{
    "fields": {
        "patient_id": {
            "type": "hidden"
        },
        "_formdata": {
            "type": "hidden"
        },
        "clinic": {
            "label": "Clinic:"
        },
        "clinician": {
            "label": "Clinician:"
        },
        "note": {
            "label": "Notes:",
            "type": "textarea"
        },
        "current_created_years": {
            "type": "hidden"
        }
    },
    "definitions": {
        "schema": {
            "parent": {
                "visit": {
                    "list": {
                        "label": "Reason for Visit:",
                        "type": "checkbox",
                        "multiple": true,
                        "optionLabels": [
                            "Disease Diagnosis",
                            "Bodily Injury",
                            "Immunization/Post-Immunization",
                            "HIV Counseling Mother",
                            "HIV Counseling Child",
                            "Reproductive Counceling/Treatment",
                            "First Antenatal Visit",
                            "Follow-up Antenatal Visit",
                            "Postnatal Visit",
                            "TB and Leprosy",
                            "HIV in Pregnancy",
                            "Well Child Visit",
                            "Delivery Record",
                            "Diarrhea Treatment"
                        ]
                    },
                    "subforms": {
                        "fields": {
                            "disease_diagnosis": {
                                "dependencies": {
                                    "#reasons": "disease_diagnosis"
                                }
                            },
                            "bodily_injury": {
                                "dependencies": {
                                    "#reasons": "bodily_injury"
                                }
                            },
                            "immunization": {
                                "dependencies": {
                                    "#reasons": "immunization"
                                }
                            },
                            "hiv_counseling_mother": {
                                "dependencies": {
                                    "#reasons": "hiv_counseling_mother"
                                }
                            },
                            "hiv_counseling_child": {
                                "dependencies": {
                                    "#reasons": "hiv_counseling_child"
                                }
                            },
                            "reproductive_counseling": {
                                "dependencies": {
                                    "#reasons": "reproductive_counseling"
                                }
                            },
                            "anc_first_visit": {
                                "dependencies": {
                                    "#reasons": "anc_first_visit"
                                }
                            },
                            "anc_followup": {
                                "dependencies": {
                                    "#reasons": "anc_followup"
                                }
                            },
                            "postnatal": {
                                "dependencies": {
                                    "#reasons": "postnatal"
                                }
                            },
                            "tb_leprosy": {
                                "dependencies": {
                                    "#reasons": "tb_leprosy"
                                }
                            },
                            "hiv_pregnancy_clinic": {
                                "dependencies": {
                                    "#reasons": "hiv_pregnancy_clinic"
                                }
                            },
                            "well_child_visit": {
                                "dependencies": {
                                    "#reasons": "well_child_visit"
                                }
                            },
                            "delivery_record": {
                                "dependencies": {
                                    "#reasons": "delivery_record"
                                }
                            },
                            "diarrhea": {
                                "dependencies": {
                                    "#reasons": "diarrhea"
                                }
                            }
                        }
                    }
                }
            }
        }
    }
}