ushead.html

<htmlform formUuid="acb2d701-3deb-4c74-adc1-78b7dc2fce79" formName="US Head Investigation" formEncounterType="b7d7740b-5767-45b6-8ae3-332476e75abf" formVersion="1.0">
    <style>
        .background {
            background-color: #888;
        }
        table.ushead {
            border-collapse: collapse;
            background-color: #000;
        }
        table.ushead > tbody > tr > td, table.ushead > tbody > tr > th {
            border: 0;
            vertical-align: baseline;
            padding: 2px;
            text-align: left;
            background-color: #F3F9FF;
        }
    </style>
    <h2>Us Head Evaluation</h2>
    <div style="display:none">
        <td>Evaluation date:<encounterDate id="encounterDate" showTime="false" default="now" /></td>
    </div>
    <div class="background">
        <table class="ushead">
            <tbody>
                <tr>
                    <td>Location:<encounterLocation default="24" /></td>
                    <td>Provider:<encounterProvider default="currentUser"/></td>
                    <td>Date of test:<obs conceptId="163724AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" allowTime="false" /></td>
                </tr>
                <tr>
                    <td>RV (mm):<obs id="rv" conceptId="164324AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" /></td>
                    <td>LV (mm):<obs id="lv" conceptId="164325AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" /></td>
                    <td>RV+LV (mm):<obs id="rvlv" conceptId="164326AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" /></td>
                </tr>
                <tr>
                    <td colspan="2">Hydrocephalus Severity:<obs conceptId="164342AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" /></td>
                    <td>Mantle thickness (cm):<obs conceptId="164327AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" /></td>
                </tr>
                <tr>
                    <td colspan="3">
                        <label><uimessage code="coreapps.consult.freeTextComments"/></label>
                        <obs conceptId="162169AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" style="textarea" rows="5"/>
                    </td>
                </tr>
            </tbody>
        </table>
    </div>



    <ifMode mode="VIEW" include="false">
        <div id="buttons">
            <submit submitClass="confirm right" submitCode="general.save"/>
            <button type="button" class="cancel"><uimessage code="general.cancel"/></button>
        </div>
    </ifMode>

</htmlform>