{#if patientLoading}

{:else}

e.preventDefault()}>

{#if activeTab === 'personal'}

Patient ID * {#if formErrors.PatientID} {formErrors.PatientID} {/if}

First Name * {#if formErrors.NameFirst} {formErrors.NameFirst} {/if}

Middle Name

Last Name

Maiden Name

Suffix

Birthdate * {#if formErrors.Birthdate} {formErrors.Birthdate} {/if}

Place of Birth

Citizenship

{/if} {#if activeTab === 'location'}

Street Address

Street Address Line 2

Street Address Line 3

ZIP Code

Phone

Mobile Phone

Email Address

Secondary Email

{/if}

{/if} {#snippet footer()} {#if patientLoading}

{:else}

{/if} {/snippet}