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Visual Basic Form | 1995-05-07 | 18.4 KB | 571 lines

VERSION 2.00 Begin Form Form3 BackColor = &H00C0C0C0& BorderStyle = 3 'Fixed Double Caption = "Medical Information" ClientHeight = 5880 ClientLeft = 150 ClientTop = 1290 ClientWidth = 9255 ControlBox = 0 'False Height = 6285 Left = 90 LinkMode = 1 'Source LinkTopic = "Form3" MaxButton = 0 'False MinButton = 0 'False ScaleHeight = 5880 ScaleWidth = 9255 Top = 945 Width = 9375 Begin PictureBox Panel3D1 BackColor = &H00C0C0C0& ForeColor = &H00000000& Height = 1155 Left = 2370 ScaleHeight = 1125 ScaleWidth = 4305 TabIndex = 35 Top = 5715 Width = 4335 Begin PictureBox Command3D3 ForeColor = &H00000000& Height = 855 Left = 1275 Picture = FORM3.FRX:0000 ScaleHeight = 825 ScaleWidth = 1845 TabIndex = 36 Top = 150 Width = 1875 End End Begin PictureBox Frame3D5 ForeColor = &H00000000& Height = 1335 Left = 120 ScaleHeight = 1305 ScaleWidth = 9030 TabIndex = 23 Top = 4290 Width = 9060 Begin PictureBox Picture6 BackColor = &H00C0C0C0& BorderStyle = 0 'None Height = 180 Left = 7560 ScaleHeight = 180 ScaleWidth = 1215 TabIndex = 43 Top = 1035 Width = 1215 Begin PictureBox Option3D8 ForeColor = &H00000000& Height = 195 Left = 675 ScaleHeight = 165 ScaleWidth = 540 TabIndex = 45 Top = 0 Width = 570 End Begin PictureBox Option3D7 ForeColor = &H00000000& Height = 195 Left = 0 ScaleHeight = 165 ScaleWidth = 600 TabIndex = 44 Top = 0 Width = 630 End End Begin PictureBox Picture7 BackColor = &H00C0C0C0& BorderStyle = 0 'None Height = 180 Left = 7560 ScaleHeight = 180 ScaleWidth = 1215 TabIndex = 46 Top = 810 Width = 1215 Begin PictureBox Option3D10 ForeColor = &H00000000& Height = 195 Left = 675 ScaleHeight = 165 ScaleWidth = 540 TabIndex = 48 Top = 0 Width = 570 End Begin PictureBox Option3D9 ForeColor = &H00000000& Height = 195 Left = 0 ScaleHeight = 165 ScaleWidth = 600 TabIndex = 47 Top = 0 Width = 630 End End Begin PictureBox Picture4 BackColor = &H00C0C0C0& BorderStyle = 0 'None Height = 180 Left = 7560 ScaleHeight = 180 ScaleWidth = 1215 TabIndex = 40 Top = 570 Width = 1215 Begin PictureBox Option3D3 ForeColor = &H00000000& Height = 195 Left = 675 ScaleHeight = 165 ScaleWidth = 540 TabIndex = 42 Top = 0 Width = 570 End Begin PictureBox Option3D1 ForeColor = &H00000000& Height = 195 Left = 0 ScaleHeight = 165 ScaleWidth = 585 TabIndex = 41 Top = 0 Width = 615 End End Begin PictureBox Picture3 BackColor = &H00C0C0C0& BorderStyle = 0 'None Height = 180 Left = 7560 ScaleHeight = 180 ScaleWidth = 1215 TabIndex = 37 Top = 330 Width = 1215 Begin PictureBox Option3D2 ForeColor = &H00000000& Height = 195 Left = 675 ScaleHeight = 165 ScaleWidth = 540 TabIndex = 39 Top = 0 Width = 570 End Begin PictureBox Option3D4 ForeColor = &H00000000& Height = 195 Left = 0 ScaleHeight = 165 ScaleWidth = 600 TabIndex = 38 Top = 0 Width = 630 End End Begin Label Label5 BackColor = &H00C0C0C0& Caption = "Are you currently being treated for or taking medication for any condition or disease?" FontBold = -1 'True FontItalic = 0 'False FontName = "Arial" FontSize = 8.25 FontStrikethru = 0 'False FontUnderline = 0 'False Height = 195 Left = 150 TabIndex = 27 Top = 1005 Width = 7125 End Begin Label Label3 BackColor = &H00C0C0C0& Caption = "Had treatment or counseling for alcohol or drug dependency?" FontBold = -1 'True FontItalic = 0 'False FontName = "Arial" FontSize = 8.25 FontStrikethru = 0 'False FontUnderline = 0 'False Height = 195 Left = 150 TabIndex = 25 Top = 780 Width = 5175 End Begin Label Label4 BackColor = &H00C0C0C0& Caption = "Been a patient in a hospital, sanitarium or other institution?" FontBold = -1 'True FontItalic = 0 'False FontName = "Arial" FontSize = 8.25 FontStrikethru = 0 'False FontUnderline = 0 'False Height = 195 Left = 150 TabIndex = 26 Top = 555 Width = 4950 End Begin Label Label2 BackColor = &H00C0C0C0& Caption = "Had surgery or been advised to have surgery which was not done?" FontBold = -1 'True FontItalic = 0 'False FontName = "Arial" FontSize = 8.25 FontStrikethru = 0 'False FontUnderline = 0 'False Height = 195 Left = 150 TabIndex = 24 Top = 345 Width = 5595 End End Begin PictureBox Frame3D6 ForeColor = &H00000000& Height = 1770 Left = 6285 ScaleHeight = 1740 ScaleWidth = 3045 TabIndex = 28 Top = 2430 Width = 3075 Begin PictureBox Check3D22 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 2835 TabIndex = 33 Top = 1455 Width = 2865 End Begin PictureBox Check3D12 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 855 TabIndex = 32 Top = 1185 Width = 885 End Begin PictureBox Check3D11 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 1080 TabIndex = 31 Top = 915 Width = 1110 End Begin PictureBox Check3D9 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 1005 TabIndex = 30 Top = 630 Width = 1035 End Begin PictureBox Check3D10 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 795 TabIndex = 29 Top = 345 Width = 825 End End Begin PictureBox Frame3D3 ForeColor = &H00000000& Height = 1770 Left = 3105 ScaleHeight = 1740 ScaleWidth = 3090 TabIndex = 7 Top = 2430 Width = 3120 Begin PictureBox Check3D18 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 2910 TabIndex = 15 Top = 1290 Width = 2940 End Begin PictureBox Check3D19 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 1605 TabIndex = 14 Top = 990 Width = 1635 End Begin PictureBox Check3D20 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 945 TabIndex = 13 Top = 690 Width = 975 End Begin PictureBox Check3D21 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 1275 TabIndex = 12 Top = 375 Width = 1305 End End Begin PictureBox Frame3D2 ForeColor = &H00000000& Height = 1770 Left = 120 ScaleHeight = 1740 ScaleWidth = 2895 TabIndex = 6 Top = 2430 Width = 2925 Begin PictureBox Check3D13 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 2730 TabIndex = 11 Top = 1290 Width = 2760 End Begin PictureBox Check3D8 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 1320 TabIndex = 10 Top = 975 Width = 1350 End Begin PictureBox Check3D7 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 1230 TabIndex = 9 Top = 660 Width = 1260 End Begin PictureBox Check3D6 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 855 TabIndex = 8 Top = 360 Width = 885 End End Begin PictureBox Picture1 AutoSize = -1 'True BackColor = &H00C0C0C0& BorderStyle = 0 'None Height = 2205 Left = 8340 Picture = FORM3.FRX:0302 ScaleHeight = 2205 ScaleWidth = 1440 TabIndex = 34 Top = 600 Width = 1440 Begin PictureBox Picture2 AutoSize = -1 'True BackColor = &H00FFFFFF& BorderStyle = 0 'None Height = 480 Left = 150 Picture = FORM3.FRX:1DBE ScaleHeight = 480 ScaleWidth = 480 TabIndex = 49 Top = 315 Width = 480 End End Begin PictureBox Frame3D4 ForeColor = &H00000000& Height = 1905 Left = 3570 ScaleHeight = 1875 ScaleWidth = 4680 TabIndex = 17 Top = 480 Width = 4710 Begin PictureBox Check3D27 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 2775 TabIndex = 22 Top = 1560 Width = 2805 End Begin PictureBox Check3D26 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 2160 TabIndex = 21 Top = 1275 Width = 2190 End Begin PictureBox Check3D25 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 3255 TabIndex = 20 Top = 975 Width = 3285 End Begin PictureBox Check3D24 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 4410 TabIndex = 19 Top = 675 Width = 4440 End Begin PictureBox Check3D23 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 4485 TabIndex = 18 Top = 360 Width = 4515 End End Begin PictureBox Frame3D1 ForeColor = &H00000000& Height = 1905 Left = 120 ScaleHeight = 1875 ScaleWidth = 3360 TabIndex = 0 Top = 480 Width = 3390 Begin PictureBox Check3D5 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 3000 TabIndex = 5 Top = 1575 Width = 3030 End Begin PictureBox Check3D4 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 1395 TabIndex = 4 Top = 1275 Width = 1425 End Begin PictureBox Check3D3 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 1695 TabIndex = 3 Top = 975 Width = 1725 End Begin PictureBox Check3D2 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 2205 TabIndex = 2 Top = 660 Width = 2235 End Begin PictureBox Check3D1 ForeColor = &H00000000& Height = 195 Left = 120 ScaleHeight = 165 ScaleWidth = 1980 TabIndex = 1 Top = 345 Width = 2010 End End Begin Label Label1 BackColor = &H00C0C0C0& Caption = "Please Check All Below that Apply:" FontBold = -1 'True FontItalic = 0 'False FontName = "Arial" FontSize = 18 FontStrikethru = 0 'False FontUnderline = 0 'False Height = 450 Left = 1710 TabIndex = 16 Top = 60 Width = 6120 End Sub Command1_Click () form2.Hide form1.Show End Sub Sub Command3D3_Click () form1.Show form3.Hide End Sub Sub Form_Load () form3.WindowState = 2 picture1.Width = 1020 picture1.Height = 1740 End Sub