clinic/netforce_clinic/layouts/clinic_report_visit.xml

<form model="clinic.report.visit">
    <field name="date" span="2" mode="month" onchange="onchange_date"/>
    <field name="date_from" span="2"/>
    <field name="date_to" span="2"/>
    <field name="patient_id" span="2"/>
    <field name="doctor_id" span="2"/>
    <field name="state" span="2"/>
</form>