VitalApp/assets/templates/PrenatalFollowupServiceRecord.json

{
    "Key": "PrenatalFollowupServiceRecord",
    "Name": "第 2～5 次产前随访",
    "Content": [
        {
            "label": "(随访/督促)日期",
            "defaultValue": null,
            "span": 24,
            "key": "Form_Date",
            "type": "dateTime",
            "border": null,
            "disabledValue": null,
            "options": [],
            "children": null,
            "append": "",
            "placeholder": "",
            "required": null,
            "show-limit": false,
            "parentKey": null,
            "buttonName": null,
            "childrenKey": null
        },
        {
            "label": "孕周",
            "defaultValue": null,
            "span": 12,
            "key": "Gestational_Week",
            "type": "numberInput",
            "border": null,
            "disabledValue": null,
            "options": [],
            "children": null,
            "append": "周",
            "placeholder": "",
            "required": null,
            "show-limit": false,
            "parentKey": null,
            "buttonName": null,
            "childrenKey": null
        },
        {
            "label": "主诉",
            "defaultValue": null,
            "span": 12,
            "key": "Chief_Complaint",
            "type": "input",
            "border": null,
            "disabledValue": null,
            "options": [],
            "children": null,
            "append": "",
            "placeholder": "",
            "required": null,
            "show-limit": false,
            "parentKey": null,
            "buttonName": null,
            "childrenKey": null
        },
        {
            "label": "体重",
            "defaultValue": null,
            "span": 12,
            "key": "Weight",
            "type": "numberInput",
            "border": null,
            "disabledValue": null,
            "options": [],
            "children": null,
            "append": "kg",
            "placeholder": "",
            "required": null,
            "show-limit": false,
            "parentKey": null,
            "buttonName": null,
            "childrenKey": null
        },
        {
            "label": "产科检查",
            "defaultValue": null,
            "span": 24,
            "key": "ObstetricExamination",
            "type": "virtualTitle",
            "border": null,
            "disabledValue": null,
            "options": null,
            "children": [
                {
                    "label": "宫底高度",
                    "defaultValue": [],
                    "span": 24,
                    "key": "Fundal_Height",
                    "type": "numberInput",
                    "border": false,
                    "disabledValue": "1",
                    "maxItems": 10,
                    "options": null,
                    "children": null,
                    "append": "cm",
                    "placeholder": null,
                    "required": null,
                    "show-limit": null,
                    "parentKey": "ObstetricExamination",
                    "buttonName": null,
                    "childrenKey": null
                },
                {
                    "label": "腹围",
                    "defaultValue": [],
                    "span": 24,
                    "key": "Abdominal_Circumference",
                    "type": "numberInput",
                    "border": false,
                    "disabledValue": "1",
                    "maxItems": 10,
                    "options": null,
                    "children": null,
                    "append": "cm",
                    "placeholder": null,
                    "required": null,
                    "show-limit": null,
                    "parentKey": "ObstetricExamination",
                    "buttonName": null,
                    "childrenKey": null
                },
                {
                    "label": "胎位",
                    "defaultValue": [],
                    "span": 24,
                    "key": "Fetal_Position",
                    "type": "input",
                    "border": false,
                    "disabledValue": "1",
                    "maxItems": 10,
                    "options": null,
                    "children": null,
                    "append": "",
                    "placeholder": null,
                    "required": null,
                    "show-limit": null,
                    "parentKey": "ObstetricExamination",
                    "buttonName": null,
                    "childrenKey": null
                },
                {
                    "label": "胎心率",
                    "defaultValue": [],
                    "span": 24,
                    "key": "Fetal_HeartRate",
                    "type": "numberInput",
                    "border": false,
                    "disabledValue": "1",
                    "maxItems": 10,
                    "options": null,
                    "children": null,
                    "append": "次/分钟",
                    "placeholder": null,
                    "required": null,
                    "show-limit": null,
                    "parentKey": "ObstetricExamination",
                    "buttonName": null,
                    "childrenKey": null
                }
            ],
            "append": "mmHg",
            "placeholder": "",
            "required": null,
            "show-limit": false,
            "parentKey": null
        },
        {
            "label": "血压",
            "defaultValue": null,
            "span": 24,
            "key": "BloodPressure",
            "type": "bloodPressure",
            "border": null,
            "disabledValue": null,
            "options": [],
            "children": null,
            "append": "mmHg",
            "placeholder": "",
            "required": null,
            "show-limit": false,
            "parentKey": null
        },
        {
            "label": "血红蛋白值",
            "defaultValue": null,
            "span": 12,
            "key": "Hemoglobin",
            "type": "input",
            "border": null,
            "disabledValue": null,
            "options": null,
            "children": null,
            "append": "g/L",
            "placeholder": "",
            "required": null,
            "show-limit": false,
            "parentKey": null,
            "buttonName": null,
            "childrenKey": null
        },
        {
            "label": "尿蛋白",
            "defaultValue": null,
            "span": 12,
            "key": "Urine_Protein",
            "type": "input",
            "border": null,
            "disabledValue": null,
            "options": null,
            "children": null,
            "append": "",
            "placeholder": "",
            "required": null,
            "show-limit": false,
            "parentKey": null,
            "buttonName": null,
            "childrenKey": null
        },
        {
            "label": "其他辅助检查",
            "defaultValue": null,
            "span": 12,
            "key": "Auxiliary_Examinations",
            "type": "input",
            "border": null,
            "disabledValue": null,
            "options": null,
            "children": null,
            "append": "",
            "placeholder": "",
            "required": null,
            "show-limit": false,
            "parentKey": null,
            "buttonName": null,
            "childrenKey": null
        },
        {
            "label": "分类",
            "defaultValue": null,
            "span": 12,
            "key": "Classification",
            "type": "virtualTitle",
            "border": null,
            "disabledValue": null,
            "options": null,
            "children": [
                {
                    "label": "未见异常",
                    "defaultValue": null,
                    "span": 12,
                    "key": "Classification_1",
                    "type": "option",
                    "border": null,
                    "disabledValue": null,
                    "options": null,
                    "children": null,
                    "append": "",
                    "placeholder": "",
                    "required": false,
                    "show-limit": false,
                    "parentKey": "Classification",
                    "buttonName": null,
                    "childrenKey": null
                },
                {
                    "label": "异常：",
                    "defaultValue": null,
                    "span": 12,
                    "key": "Classification_2",
                    "type": "input",
                    "border": null,
                    "disabledValue": null,
                    "options": null,
                    "children": null,
                    "append": "",
                    "placeholder": "",
                    "required": false,
                    "show-limit": false,
                    "parentKey": "Classification",
                    "buttonName": null,
                    "childrenKey": null
                }
            ],
            "append": "",
            "placeholder": "",
            "required": null,
            "show-limit": false,
            "parentKey": null,
            "buttonName": null,
            "childrenKey": null
        },
        {
            "label": "指导",
            "defaultValue": null,
            "span": 24,
            "key": "Guidance",
            "type": "virtualTitle",
            "border": null,
            "disabledValue": null,
            "options": null,
            "children": [
                {
                    "label": "生活方式",
                    "defaultValue": null,
                    "span": 12,
                    "key": "Guidance_1",
                    "type": "option",
                    "border": null,
                    "disabledValue": null,
                    "options": null,
                    "children": null,
                    "append": "",
                    "placeholder": "",
                    "required": false,
                    "show-limit": false,
                    "parentKey": "Guidance",
                    "buttonName": null,
                    "childrenKey": null
                },
                {
                    "label": "营养",
                    "defaultValue": null,
                    "span": 12,
                    "key": "Guidance_2",
                    "type": "option",
                    "border": null,
                    "disabledValue": null,
                    "options": null,
                    "children": null,
                    "append": "",
                    "placeholder": "",
                    "required": false,
                    "show-limit": false,
                    "parentKey": "Guidance",
                    "buttonName": null,
                    "childrenKey": null
                },
                {
                    "label": "心理",
                    "defaultValue": null,
                    "span": 12,
                    "key": "Guidance_3",
                    "type": "option",
                    "border": null,
                    "disabledValue": null,
                    "options": null,
                    "children": null,
                    "append": "",
                    "placeholder": "",
                    "required": false,
                    "show-limit": false,
                    "parentKey": "Guidance",
                    "buttonName": null,
                    "childrenKey": null
                },
                {
                    "label": "运动",
                    "defaultValue": null,
                    "span": 12,
                    "key": "Guidance_4",
                    "type": "option",
                    "border": null,
                    "disabledValue": null,
                    "options": null,
                    "children": null,
                    "append": "",
                    "placeholder": "",
                    "required": false,
                    "show-limit": false,
                    "parentKey": "Guidance",
                    "buttonName": null,
                    "childrenKey": null
                },
                {
                    "label": "自我监测",
                    "defaultValue": null,
                    "span": 12,
                    "key": "Guidance_5",
                    "type": "option",
                    "border": null,
                    "disabledValue": null,
                    "options": null,
                    "children": null,
                    "append": "",
                    "placeholder": "",
                    "required": false,
                    "show-limit": false,
                    "parentKey": "Guidance",
                    "buttonName": null,
                    "childrenKey": null
                },
                {
                    "label": "分娩准备",
                    "defaultValue": null,
                    "span": 12,
                    "key": "Guidance_Delivery_Preparation",
                    "type": "option",
                    "border": null,
                    "disabledValue": null,
                    "options": null,
                    "children": null,
                    "append": "",
                    "placeholder": "",
                    "required": false,
                    "show-limit": false,
                    "parentKey": "Guidance",
                    "buttonName": null,
                    "childrenKey": null
                },
                {
                    "label": "母乳喂养",
                    "defaultValue": null,
                    "span": 12,
                    "key": "Guidance_Breast_Feeding",
                    "type": "option",
                    "border": null,
                    "disabledValue": null,
                    "options": null,
                    "children": null,
                    "append": "",
                    "placeholder": "",
                    "required": false,
                    "show-limit": false,
                    "parentKey": "Guidance",
                    "buttonName": null,
                    "childrenKey": null
                },
                {
                    "label": "其他",
                    "defaultValue": null,
                    "span": 12,
                    "key": "Guidance_Other",
                    "type": "input",
                    "border": null,
                    "disabledValue": null,
                    "options": null,
                    "children": null,
                    "append": "",
                    "placeholder": "",
                    "required": false,
                    "show-limit": false,
                    "parentKey": "Guidance",
                    "buttonName": null,
                    "childrenKey": null
                }
            ],
            "append": "",
            "placeholder": "",
            "required": null,
            "show-limit": false,
            "parentKey": null
        },
        {
            "label": "转诊",
            "defaultValue": null,
            "span": 12,
            "key": "Referral",
            "type": "virtualTitle",
            "border": null,
            "disabledValue": null,
            "options": null,
            "children": [
                {
                    "label": "无",
                    "defaultValue": null,
                    "span": 12,
                    "key": "referral_1",
                    "type": "option",
                    "border": null,
                    "disabledValue": null,
                    "options": null,
                    "children": null,
                    "append": "",
                    "placeholder": "",
                    "required": false,
                    "show-limit": false,
                    "parentKey": "Referral",
                    "buttonName": null,
                    "childrenKey": null
                },
                {
                    "label": "有",
                    "defaultValue": null,
                    "span": 12,
                    "key": "referral_2",
                    "type": "option",
                    "border": null,
                    "disabledValue": null,
                    "options": null,
                    "children": null,
                    "append": "",
                    "placeholder": "",
                    "required": false,
                    "show-limit": false,
                    "parentKey": "Referral",
                    "buttonName": null,
                    "childrenKey": null
                },
                {
                    "label": "原因",
                    "defaultValue": null,
                    "span": 12,
                    "key": "Reason_For_Referral",
                    "type": "input",
                    "border": null,
                    "disabledValue": null,
                    "options": null,
                    "children": null,
                    "append": "",
                    "placeholder": "",
                    "required": false,
                    "show-limit": false,
                    "parentKey": "referral_Input",
                    "buttonName": null,
                    "childrenKey": null
                },
                {
                    "label": "机构及科室",
                    "defaultValue": null,
                    "span": 12,
                    "key": "Institution_And_Department",
                    "type": "input",
                    "border": null,
                    "disabledValue": null,
                    "options": null,
                    "children": null,
                    "append": "",
                    "placeholder": "",
                    "required": false,
                    "show-limit": false,
                    "parentKey": "referral_Input",
                    "buttonName": null,
                    "childrenKey": null
                }
            ],
            "append": "",
            "placeholder": "",
            "required": false,
            "show-limit": false,
            "parentKey": null,
            "buttonName": null,
            "childrenKey": null
        },
        {
            "label": "下次随访日期",
            "defaultValue": null,
            "span": 12,
            "key": "Next_Follow_Up_Date",
            "type": "dateTime",
            "border": null,
            "disabledValue": null,
            "options": null,
            "children": null,
            "append": "",
            "placeholder": "",
            "required": false,
            "show-limit": false,
            "parentKey": null,
            "buttonName": null,
            "childrenKey": null
        },
        {
            "label": "随访医生签名",
            "defaultValue": null,
            "span": 12,
            "key": "Follow_up_Physician_Signature",
            "type": "signature",
            "border": null,
            "disabledValue": null,
            "options": null,
            "children": null,
            "append": "",
            "placeholder": "",
            "required": false,
            "show-limit": false,
            "parentKey": null,
            "buttonName": null,
            "childrenKey": null
        }
    ]
}