
<div class="page-content-wrapper">
    <div class="page-content all">
        <div class="row">
            <div class="col-md-12" style="padding-right: 0px; padding-left: 0px;">
                <div class="portlet box blue">
                    <div class="portlet-title" style="height: 5px">
                        <div class="caption">
                            <i class="fa fa-edit"></i> Antenatal visits
                        </div>

                    </div>
                    <div class="portlet-body">


                        <table class="table table-striped table-hover table-bordered">
                            <tbody>
                                <tr>
                                    <th class="col-md-2">
                                        Hospital Name
                                    </th>

                                    <td>
                                        <!--<input type="text" class="form-control"  id="hospitalName" value="مستشفى الدلتا - شارع جيهان - أمام مستشفى الطوارئ" />
                                        <input type="text" class="form-control"  id="hospitalName" value="" />-->

                                        <select  class="form-control" name="hospitalName" id="hospitalName" >
                                            <option value="">choose</option>
                                            {foreach $hospitalnames as $hospital}
                                            <option value="{$hospital->id}" >{$hospital->name}</option>
                                            {/foreach}
                                            <option value="-2" class="deleteoptincompo">Delete</option>
                                        </select>
                                    </td>
                                </tr>
                                <!--
                                    </tbody>
                                </table>





                                                        <table class="table table-striped table-hover table-bordered">
                                                            <tbody>
                                                                <tr>
                                                                    <th colspan="8">
                                                                        Patient Information
                                                                    </th>

                                                                </tr>
                                                                <tr>
                                                                    <th class="col-md-2 wds5">
                                                                        G
                                                                    </th>
                                                                    <td class="wds17">
                                                                        {$mainObj->g}
                                                                    </td>
                                                                    <th class="col-md-2 wds5">
                                                                        P
                                                                    </th>
                                                                    <td class="wds17">
                                                                        {$p}
                                                                    </td>
                                                                    <th class="col-md-2 wds13">
                                                                        Pregnant (weeks)
                                                                    </th>
                                                                    <td class="wds17">
                                                                        {$weeks}
                                                                    </td>
                                                                    <th class="col-md-2 wds9">
                                                                        Blood Group
                                                                    </th>
                                                                    <td class="wds17">
                                                                        {$blodd}
                                                                    </td>

                                                                </tr>
                                                                <tr>
                                                                    <th class="col-md-2 wds5">
                                                                        Hb
                                                                    </th>
                                                                    <td>
                                                                        {$mainObj->hb }
                                                                    </td>

                                                                    <th class="col-md-2 wds5">
                                                                        Placenta
                                                                    </th>
                                                                    <td colspan="3">
                                                                        {$antUS.placenta}
                                                                    </td>
                                                                    <th class="col-md-2 wds5">
                                                                        EDD
                                                                    </th>
                                                                    <td>
                                                                        {$mainObj->eed }
                                                                    </td>

                                                                </tr>
                                                                <tr>
                                                                    <th class="col-md-2 wds12">
                                                                        Medical diseases
                                                                    </th>
                                                                    <td colspan="9">
                                                                        {$mypastmedical }
                                                                    </td>
                                                                </tr>

                                                                <tr>
                                                                    <th class="col-md-2 wds5">
                                                                        Notes
                                                                    </th>
                                                                    <td colspan="9">
                                                                        {$mainObj->notes }
                                                                    </td>
                                                                </tr>

                                                            </tbody>
                                                        </table>



                                <table class="table table-striped table-hover table-bordered">
                                    <tbody>-->
                                <tr>
                                    <th class="col-md-2">
                                        Notes
                                    </th>

                                    <td>
                                        <textarea class="form-control wds100 txtl" name="instNotes" id="instNotes"></textarea>
                                    </td>
                                </tr>


                                <tr>
                                    <th class="col-md-2">
                                        Operation  Instruction
                                    </th>

                                    <td>
                                        <select multiple="" size="1"  class="form-control select2me  transferInstructions" id="operationInstructions">
                                            <option value="">choose</option>

                                            {foreach $instructions as $inst}
                                            <option value="{$inst->id}">{$inst->insttext}</option>
                                            {/foreach}
                                            <option value="-1">Add</option>
                                            <option value="-2" class="deleteoptincompo">edit</option>
                                        </select>
                                    </td>
                                </tr>
                                <!--                                <tr>
                                                                    <th class="col-md-2">
                                                                        Operation Evening :
                                                                    </th>
                                                                    <td>
                                                                        <select  class="form-control select2me transferInstructions" id="eveningInstructions">
                                                                            <option value="">choose</option>

                                                                            {foreach $instructions as $inst}
                                                                            <option value="{$inst->id}">{$inst->insttext}</option>
                                                                            {/foreach}
                                                                            <option value="-2" class="deleteoptincompo">edit</option>
                                                                        </select>
                                                                    </td>
                                                                </tr>-->
                            </tbody>
                        </table>


                        <button type="button" class="btn" style="float: right;" data-patientId="{$patientData.id}" id="printTransfer"> Print  </button>
                    </div>
                </div>
            </div>
        </div>

    </div>

</div>

<div id="printTtt"></div>


<!----#########################################################################  model ##############################################################################################################--->


<div class="bootbox modal fade bootbox-alert in" tabindex="-1" role="dialog" aria-hidden="false"  id="edit_model">
    <div class="modal-dialog">
        <div class="modal-content">
            <div class="modal-header">
                <button type="button" class="close" data-dismiss="modal" aria-hidden="true"></button>
                <h4 class="modal-title"> Edit </h4>
            </div>
            <div class="modal-body">
                <div class="portlet-body form">
                    <form action="" method="post" class="form-horizontal  emptyform" >
                        <div class="form-body all" >
                            <!------===========================================------->
                            <div class="form-group">
                                <label class="col-md-1 control-label"> </label>
                                <div class="col-md-10">
                                    <div id="alldatadiv" class="" > </div>
                                </div>
                                <label class="col-md-1 control-label"> </label>
                            </div>

                            <!------===========================================------->

                            <!------===========================================------->
                            <div class="modal-footer">

                                <button type="button" id="amountcloseinput"   class="btn default" data-dismiss="modal">Close</button>
                            </div>
                        </div>
                    </form>
                </div>
            </div>
            <!-- /.modal-content -->
        </div>
    </div>
</div>

<!--------------------------------------------------------------------------- add Model-------------------------------------------------------------------------------------->
<div class="bootbox modal fade bootbox-alert in" tabindex="-1" role="dialog" aria-hidden="false"  id="add_Inst">
    <div class="modal-dialog">
        <div class="modal-content">
            <div class="modal-header">
                <button type="button" class="close" data-dismiss="modal" aria-hidden="true"></button>
                <h4 class="modal-title"> Add New </h4>
            </div>
            <div class="modal-body">
                <div class="portlet-body form">
                    <form action="" id="" method="post" class="form-horizontal  emptyform" >
                        <div class="form-body">
                            <!------===========================================------->
                            <div class="form-group">
                                <label class="col-md-1 control-label"> Name </label>
                                <div class="col-md-10">
                                    <input type="text" class="addOpInst" id="addOpInst" data-select="" data-tablename="" data-id="" value="">
                                </div>
                                <label class="col-md-1 control-label"> </label>
                            </div>

                            <!------===========================================------->
                            <div class="modal-footer">
                                <button type="button" id="amountcloseinput"   class="btn default" data-dismiss="modal">Close</button>
                            </div>
                        </div>
                    </form>
                </div>
            </div>
            <!-- /.modal-content -->
        </div>
    </div>
</div>