PWAPP/PWAPPv2/MainWindow.xaml

<Window x:Class="PWAPPv2.MainWindow"
        xmlns="http://schemas.microsoft.com/winfx/2006/xaml/presentation"
        xmlns:x="http://schemas.microsoft.com/winfx/2006/xaml"
        xmlns:d="http://schemas.microsoft.com/expression/blend/2008"
        xmlns:mc="http://schemas.openxmlformats.org/markup-compatibility/2006"
        xmlns:local="clr-namespace:PWAPPv2"
        mc:Ignorable="d"
        Title="Quick Referral" Height="500" Width="800">
    <Grid>
        <Grid.ColumnDefinitions>
            <ColumnDefinition Width="9*"/>
            <ColumnDefinition Width="13*"/>
        </Grid.ColumnDefinitions>
        <GroupBox Header="Patient" HorizontalAlignment="Left" Height="226" Margin="10,10,0,0" VerticalAlignment="Top" Width="309">
            <Grid HorizontalAlignment="Left" Height="198" VerticalAlignment="Top" Width="289" Margin="0,0,0,-1">
                <Grid.ColumnDefinitions>
                    <ColumnDefinition Width="1*"/>
                    <ColumnDefinition Width="1*"/>
                </Grid.ColumnDefinitions>
                <Grid.RowDefinitions>
                    <RowDefinition Height="1*"/>
                    <RowDefinition Height="1*"/>
                    <RowDefinition Height="1*"/>
                    <RowDefinition Height="1*"/>
                    <RowDefinition Height="1*"/>
                    <RowDefinition Height="1*"/>
                    <RowDefinition Height="1*"/>
                    <RowDefinition Height="1*"/>
                </Grid.RowDefinitions>
                <Label Content="Last Name:" HorizontalAlignment="Left" VerticalAlignment="Top"/>
                <Label Content="First Name:" HorizontalAlignment="Left" Grid.Row="1" VerticalAlignment="Top"/>
                <Label Content="Middle Name:" HorizontalAlignment="Left" Grid.Row="2" VerticalAlignment="Top"/>
                <Label Content="Data of Birth:" HorizontalAlignment="Left" Grid.Row="3" VerticalAlignment="Top"/>
                <Label Content="State:" HorizontalAlignment="Left" Grid.Row="6" VerticalAlignment="Top"/>
                <Label Content="Street Address:" HorizontalAlignment="Left" Grid.Row="4" VerticalAlignment="Top"/>
                <Label Content="City:" HorizontalAlignment="Left" Grid.Row="5" VerticalAlignment="Top"/>
                <Label Content="Zip Code:" HorizontalAlignment="Left" Grid.Row="7" VerticalAlignment="Top"/>
                <Label x:Name="txtLName"  Content="{Binding Path=txtLName}" Grid.Column="1" HorizontalAlignment="Left" VerticalAlignment="Top"/>
                <Label x:Name="txtFName" Content="{Binding Path=txtFName}" Grid.Column="1" HorizontalAlignment="Left" Grid.Row="1" VerticalAlignment="Top"/>
                <Label x:Name="txtMName" Content="{Binding Path=txtMName}" Grid.Column="1" HorizontalAlignment="Left" Grid.Row="2" VerticalAlignment="Top"/>
                <Label x:Name="txtDob" Content="{Binding Path=txtDob}" Grid.Column="1" HorizontalAlignment="Left" Grid.Row="3" VerticalAlignment="Top"/>
                <Label x:Name="txtStreet" Content="{Binding Path=txtStreet}" Grid.Column="1" HorizontalAlignment="Left" Grid.Row="4" VerticalAlignment="Top"/>
                <Label x:Name="txtCity" Content="{Binding Path=txtCity}" Grid.Column="1" HorizontalAlignment="Left" Grid.Row="5" VerticalAlignment="Top"/>
                <Label x:Name="txtState" Content="{Binding Path=txtState}" Grid.Column="1" HorizontalAlignment="Left" Grid.Row="6" VerticalAlignment="Top"/>
                <Label x:Name="txtZip" Content="{Binding Path=txtZip}" Grid.Column="1" HorizontalAlignment="Left" Grid.Row="7" VerticalAlignment="Top"/>
            </Grid>
        </GroupBox>
        <GroupBox Header="Referral Type" HorizontalAlignment="Left" Height="55" Margin="0,10,0,0" VerticalAlignment="Top" Width="458" Grid.Column="1">
            <ComboBox x:Name="boxReferType" HorizontalAlignment="Left" Margin="0,10,-2,0" VerticalAlignment="Top" Width="448"/>
        </GroupBox>
        <GroupBox Header="Refer From" HorizontalAlignment="Left" Height="55" Margin="0,65,0,0" VerticalAlignment="Top" Width="458" Grid.Column="1">
            <ComboBox x:Name="boxReferFrom" HorizontalAlignment="Left" Margin="0,10,-2,0" VerticalAlignment="Top" Width="448"/>
        </GroupBox>
        <GroupBox Header="Refer To" HorizontalAlignment="Left" Height="55" Margin="0,120,0,0" VerticalAlignment="Top" Width="458" Grid.Column="1">
            <ComboBox x:Name="boxReferTo" HorizontalAlignment="Left" Margin="0,10,-2,0" VerticalAlignment="Top" Width="448"/>
        </GroupBox>
        <CheckBox Content="Contact Doctor" HorizontalAlignment="Left" Margin="0,175,0,0" VerticalAlignment="Top" Grid.Column="1" Checked="CheckBox_Checked" Height="15" Width="101"/>
        <GroupBox Header="Remarks" HorizontalAlignment="Left" Height="218" Margin="10,241,0,0" VerticalAlignment="Top" Width="309">
            <RichTextBox x:Name="fieldRemakrs" HorizontalAlignment="Left" Height="198" VerticalAlignment="Top" Width="299" Margin="0,0,-2,-3">
                <FlowDocument>
                    <Paragraph>
                        <Run x:Name="fieldRemakrsText" Text=""/>
                    </Paragraph>
                </FlowDocument>
            </RichTextBox>
        </GroupBox>
        <Button Content="Send" HorizontalAlignment="Left" Margin="383,429,0,0" VerticalAlignment="Top" Width="75" Grid.Column="1" Height="20"/>
        <Button Content="Cancel" HorizontalAlignment="Left" Margin="303,429,0,0" VerticalAlignment="Top" Width="75" Grid.Column="1" Height="20"/>
        <GroupBox Header="Images" HorizontalAlignment="Left" Height="234" Margin="1,190,0,0" VerticalAlignment="Top" Width="457" Grid.Column="1">
            <Grid HorizontalAlignment="Left" Height="210" VerticalAlignment="Top" Width="447" Margin="0,0,-2,0">
                <Grid.RowDefinitions>
                    <RowDefinition Height="13*"/>
                    <RowDefinition Height="92*"/>

                </Grid.RowDefinitions>
                <Grid HorizontalAlignment="Left" Height="21" VerticalAlignment="Top" Width="447" RenderTransformOrigin="0.486,2.034">
                    <Grid.ColumnDefinitions>
                        <ColumnDefinition Width="290*"/>
                        <ColumnDefinition Width="80*"/>
                        <ColumnDefinition Width="77*"/>
                    </Grid.ColumnDefinitions>
                    <Button Content="Add Image" Grid.Column="2" HorizontalAlignment="Left" VerticalAlignment="Top" Width="75" Height="20"/>
                    <Button Content="Remove" Grid.Column="1" HorizontalAlignment="Left" VerticalAlignment="Top" Width="75" Height="20"/>
                </Grid>
            </Grid>
        </GroupBox>
    </Grid>
</Window>