<div class="portlet box purple">
    <div class="portlet-title">
        <div class="caption">Local Examination </div>
        <div class="actions"></div>
        <div class="tools">
            <a href="#" class="collapse" title="تصغير / تكبير"></a>
        </div>
    </div>
    <div class="portlet-body">
        <div class="row">
            <div id="ultrasoundgynaDiv">
                <div class="row">
                    <div class="portlet-body form" >
                        <form>
                            <div class="form-body">
                                <table>
                                    <thead>
                                        <tr>
                                            <th colspan="5">  Pelvic score (Bishop score) </th>  
                                        </tr>
                                        <tr>
                                            <th class="wds20">   </th>  
                                            <th class="wds20"> 0     </th> 
                                            <th class="wds20"> 1     </th>  
                                            <th class="wds20"> 2     </th>  
                                            <th class="wds20">3     </th>  
                                        </tr>
                                    </thead>
                                    <tbody>
                                        <tr>
                                            <th>Cx. consistency</th>
                                            <td>
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       data-colName="consistency0" data-id="{$obstetric_case_ex->id}" 
                                                       data-tableName="obstetric_case_ex" value="{$obstetric_case_ex->consistency0}"/> 
                                            </td>
                                            <td>
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       data-colName="consistency1" data-id="{$obstetric_case_ex->id}" 
                                                       data-tableName="obstetric_case_ex" value="{$obstetric_case_ex->consistency1}"/> 
                                            </td>
                                            <td>
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       data-colName="consistency2" data-id="{$obstetric_case_ex->id}" 
                                                       data-tableName="obstetric_case_ex" value="{$obstetric_case_ex->consistency2}"/> 
                                            </td>
                                            <td>
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       data-colName="consistency3" data-id="{$obstetric_case_ex->id}" 
                                                       data-tableName="obstetric_case_ex" value="{$obstetric_case_ex->consistency3}"/> 
                                            </td>
                                        </tr>

                                        <tr>
                                            <th>Cx. effacement</th>
                                            <td>
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       data-colName="effacement0" data-id="{$obstetric_case_ex->id}" 
                                                       data-tableName="obstetric_case_ex" value="{$obstetric_case_ex->effacement0}"/> 
                                            </td>
                                            <td>
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       data-colName="effacement1" data-id="{$obstetric_case_ex->id}" 
                                                       data-tableName="obstetric_case_ex" value="{$obstetric_case_ex->effacement1}"/> 
                                            </td>
                                            <td>
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       data-colName="effacement2" data-id="{$obstetric_case_ex->id}" 
                                                       data-tableName="obstetric_case_ex" value="{$obstetric_case_ex->effacement2}"/> 
                                            </td>
                                            <td>
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       data-colName="effacement3" data-id="{$obstetric_case_ex->id}" 
                                                       data-tableName="obstetric_case_ex" value="{$obstetric_case_ex->effacement3}"/> 
                                            </td>
                                        </tr>

                                        <tr>
                                            <th>Cx. dilatation</th>
                                            <td>
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       data-colName="dilatation0" data-id="{$obstetric_case_ex->id}" 
                                                       data-tableName="obstetric_case_ex" value="{$obstetric_case_ex->dilatation0}"/> 
                                            </td>
                                            <td>
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       data-colName="dilatation1" data-id="{$obstetric_case_ex->id}" 
                                                       data-tableName="obstetric_case_ex" value="{$obstetric_case_ex->dilatation1}"/> 
                                            </td>
                                            <td>
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       data-colName="dilatation2" data-id="{$obstetric_case_ex->id}" 
                                                       data-tableName="obstetric_case_ex" value="{$obstetric_case_ex->dilatation2}"/> 
                                            </td>
                                            <td>
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       data-colName="dilatation3" data-id="{$obstetric_case_ex->id}" 
                                                       data-tableName="obstetric_case_ex" value="{$obstetric_case_ex->dilatation3}"/> 
                                            </td>
                                        </tr>

                                        <tr>
                                            <th>Cx. position</th>
                                            <td>
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       data-colName="position0" data-id="{$obstetric_case_ex->id}" 
                                                       data-tableName="obstetric_case_ex" value="{$obstetric_case_ex->position0}"/> 
                                            </td>
                                            <td>
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       data-colName="position1" data-id="{$obstetric_case_ex->id}" 
                                                       data-tableName="obstetric_case_ex" value="{$obstetric_case_ex->position1}"/> 
                                            </td>
                                            <td>
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       data-colName="position2" data-id="{$obstetric_case_ex->id}" 
                                                       data-tableName="obstetric_case_ex" value="{$obstetric_case_ex->position2}"/> 
                                            </td>
                                            <td>
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       data-colName="position3" data-id="{$obstetric_case_ex->id}" 
                                                       data-tableName="obstetric_case_ex" value="{$obstetric_case_ex->position3}"/> 
                                            </td>
                                        </tr>

                                        <tr>
                                            <th>Station of head</th>
                                            <td>
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       data-colName="station0" data-id="{$obstetric_case_ex->id}" 
                                                       data-tableName="obstetric_case_ex" value="{$obstetric_case_ex->station0}"/> 
                                            </td>
                                            <td>
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       data-colName="station1" data-id="{$obstetric_case_ex->id}" 
                                                       data-tableName="obstetric_case_ex" value="{$obstetric_case_ex->station1}"/> 
                                            </td>
                                            <td>
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       data-colName="station2" data-id="{$obstetric_case_ex->id}" 
                                                       data-tableName="obstetric_case_ex" value="{$obstetric_case_ex->station2}"/> 
                                            </td>
                                            <td>
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       data-colName="station3" data-id="{$obstetric_case_ex->id}" 
                                                       data-tableName="obstetric_case_ex" value="{$obstetric_case_ex->station3}"/> 
                                            </td>
                                        </tr>

                                        <tr>
                                            <th>Score</th>
                                            <td>
                                                <div class="col-md-4">
                                                    <div class="md-radio-list">
                                                        <div class="md-radio">
                                                            <input type="radio" id="score1" name="score"  
                                                                   class="md-radiobtn sradio updateElement" value="1"  
                                                                   data-id="{$obstetric_case_ex->id}"
                                                                   data-colName="score" data-tableName="obstetric_case_ex"
                                                                   {if  $obstetric_case_ex->score == 1 } checked {/if}>
                                                            <label for="score1">
                                                                <span></span>
                                                                <span class="check"></span>
                                                                <span class="box"></span>
                                                                > 9  </label>
                                                        </div>
                                                    </div>
                                                </div>
                                            </td>
                                            <td>

                                                <div class="col-md-4">
                                                    <div class="md-radio-list">
                                                        <div class="md-radio">
                                                            <input type="radio" id="score2" name="score" 
                                                                   class="md-radiobtn sradio updateElement" value="2"  
                                                                   data-id="{$obstetric_case_ex->id}"
                                                                   data-colName="score" data-tableName="obstetric_case_ex"
                                                                   {if  $obstetric_case_ex->score  == 2 } checked {/if}>
                                                            <label for="score2">
                                                                <span></span>
                                                                <span class="check"></span>
                                                                <span class="box"></span>
                                                                5 - 9   </label>
                                                        </div>
                                                    </div>
                                                </div>
                                            </td>
                                            <td>

                                                <div class="col-md-4">
                                                    <div class="md-radio-list">
                                                        <div class="md-radio">
                                                            <input type="radio" id="score3" name="score" 
                                                                   class="md-radiobtn sradio updateElement" value="3"  
                                                                   data-id="{$obstetric_case_ex->id}"
                                                                   data-colName="score" data-tableName="obstetric_case_ex"
                                                                   {if  $obstetric_case_ex->score  == 3 } checked {/if}>
                                                            <label for="score3">
                                                                <span></span>
                                                                <span class="check"></span>
                                                                <span class="box"></span>
                                                                < 4   </label>
                                                        </div>
                                                    </div>
                                                </div>
                                            </td>
                                            <td></td>
                                        </tr>
                                    </tbody>
                                </table>


                                <table>
                                    <tbody>
                                        <tr>
                                            <th class="wds25">  Condition of fetal membranes :  </th>  
                                            <td>
                                                <div class="col-md-12">
                                                    <div class="md-checkbox-inline">
                                                        <div class="md-checkbox">
                                                            <input type="checkbox" id="intact"  data-id="{$obstetric_case_ex->id}"  
                                                                   class="md-check updateElementCheck" value="1"  
                                                                   data-colName="intact" data-tableName="obstetric_case_ex"
                                                                   {if  $obstetric_case_ex->intact == 1 } checked {/if}>
                                                            <label for="intact">
                                                                <span></span>
                                                                <span class="check"></span>
                                                                <span class="box"></span>
                                                                Intact </label>
                                                        </div>

                                                        <div class="md-checkbox">
                                                            <input type="checkbox" id="ruptured"    data-id="{$obstetric_case_ex->id}"
                                                                   class="md-check updateElementCheck" value="1"  
                                                                   data-colName="ruptured" data-tableName="obstetric_case_ex"
                                                                   {if  $obstetric_case_ex->ruptured == 1 } checked {/if}>
                                                            <label for="ruptured">
                                                                <span></span>
                                                                <span class="check"></span>
                                                                <span class="box"></span>
                                                                ruptured</label>
                                                        </div>
                                                    </div>
                                                </div>
                                            </td>
                                        </tr>

                                        <tr>
                                            <th class="wds25">  Fetal presentation :  </th>  
                                            <td>
                                                <div class="col-md-12">
                                                    <div class="md-checkbox-inline">
                                                        <div class="md-checkbox">
                                                            <input type="checkbox" id="vertex"  data-id="{$obstetric_case_ex->id}"  
                                                                   class="md-check updateElementCheck" value="1"  
                                                                   data-colName="vertex" data-tableName="obstetric_case_ex"
                                                                   {if  $obstetric_case_ex->vertex == 1 } checked {/if}>
                                                            <label for="vertex">
                                                                <span></span>
                                                                <span class="check"></span>
                                                                <span class="box"></span>
                                                                Vertex </label>
                                                        </div>

                                                        <div class="md-checkbox">
                                                            <input type="checkbox" id="face"  data-id="{$obstetric_case_ex->id}"  
                                                                   class="md-check updateElementCheck" value="1"  
                                                                   data-colName="face" data-tableName="obstetric_case_ex"
                                                                   {if  $obstetric_case_ex->face == 1 } checked {/if}>
                                                            <label for="face">
                                                                <span></span>
                                                                <span class="check"></span>
                                                                <span class="box"></span>
                                                                Face </label>
                                                        </div>

                                                        <div class="md-checkbox">
                                                            <input type="checkbox" id="brow"  data-id="{$obstetric_case_ex->id}"  
                                                                   class="md-check updateElementCheck" value="1"  
                                                                   data-colName="brow" data-tableName="obstetric_case_ex"
                                                                   {if  $obstetric_case_ex->brow == 1 } checked {/if}>
                                                            <label for="brow">
                                                                <span></span>
                                                                <span class="check"></span>
                                                                <span class="box"></span>
                                                                Brow </label>
                                                        </div>

                                                        <div class="md-checkbox">
                                                            <input type="checkbox" id="parietal_bone"  data-id="{$obstetric_case_ex->id}"  
                                                                   class="md-check updateElementCheck" value="1"  
                                                                   data-colName="parietal_bone" data-tableName="obstetric_case_ex"
                                                                   {if  $obstetric_case_ex->parietal_bone == 1 } checked {/if}>
                                                            <label for="parietal_bone">
                                                                <span></span>
                                                                <span class="check"></span>
                                                                <span class="box"></span>
                                                                Parietal bone(asynclitism) </label>
                                                        </div>
                                                    </div>
                                                </div>
                                            </td>
                                        </tr>
                                </table>
                            </div>
                        </form>
                    </div>
                </div>
                <div class="clearfix"></div>
            </div>
        </div>
        <div class="clearfix"></div>
    </div>
</div>