object frmPtDemoEdit: TfrmPtDemoEdit
  Left = 286
  Top = 150
  Width = 594
  Height = 502
  Caption = 'Edit Patient Demographics'
  Color = clBtnFace
  Font.Charset = DEFAULT_CHARSET
  Font.Color = clWindowText
  Font.Height = -11
  Font.Name = 'MS Sans Serif'
  Font.Style = []
  OldCreateOrder = False
  Position = poScreenCenter
  OnCreate = FormCreate
  OnDestroy = FormDestroy
  OnShow = FormShow
  DesignSize = (
    586
    468)
  PixelsPerInch = 96
  TextHeight = 13
  object OKBtn: TButton
    Left = 296
    Top = 435
    Width = 75
    Height = 25
    Anchors = [akRight, akBottom]
    Caption = '&OK'
    ModalResult = 1
    TabOrder = 0
    OnClick = OKBtnClick
  end
  object CancelBtn: TButton
    Left = 488
    Top = 435
    Width = 75
    Height = 25
    Anchors = [akRight, akBottom]
    Caption = '&Cancel'
    TabOrder = 2
    OnClick = CancelBtnClick
  end
  object ApplyBtn: TButton
    Left = 376
    Top = 435
    Width = 107
    Height = 25
    Anchors = [akRight, akBottom]
    Caption = '&Apply Changes'
    Enabled = False
    TabOrder = 1
    OnClick = ApplyBtnClick
  end
  object PageControl: TPageControl
    Left = 0
    Top = 0
    Width = 586
    Height = 428
    ActivePage = DemoTabSheet
    Align = alTop
    Anchors = [akLeft, akTop, akRight, akBottom]
    TabOrder = 3
    object DemoTabSheet: TTabSheet
      Caption = 'Demographics'
      DesignSize = (
        578
        400)
      object LNameLabel: TLabel
        Left = 27
        Top = 32
        Width = 57
        Height = 13
        Caption = 'Family/Last:'
      end
      object FNameLabel: TLabel
        Left = 29
        Top = 56
        Width = 55
        Height = 13
        Caption = 'Given/First:'
      end
      object MNameLabel: TLabel
        Left = 50
        Top = 80
        Width = 34
        Height = 13
        Caption = 'Middle:'
      end
      object CombinedNameLabel: TLabel
        Left = 56
        Top = 8
        Width = 28
        Height = 13
        Caption = 'Name'
      end
      object PrefixLabel: TLabel
        Left = 289
        Top = 136
        Width = 26
        Height = 13
        Anchors = [akTop, akRight]
        Caption = 'Prefix'
        Visible = False
      end
      object SuffixLabel: TLabel
        Left = 58
        Top = 104
        Width = 26
        Height = 13
        Anchors = [akTop, akRight]
        Caption = 'Suffix'
      end
      object DOBLabel: TLabel
        Left = 25
        Top = 128
        Width = 59
        Height = 13
        Anchors = [akTop, akRight]
        Caption = 'Date of Birth'
      end
      object SSNumLabel: TLabel
        Left = 5
        Top = 152
        Width = 79
        Height = 13
        Anchors = [akTop, akRight]
        Caption = 'Social Sec Num.'
      end
      object SexLabel: TLabel
        Left = 66
        Top = 176
        Width = 18
        Height = 13
        Caption = 'Sex'
      end
      object DegreeLabel: TLabel
        Left = 288
        Top = 160
        Width = 35
        Height = 13
        Anchors = [akTop, akRight]
        Caption = 'Degree'
        Visible = False
      end
      object CombinedNameEdit: TEdit
        Left = 95
        Top = 8
        Width = 165
        Height = 21
        Anchors = [akLeft, akTop, akRight]
        TabOrder = 0
        OnChange = CombinedNameEditChange
      end
      object LNameEdit: TEdit
        Left = 95
        Top = 32
        Width = 165
        Height = 21
        Anchors = [akLeft, akTop, akRight]
        TabOrder = 1
        OnChange = LNameEditChange
      end
      object FNameEdit: TEdit
        Left = 95
        Top = 56
        Width = 165
        Height = 21
        Anchors = [akLeft, akTop, akRight]
        TabOrder = 2
        OnChange = FNameEditChange
      end
      object MNameEdit: TEdit
        Left = 95
        Top = 80
        Width = 165
        Height = 21
        Anchors = [akLeft, akTop, akRight]
        TabOrder = 3
        OnChange = MNameEditChange
      end
      object PrefixEdit: TEdit
        Left = 325
        Top = 136
        Width = 135
        Height = 21
        Anchors = [akTop, akRight]
        TabOrder = 8
        Visible = False
        OnChange = PrefixEditChange
      end
      object SuffixEdit: TEdit
        Left = 95
        Top = 104
        Width = 165
        Height = 21
        Anchors = [akTop, akRight]
        TabOrder = 4
        OnChange = SuffixEditChange
      end
      object DOBEdit: TEdit
        Left = 95
        Top = 128
        Width = 165
        Height = 21
        Anchors = [akLeft, akTop, akRight]
        TabOrder = 5
        OnChange = DOBEditChange
      end
      object SSNumEdit: TEdit
        Left = 95
        Top = 152
        Width = 165
        Height = 21
        Anchors = [akLeft, akTop, akRight]
        TabOrder = 6
        OnChange = SSNumEditChange
      end
      object AliasGroupBox: TGroupBox
        Left = 272
        Top = 8
        Width = 297
        Height = 121
        Anchors = [akTop, akRight]
        Caption = 'Alias'
        TabOrder = 10
        TabStop = True
        object AliasNameLabel: TLabel
          Left = 16
          Top = 48
          Width = 53
          Height = 13
          Caption = 'Alias Name'
        end
        object AliasSSNumLabel: TLabel
          Left = 8
          Top = 80
          Width = 64
          Height = 13
          Caption = 'Alias SS Num'
        end
        object AliasComboBox: TComboBox
          Left = 8
          Top = 16
          Width = 161
          Height = 21
          Style = csDropDownList
          ItemHeight = 13
          TabOrder = 0
          OnChange = AliasComboBoxChange
          Items.Strings = (
            'Stuff here...'
            '<Add New Alias>')
        end
        object AliasNameEdit: TEdit
          Left = 80
          Top = 48
          Width = 201
          Height = 21
          Color = clInactiveBorder
          Enabled = False
          TabOrder = 1
          OnChange = AliasNameEditChange
        end
        object AliasSSNEdit: TEdit
          Left = 80
          Top = 80
          Width = 201
          Height = 21
          Color = clInactiveBorder
          Enabled = False
          TabOrder = 2
          OnChange = AliasSSNEditChange
        end
        object DelAliasBtn: TButton
          Left = 227
          Top = 16
          Width = 54
          Height = 22
          Caption = 'Delete'
          TabOrder = 3
          OnClick = DelAliasBtnClick
        end
        object AddAliasBtn: TButton
          Left = 176
          Top = 16
          Width = 41
          Height = 22
          Caption = 'Add'
          TabOrder = 4
          OnClick = AddAliasBtnClick
        end
      end
      object AddressGroupBox: TGroupBox
        Left = 8
        Top = 208
        Width = 569
        Height = 185
        Caption = 'Address'
        TabOrder = 11
        object CityLabel: TLabel
          Left = 172
          Top = 96
          Width = 17
          Height = 13
          Caption = 'City'
        end
        object Zip4Label: TLabel
          Left = 162
          Top = 120
          Width = 27
          Height = 13
          Caption = 'Zip+4'
        end
        object StartingDateLabel: TLabel
          Left = 104
          Top = 152
          Width = 62
          Height = 13
          Caption = 'Starting Date'
          Visible = False
        end
        object EndingDateLabel: TLabel
          Left = 328
          Top = 152
          Width = 59
          Height = 13
          Caption = 'Ending Date'
          Visible = False
        end
        object AddressRGrp: TRadioGroup
          Left = 8
          Top = 24
          Width = 153
          Height = 81
          Caption = 'Address to Edit'
          ItemIndex = 0
          Items.Strings = (
            'Permanent Address'
            'Temporary Address'
            'Confidential Address')
          TabOrder = 0
          OnClick = AddressRGrpClick
        end
        object AddressLine1Edit: TEdit
          Left = 176
          Top = 16
          Width = 225
          Height = 21
          TabOrder = 1
          OnChange = AddressLine1EditChange
        end
        object AddressLine2Edit: TEdit
          Left = 176
          Top = 38
          Width = 225
          Height = 21
          TabOrder = 2
          OnChange = AddressLine2EditChange
        end
        object AddressLine3Edit: TEdit
          Left = 176
          Top = 60
          Width = 225
          Height = 21
          TabOrder = 3
          OnChange = AddressLine3EditChange
        end
        object CityEdit: TEdit
          Left = 200
          Top = 96
          Width = 121
          Height = 21
          TabOrder = 4
          OnChange = CityEditChange
        end
        object StateComboBox: TComboBox
          Left = 328
          Top = 96
          Width = 73
          Height = 21
          ItemHeight = 13
          TabOrder = 6
          Text = '<State>'
          OnChange = StateComboBoxChange
          Items.Strings = (
            'AK'
            'AL'
            'AR'
            'AZ'
            'CA'
            'CO'
            'CT'
            'DC'
            'DE'
            'FL'
            'GA'
            'HI'
            'IA'
            'ID'
            'IL'
            'IN'
            'KS'
            'KY'
            'LA'
            'MA'
            'MD'
            'ME'
            'MI'
            'MN'
            'MO'
            'MS'
            'MT'
            'NC'
            'ND'
            'NE'
            'NH'
            'NJ'
            'NM'
            'NV'
            'NY'
            'OH'
            'OK'
            'OR'
            'PA'
            'RI'
            'SC'
            'SD'
            'TN'
            'TX'
            'UT'
            'VA'
            'VT'
            'WA'
            'WI'
            'WV'
            'WY')
        end
        object Zip4Edit: TEdit
          Left = 200
          Top = 120
          Width = 121
          Height = 21
          TabOrder = 5
          OnChange = Zip4EditChange
        end
        object BadAddressCB: TCheckBox
          Left = 16
          Top = 151
          Width = 89
          Height = 17
          Caption = 'Bad Address'
          TabOrder = 7
          OnClick = BadAddressCBClick
        end
        object TempActiveCB: TCheckBox
          Left = 16
          Top = 106
          Width = 129
          Height = 17
          Caption = 'Temp Address Active'
          TabOrder = 8
          OnClick = TempActiveCBClick
        end
        object PhoneNumGrp: TRadioGroup
          Left = 416
          Top = 16
          Width = 137
          Height = 89
          Caption = 'Phone Number'
          ItemIndex = 0
          Items.Strings = (
            'Residence'
            'Work'
            'Cell'
            'Temporary')
          TabOrder = 9
          OnClick = PhoneNumGrpClick
        end
        object PhoneNumEdit: TEdit
          Left = 416
          Top = 120
          Width = 137
          Height = 21
          TabOrder = 10
          Text = '<Phone Number>'
          OnChange = PhoneNumEditChange
        end
        object StartingDateEdit: TEdit
          Left = 176
          Top = 152
          Width = 145
          Height = 21
          TabOrder = 11
          Visible = False
          OnChange = StartingDateEditChange
        end
        object EndingDateEdit: TEdit
          Left = 408
          Top = 152
          Width = 145
          Height = 21
          TabOrder = 12
          Visible = False
          OnChange = EndingDateEditChange
        end
        object ConfActiveCB: TCheckBox
          Left = 16
          Top = 129
          Width = 129
          Height = 17
          Caption = 'Confidential Active'
          TabOrder = 13
          Visible = False
          OnClick = ConfActiveCBClick
        end
      end
      object SexComboBox: TComboBox
        Left = 95
        Top = 176
        Width = 165
        Height = 21
        Anchors = [akLeft, akTop, akRight]
        ItemHeight = 13
        TabOrder = 7
        Text = '<Sex>'
        OnChange = SexComboBoxChange
        Items.Strings = (
          'MALE'
          'FEMALE')
      end
      object DegreeEdit: TEdit
        Left = 325
        Top = 160
        Width = 136
        Height = 21
        Anchors = [akTop, akRight]
        TabOrder = 9
        Visible = False
        OnChange = DegreeEditChange
      end
    end
  end
end