker').selectpicker('refresh');\r\n    });\r\n\r\n\tdocument.addEventListener('DOMContentLoaded', function() {\r\n\t\tdocument.getElementById('doctorimbuhantahun').setAttribute('disabled',true)\r\n\t\tdocument.getElementById('doctorimbuhanbulan').setAttribute('disabled',true)\r\n\t\tdocument.getElementById('doctorimbuhanhari').setAttribute('disabled',true)\r\n\r\n\t\t// onchange date picker\r\n\t\tvar birthdateInput = document.querySelector(\"#doctorimbuhantanggallahir\");\r\n    \tvar invalidFeedback = birthdateInput.closest(\".form-group\").querySelector(\".invalid-feedback\");\r\n\r\n    \tvar birthdateValue = birthdateInput.value;\r\n\r\n\t\tvar todayInput = document.querySelector(\"#doctortglnow\");\r\n\t\r\n\t\tbirthdateInput.addEventListener('change', function() {\r\n\t\t\tvar birthdateValue = new Date(birthdateInput.value);\r\n\t\t\tif (!isNaN(birthdateValue)) {\r\n\t\t\t\tvar today = new Date(todayInput.value);\r\n\t\t\t\t\r\n\t\t\t\tvar years = today.getFullYear() - birthdateValue.getFullYear();\r\n\t\t\t\tvar months = today.getMonth() - birthdateValue.getMonth();\r\n\t\t\t\tvar days = today.getDate() - birthdateValue.getDate();\r\n\t\t\t\t\r\n\t\t\t\tif (days < 0) {\r\n\t\t\t\t\tmonths--;\r\n\t\t\t\t\tdays += new Date(today.getFullYear(), today.getMonth(), 0).getDate();\r\n\t\t\t\t}\r\n\t\t\t\t\r\n\t\t\t\tif (months < 0) {\r\n\t\t\t\t\tyears--;\r\n\t\t\t\t\tmonths += 12;\r\n\t\t\t\t}\r\n\r\n\t\t\t\tdocument.querySelector(\"[name='doctorimbuhantahun']\").value = years + ' Tahun';\r\n\t\t\t\tdocument.querySelector(\"[name='doctorimbuhanbulan']\").value = months + ' Bulan';\r\n\t\t\t\tdocument.querySelector(\"[name='doctorimbuhanhari']\").value = days + ' Hari';\r\n\t\t\t} else{\r\n\t\t\t\tbirthdateInput.classList.add('is-invalid');\r\n\t\t\t\tinvalidFeedback.textContent = 'Tanggal lahir tidak valid.';\r\n\t\t\t}\r\n\t\t})\r\n\t});\r\n    </script>")
 		if templ_7745c5c3_Err != nil {
 			return templ_7745c5c3_Err
 		}
@@ -407,7 +552,7 @@ func ActionFormDoctor(LinkClose string, targetClose string, hxSwapClose string,
 		var templ_7745c5c3_Var14 string
 		templ_7745c5c3_Var14, templ_7745c5c3_Err = templ.JoinStringErrs(LinkClose)
 		if templ_7745c5c3_Err != nil {
-			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 198, Col: 22}
+			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 365, Col: 22}
 		}
 		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString(templ.EscapeString(templ_7745c5c3_Var14))
 		if templ_7745c5c3_Err != nil {
@@ -420,7 +565,7 @@ func ActionFormDoctor(LinkClose string, targetClose string, hxSwapClose string,
 		var templ_7745c5c3_Var15 string
 		templ_7745c5c3_Var15, templ_7745c5c3_Err = templ.JoinStringErrs(targetClose)
 		if templ_7745c5c3_Err != nil {
-			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 199, Col: 26}
+			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 366, Col: 26}
 		}
 		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString(templ.EscapeString(templ_7745c5c3_Var15))
 		if templ_7745c5c3_Err != nil {
@@ -433,7 +578,7 @@ func ActionFormDoctor(LinkClose string, targetClose string, hxSwapClose string,
 		var templ_7745c5c3_Var16 string
 		templ_7745c5c3_Var16, templ_7745c5c3_Err = templ.JoinStringErrs(hxSwapClose)
 		if templ_7745c5c3_Err != nil {
-			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 200, Col: 24}
+			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 367, Col: 24}
 		}
 		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString(templ.EscapeString(templ_7745c5c3_Var16))
 		if templ_7745c5c3_Err != nil {
@@ -474,7 +619,7 @@ func BtnCloseFormDoctor(LinkClose string, targetClose string, hxSwapClose string
 		var templ_7745c5c3_Var18 string
 		templ_7745c5c3_Var18, templ_7745c5c3_Err = templ.JoinStringErrs(LinkClose)
 		if templ_7745c5c3_Err != nil {
-			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 221, Col: 21}
+			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 388, Col: 21}
 		}
 		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString(templ.EscapeString(templ_7745c5c3_Var18))
 		if templ_7745c5c3_Err != nil {
@@ -487,7 +632,7 @@ func BtnCloseFormDoctor(LinkClose string, targetClose string, hxSwapClose string
 		var templ_7745c5c3_Var19 string
 		templ_7745c5c3_Var19, templ_7745c5c3_Err = templ.JoinStringErrs(targetClose)
 		if templ_7745c5c3_Err != nil {
-			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 222, Col: 25}
+			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 389, Col: 25}
 		}
 		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString(templ.EscapeString(templ_7745c5c3_Var19))
 		if templ_7745c5c3_Err != nil {
@@ -500,7 +645,7 @@ func BtnCloseFormDoctor(LinkClose string, targetClose string, hxSwapClose string
 		var templ_7745c5c3_Var20 string
 		templ_7745c5c3_Var20, templ_7745c5c3_Err = templ.JoinStringErrs(hxSwapClose)
 		if templ_7745c5c3_Err != nil {
-			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 223, Col: 23}
+			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 390, Col: 23}
 		}
 		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString(templ.EscapeString(templ_7745c5c3_Var20))
 		if templ_7745c5c3_Err != nil {
@@ -555,7 +700,7 @@ func DeleteConfirmationBodyDoctor(inputId models.CustomTextFieldv2Prm,
 		var templ_7745c5c3_Var23 string
 		templ_7745c5c3_Var23, templ_7745c5c3_Err = templ.JoinStringErrs(componentID)
 		if templ_7745c5c3_Err != nil {
-			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 240, Col: 22}
+			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 407, Col: 22}
 		}
 		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString(templ.EscapeString(templ_7745c5c3_Var23))
 		if templ_7745c5c3_Err != nil {
@@ -577,7 +722,7 @@ func DeleteConfirmationBodyDoctor(inputId models.CustomTextFieldv2Prm,
 		var templ_7745c5c3_Var25 string
 		templ_7745c5c3_Var25, templ_7745c5c3_Err = templ.JoinStringErrs(message)
 		if templ_7745c5c3_Err != nil {
-			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 241, Col: 14}
+			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 408, Col: 14}
 		}
 		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString(templ.EscapeString(templ_7745c5c3_Var25))
 		if templ_7745c5c3_Err != nil {
@@ -595,7 +740,7 @@ func DeleteConfirmationBodyDoctor(inputId models.CustomTextFieldv2Prm,
 			var templ_7745c5c3_Var26 string
 			templ_7745c5c3_Var26, templ_7745c5c3_Err = templ.JoinStringErrs(v)
 			if templ_7745c5c3_Err != nil {
-				return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 246, Col: 68}
+				return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 413, Col: 68}
 			}
 			_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString(templ.EscapeString(templ_7745c5c3_Var26))
 			if templ_7745c5c3_Err != nil {
@@ -618,7 +763,7 @@ func DeleteConfirmationBodyDoctor(inputId models.CustomTextFieldv2Prm,
 			var templ_7745c5c3_Var27 string
 			templ_7745c5c3_Var27, templ_7745c5c3_Err = templ.JoinStringErrs(v)
 			if templ_7745c5c3_Err != nil {
-				return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 252, Col: 10}
+				return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 419, Col: 10}
 			}
 			_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString(templ.EscapeString(templ_7745c5c3_Var27))
 			if templ_7745c5c3_Err != nil {
@@ -685,7 +830,7 @@ func ActionFormDoctorDelete(LinkClose string, targetClose string, hxSwapClose st
 		var templ_7745c5c3_Var30 string
 		templ_7745c5c3_Var30, templ_7745c5c3_Err = templ.JoinStringErrs(LinkClose)
 		if templ_7745c5c3_Err != nil {
-			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 266, Col: 22}
+			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 433, Col: 22}
 		}
 		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString(templ.EscapeString(templ_7745c5c3_Var30))
 		if templ_7745c5c3_Err != nil {
@@ -698,7 +843,7 @@ func ActionFormDoctorDelete(LinkClose string, targetClose string, hxSwapClose st
 		var templ_7745c5c3_Var31 string
 		templ_7745c5c3_Var31, templ_7745c5c3_Err = templ.JoinStringErrs(targetClose)
 		if templ_7745c5c3_Err != nil {
-			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 267, Col: 26}
+			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 434, Col: 26}
 		}
 		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString(templ.EscapeString(templ_7745c5c3_Var31))
 		if templ_7745c5c3_Err != nil {
@@ -711,7 +856,7 @@ func ActionFormDoctorDelete(LinkClose string, targetClose string, hxSwapClose st
 		var templ_7745c5c3_Var32 string
 		templ_7745c5c3_Var32, templ_7745c5c3_Err = templ.JoinStringErrs(hxSwapClose)
 		if templ_7745c5c3_Err != nil {
-			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 268, Col: 24}
+			return templ.Error{Err: templ_7745c5c3_Err, FileName: `views\dev\mddoctor\mddoctorformmodal.templ`, Line: 435, Col: 24}
 		}
 		_, templ_7745c5c3_Err = templ_7745c5c3_Buffer.WriteString(templ.EscapeString(templ_7745c5c3_Var32))
 		if templ_7745c5c3_Err != nil {