text: import React, { PureComponent } from 'react';
  import { Field, reduxForm } from 'redux-form'
  
  import ValidatedInput from '../../../form-fields/ValidatedInputFormGroup';
  import ValidatedTextareaFormGroup from '../../../form-fields/ValidatedTextareaFormGroup';
  import DateInput from '../../../form-fields/DateInput';
  import { validateForm } from '../forms.validation';
  import { valuesNames, valuesLabels } from '../forms.config';
  import { defaultFormValues } from './default-values.config';
  
  @reduxForm({
    form: 'clinicalNotesCreateFormSelector',
    validate: validateForm,
  })
  export default class ProblemsDiagnosisCreateForm extends PureComponent {
    componentDidMount() {
      this.props.initialize(defaultFormValues);
    }
    render() {
      const {isSubmit} = this.props;
      const date = new Date();
      const dateCreated = date.getTime();
      return (
        <div className="panel-body-inner">
          <form name="clinicalNoteCreateForm" className="form">
            <div className="form-group-wrapper">
              <div className="row-expand">
                <div className="col-expand-left">
                  <Field
                    label={valuesLabels.TYPE}
                    name={valuesNames.TYPE}
                    id={valuesNames.TYPE}
                    type="text"
                    placeholder=""
                    component={ValidatedInput}
                    props={{ isSubmit }}
                  />
                </div>
              </div>
              <div className="row-expand">
                <div className="col-expand-left">
                  <Field
                    label={valuesLabels.NOTE}
                    name={valuesNames.NOTE}
                    id={valuesNames.NOTE}
                    component={ValidatedTextareaFormGroup}
                    props={{ isSubmit }}
                  />
                </div>
              </div>
              <div className="row-expand">
                <div className="col-expand-left">
                  <Field
                    label={valuesLabels.AUTHOR}
                    name={valuesNames.AUTHOR}
                    id={valuesNames.AUTHOR}
                    component={ValidatedInput}
                    props={{ disabled: true }}
                  />
                </div>
                <div className="col-expand-right">
                  <Field
                    label={valuesLabels.DATE}
                    name={valuesNames.DATE}
                    id={valuesNames.DATE}
                    component={DateInput}
                    props={{ disabled: true, value: dateCreated, format: 'DD-MMM-YYYY' }}
                  />
                </div>
              </div>
            </div>
          </form>
        </div>)
    }
  }
  