123456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869707172737475767778798081828384858687888990919293949596979899100101102103104105106107108109110111112113114115116117118119120121122123124125126127128129130131132133134135136137138139140141142143144145146147148149150151152153154155156157158159160161162163164165166167168169170171172173174175176177178179180181182183184185186187188189190191192193194195196197198199200201202203204205206207208209210211212213214215216217218219220221222223224225226227228229230231232233234235236237238239240241242243244245246247248249250251252253254255256257258259260261262263264265266267268269270271272273274275276277278279280281282283284285286287288289290291292293294295296297298299300301302303304305306307308309310311312313314315316317318319320321322323324325326327328329330331332333334335336337338339340341342343344345346 |
- var questionList = [
- {
- label: '(第一次)大便潜血阳性(使用试剂盒化验后填写结果)',
- type: 'radio',
- options: [
- {
- label: '阴性',
- value: '1'
- },
- {
- label: '阳性',
- value: '2'
- }
- ],
- field: 'isHigh1',
- required: true
- },
- {
- label: '(第二次)大便潜血阳性(第一次检查后7天再次复查,结果更准确,非必填)',
- type: 'radio',
- options: [
- {
- label: '阴性',
- value: '1'
- },
- {
- label: '阳性',
- value: '2'
- }
- ],
- field: 'isHigh2'
- },
- {
- label: '社区名称',
- type: 'input',
- field: 'belongCommunity',
- required: true
- },
- {
- label: '医生姓名',
- type: 'input',
- field: 'doctorName',
- required: true
- },
- {
- label: '医生电话',
- type: 'input',
- field: 'doctorPhoneNo',
- required: true
- },
- {
- label: '申请单号',
- type: 'input',
- field: 'applyNo'
- },
- {
- label: '用户姓名',
- type: 'input',
- field: 'userName',
- required: true
- },
- {
- label: '证件类型',
- type: 'input',
- field: 'idNoType',
- required: true
- },
- {
- label: '身份证号',
- type: 'input',
- field: 'idNo',
- required: true
- },
- {
- label: '手机',
- type: 'input',
- field: 'phoneNo',
- required: true
- },
- {
- label: '年龄',
- type: 'input',
- field: 'age',
- required: true
- },
- {
- label: '性别',
- type: 'radio',
- field: 'sex',
- required: true,
- options: [
- {
- label: '男',
- value: '1'
- },
- {
- label: '女',
- value: '2'
- }
- ]
- },
- {
- label: '户籍省市区',
- type: 'input',
- field: 'hujiAddress',
- required: true
- },
- {
- label: '户籍街道地址',
- type: 'input',
- field: 'hujiAddressJiedao',
- required: true
- },
- {
- label: '居住省市区',
- type: 'input',
- field: 'juzhuAddress',
- required: true
- },
- {
- label: '居住街道地址',
- type: 'input',
- field: 'juzhuAddressJiedao',
- required: true
- },
- {
- label: '婚姻状况',
- type: 'radio',
- options: [],
- field: 'isMerge',
- required: true
- },
- {
- label: '文化程度',
- type: 'radio',
- options: [],
- field: 'eduState',
- required: true
- },
- {
- label: '工作状况',
- type: 'radio',
- options: [],
- field: 'jobState',
- required: true
- },
- {
- label: '服用抗栓药物',
- type: 'radio',
- options: [
- {
- label: '有',
- value: '1'
- },
- {
- label: '无',
- value: '2'
- }
- ],
- field: 'isFuyongks',
- required: true
- },
- {
- label: '抗栓药物名称',
- type: 'checkbox',
- options: [],
- field: 'ksDrugName1'
- },
- {
- label: '抗栓药物其他名称',
- type: 'input',
- field: 'ksDrugName'
- },
- {
- label: '本人有癌症史',
- type: 'radio',
- field: 'isCancerHistory',
- options: [
- {
- label: '有',
- value: '1'
- },
- {
- label: '无',
- value: '2'
- },
- {
- label: '不详',
- value: '3'
- }
- ],
- required: true
- },
- {
- label: '癌症类型或名称',
- type: 'input',
- field: 'cancerType',
- required: true
- },
- {
- label: '是否做过胃肠镜检查',
- type: 'radio',
- field: 'isEndoscopy',
- required: true,
- options: [
- {
- label: '是',
- value: '1'
- },
- {
- label: '否',
- value: '2'
- },
- ]
- },
- {
- label: '做胃肠镜检查时间',
- type: 'input',
- field: 'endoscopyTime'
- },
- {
- label: '胃肠镜检查结果',
- type: 'input',
- field: 'endoscopyResult'
- },
- {
- label: '胃肠镜检查医院',
- type: 'input',
- field: 'endoscopyHospitalName'
- },
- {
- label: '本人有无肠息肉史',
- type: 'radio',
- field: 'isCxrHistory',
- required: true,
- options: [
- {
- label: '有',
- value: '1'
- },
- {
- label: '无',
- value: '2'
- },
- {
- label: '不详',
- value: '3'
- },
- ]
- },
- {
- label: '一级亲属有结直肠癌病史(如:父母、兄弟姐妹、子女)',
- type: 'radio',
- field: 'relativeAizHistory',
- required: true,
- options: [
- {
- label: '有',
- value: '1'
- },
- {
- label: '无',
- value: '2'
- },
- {
- label: '不详',
- value: '3'
- },
- ]
- },
- {
- label: '有无以下任意2项:慢性腹泻、慢性便秘、粘液血便、慢性阑尾炎或阑尾切除史、慢性胆囊炎或胆囊切除史、长期精神压抑',
- type:'radio',
- field: 'isMangxibing',
- required: true,
- options: [
- {
- label: '有',
- value: '1'
- },
- {
- label: '无',
- value: '2'
- },
- {
- label: '不详',
- value: '3'
- },
- ]
- },
- {
- label: '填写人签名',
- type:'input',
- field: 'signName',
- required: true
- },
- {
- label: '与被筛查人关系',
- type:'input',
- field: 'relations',
- required: true
- },
- {
- label: '申请时间',
- type:'input',
- field: 'createDate',
- required: true
- },
- {
- label: '钙卫蛋白结果(如无请忽略)',
- type:'radio',
- field: 'gwdbResult',
- options: [
- {
- label: '阴性',
- value: '1'
- },
- {
- label: '阳性',
- value: '2'
- }
- ]
- },
- {
- label: '是否医技检查',
- type:'input',
- field: 'isExam',
- required: true
- },
- {
- label: '评估结果',
- type:'radio',
- field: 'screenResult',
- required: true,
- options: [
- {
- label: '阴性',
- value: '1'
- },
- {
- label: '阳性',
- value: '2'
- }
- ]
- },
- ]
|