function MainComponent() { const patientInfoForm = /*#__PURE__*/ React.createElement("div", { className: "flex flex-col gap-3", __source: { fileName: "", lineNumber: 3, columnNumber: 5 }, __self: this }, /*#__PURE__*/ React.createElement("input", { className: "border p-2 rounded", type: "text", name: "patientName", placeholder: "Patient Name", __source: { fileName: "", lineNumber: 4, columnNumber: 7 }, __self: this }), /*#__PURE__*/ React.createElement("input", { className: "border p-2 rounded", type: "date", name: "patientDob", placeholder: "Date of Birth", __source: { fileName: "", lineNumber: 5, columnNumber: 7 }, __self: this }), /*#__PURE__*/ React.createElement("input", { className: "border p-2 rounded", type: "text", name: "patientId", placeholder: "Patient ID", __source: { fileName: "", lineNumber: 6, columnNumber: 7 }, __self: this })); const medicalHistoryForm = /*#__PURE__*/ React.createElement("div", { className: "flex flex-col gap-3 mt-5", __source: { fileName: "", lineNumber: 11, columnNumber: 5 }, __self: this }, /*#__PURE__*/ React.createElement("textarea", { className: "border p-2 rounded", name: "medicalHistory", rows: "4", placeholder: "Medical History", __source: { fileName: "", lineNumber: 12, columnNumber: 7 }, __self: this }), /*#__PURE__*/ React.createElement("textarea", { className: "border p-2 rounded", name: "currentMedication", rows: "4", placeholder: "Current Medication", __source: { fileName: "", lineNumber: 13, columnNumber: 7 }, __self: this })); const appointmentInfoForm = /*#__PURE__*/ React.createElement("div", { className: "flex flex-col gap-3 mt-5", __source: { fileName: "", lineNumber: 18, columnNumber: 5 }, __self: this }, /*#__PURE__*/ React.createElement("input", { className: "border p-2 rounded", type: "datetime-local", name: "appointmentTime", placeholder: "Appointment Time", __source: { fileName: "", lineNumber: 19, columnNumber: 7 }, __self: this }), /*#__PURE__*/ React.createElement("input", { className: "border p-2 rounded", type: "text", name: "appointmentReason", placeholder: "Reason for Appointment", __source: { fileName: "", lineNumber: 20, columnNumber: 7 }, __self: this })); const actionButtons = /*#__PURE__*/ React.createElement("div", { className: "flex justify-end gap-4 mt-5", __source: { fileName: "", lineNumber: 25, columnNumber: 5 }, __self: this }, /*#__PURE__*/ React.createElement("button", { className: "px-4 py-2 rounded text-white bg-blue-500 hover:bg-blue-700", __source: { fileName: "", lineNumber: 26, columnNumber: 7 }, __self: this }, "Save"), /*#__PURE__*/ React.createElement("button", { className: "px-4 py-2 rounded text-white bg-red-500 hover:bg-red-700", __source: { fileName: "", lineNumber: 27, columnNumber: 7 }, __self: this }, "Cancel")); return /*#__PURE__*/ React.createElement("div", { className: "font-roboto min-h-screen flex flex-col items-center justify-center bg-[#f0f2f5] p-5", __source: { fileName: "", lineNumber: 32, columnNumber: 5 }, __self: this }, /*#__PURE__*/ React.createElement("div", { className: "bg-white rounded shadow-lg p-10 w-full max-w-4xl", __source: { fileName: "", lineNumber: 33, columnNumber: 7 }, __self: this }, /*#__PURE__*/ React.createElement("h1", { className: "text-3xl text-center text-[#121212] mb-5", __source: { fileName: "", lineNumber: 34, columnNumber: 9 }, __self: this }, "Electronic Health Record (EHR)"), /*#__PURE__*/ React.createElement("form", { __source: { fileName: "", lineNumber: 35, columnNumber: 9 }, __self: this }, patientInfoForm, medicalHistoryForm, appointmentInfoForm, actionButtons))); }