Form Elements

Inputs, selects, checkboxes and validation states used across Dreams HMS

Basic Inputs

Patient Name

Email Address

We'll never share this with anyone else.

Phone Number

Patient ID (read-only)

Assigned Ward (disabled)

Leading Icon

Trailing Icon — Password Toggle

Prefix & Suffix

$ USD

Prefix Text

dreamshms.com/

Department

Multiple Select

Clinical Notes

Symptoms

Fever Persistent cough Shortness of breath (disabled)

Blood Group

A+ B+ O+ AB+

Notifications

Email alerts SMS reminders

Default File Input

Drop Area Click to upload or drag and drop PDF, PNG or JPG (max. 10MB)

Valid Input

Looks good — email is available.

Invalid Input

Please enter a valid email address.

Warning Input

This password is too weak.

Small

Default

Large

Full Name

Department

Biography