
<div class="page-content-wrapper">
    <div class="page-content">
        <div class="row clinick">
            <div class="col-md-12">
                <!-- BEGIN EXAMPLE TABLE PORTLET-->
                <div class="portlet box blue">
                    <div class="portlet-title">
                        <div class="caption" style="float: right;">
                          <i style="float: right; font-weight: bold;" class="fa fa-user"></i>       بطاقة متابعة  
                        </div>
                    </div>
                    <div class="portlet-body">
                    
                        <!--Begin Semen-->

                        <div class="row">

                            <form action="{$hosturl}/controllers/followupcard.php?ac=printit" id="followardForm" method="post" enctype="multipart/form-data">
                                <div class="form-body">

    <br/>
                                    <table class="table table-striped table-hover table-bordered">
                                        <tr>
                                            <td style="width: 39%;">{$patient->wifename}</td>
                                            <th style="width: 11%;">اسم المريض </th>
                                            <td style="width: 39%;">{$patient->statusno}</td>
                                            <th style="width: 11%;">رقم المريض </th>
                                            
                                            
                                        </tr>
                               
                                        
                                        <tr>
                                            <td style="width: 39%;"><input type="text" class="form-control datepicker updateElement" readonly="" data-colName="exitdate" data-id="{$followupcard->id}"  data-tableName="followupcard" value="{$followupcard->exitdate}"/></td>
                                            <th style="width: 11%;">تاريخ الخروج </th>
                                            <td style="width: 39%;">{$followupcard->enterdate}</td>
                                            <th style="width: 11%;">تاريخ الدخول </th>
                                            
                                            
                                        </tr>
                                        
                                        <tr>
                                            <td colspan="3"><input type="text" class="form-control updateElement"  data-colName="diagnosis" data-id="{$followupcard->id}"  data-tableName="followupcard" value="{$followupcard->diagnosis}"/></td>
                                            <th style="width: 11%;">التشخيص </th>
                                            
                                        </tr>
                                        
                                        
                                    </table>
                                    
                                   <div class="portlet box blue">
                                        <div class="portlet-title" >
                                            <div class="caption" style="float: right;"> العلاج </div>
                                            <div class="actions" style="float: left;"><a href="javascript:;" class="btn btn-default btn-sm" id="followDAdd">اضافة</a></div>
                                        </div>

                                        <div class="portlet-body">

                                            <table class="table table-striped table-hover table-bordered" id="pre_table" >
                                                <thead>
                                                    <tr>
                                                        <th class="col-md-2">
                                                            Group
                                                        </th>
                                                        <th class="col-md-2">
                                                            Drug
                                                        </th>
                                                        <th class="col-md-2">
                                                            Form
                                                        </th>
                                                        <th class="col-md-5">
                                                            Use
                                                        </th>

                                                        <th >
                                                            Delete
                                                        </th>
                                                    </tr>
                                                </thead>
                                                <tbody id="drugContent">
                                                     
                                                    <tr>
                                                        <td>
                                                            <select class="form-control  dcat select2me" name="dcat1"  id="dcat1"  data-placeholder="Select..."  data-itr="1" >
                                                                <option value="">Choose Category</option>
                                                                {foreach $allDrugcats as $cat}
                                                                <option value="{$cat['drugcat']}" >{$cat['drugcat']}</option>
                                                                {/foreach}
                                                            </select>
                                                        </td>
                                                        <td>
                                                            <select class="form-control  dname select2me " data-createNew="0" id="dname1" name="dname1" data-itr="1"    data-placeholder="Select..."  >
                                                                <option value="">Choose Drug</option>
                                                                {foreach $drugs as $drug}
                                                                <option value="{$drug['id']}" >{$drug['drugname']} {if $programSettingData->visitsform eq 3}(left {$drug['currentbalance']}){/if} </option>
                                                                {/foreach}
                                                            </select>
                                                        </td>
                                                        <td>
                                                            <select class="form-control  dtype select2me " name="dtype1" id="dtype1"  data-itr="1"     data-placeholder="Select..."  >
                                                                <option value="">Choose Form</option>
                                                                {foreach $allDrugTypes as $type}
                                                                <option value="{$type['drugtype']}" >{$type['drugtype']}</option>
                                                                {/foreach}
                                                            </select>
                                                        </td>
                                                        
                                                        <td>
                                                            <select class="form-control   select2me " name="ddos1" id="ddos1" data-itr="1"    data-placeholder="Select..."  >
                                                                <option value="">choose dose </option>
                                                                {foreach $allDrugDoses as $dos}
                                                                <option value="{$dos['drugdos']}">{$dos['drugdos']}</option>
                                                                {/foreach}
                                                            </select>
                                                        </td>
                                                        
                                                        

                                                        <td>
                                                            <a class="btn grey-cascade btn-xs deletefrow" data-id="" style=" float: left;" >
                                                                <i class="fa fa-close"></i>
                                                            </a>
                                                        </td>
                                                    </tr>

                                                </tbody>
                                            </table>
                                        <input type="hidden" id="drugItr"  value="1" name="drugItr"/>
                                            <div id="drugPrint">

                                            </div>

                                        </div>

                                    </div>
                           
                                <div class="modal-footer">
                                    <button type="button" class="btn default printCard"  id="saveNoPrint" data-print="no" data-controller="followupcard"> حفظ </button>
                                    <button type="button" class="btn default printCard"  id="saveWithPrint" data-print="yes" data-controller="followupcard"> حفظ وطباعة   </button>

                                </div>

                                    <input type="hidden" name="followupcardid" value="{$followupcard->id}">
                                    <input type="hidden" name="cardPrint" id="cardPrint" value="{$followupcard->id}">
                                    <input type="hidden" id="controllName" value="followupcard"/>
                                    <input type="hidden" id="patientId" name="patientId" value="{$patient->id}"/>

                                </div>

                            </form>

                        </div>
                    </div>
                </div>
            </div>

        </div>
    </div>
</div>


