<div class="portlet box purple">
    <div class="portlet-title">
        <div class="caption">Personal History </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>
                                            <td colspan="5">
                                                <span class="bold">Date of current marriage :  </span>
                                                <span>{$patient->mirragefromdate}</span>
                                            </td>
                                        </tr>

                                        <tr>
                                            <th rowspan="3" style="width: 3%;">Wife</th>
                                            <th>Name : </th>
                                            <td>{$patient->wifename} </td>
                                            <th>Occupation : </th>
                                            <td>{$patient->wifejob} </td>
                                        </tr>

                                        <tr>
                                            <th> Age :  </th>
                                            <td> {$wAge} </td> 
                                            <th>Special Habits :  </th>  
                                            <td> 
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       placeholder=" Special Habits " name="personal_habits"
                                                       data-colName="personal_habits" data-id="{$phpersonal->id}" 
                                                       data-tableName="phpersonal" value="{$phpersonal->personal_habits}"/>
                                            </td>
                                        </tr>
                                        <tr>
                                            <th> Pr . Marriage :  </th>
                                            <td> 
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       placeholder=" Pr . Marriage " name="present_marriage"
                                                       data-colName="present_marriage" data-id="{$phpersonal->id}" 
                                                       data-tableName="phpersonal" value="{$phpersonal->present_marriage}"/>
                                            </td> 
                                            <th>Offspring's :  </th>  
                                            <td> 
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       placeholder="  Offspring's " name="offsprings"
                                                       data-colName="offsprings" data-id="{$phpersonal->id}" 
                                                       data-tableName="phpersonal" value="{$phpersonal->offsprings}"/>
                                            </td>
                                        </tr>
                                        <tr>
                                            <th rowspan="3" >Husband</th>
                                            <th>Name : </th>
                                            <td>{$patient->husdandname} </td>
                                            <th>Occupation : </th>
                                            <td>{$patient->husbandjob} </td>
                                        </tr>

                                        <tr>
                                            <th> Age :  </th>
                                            <td> {$hAge} </td> 
                                            <th>Special Habits :  </th>  
                                            <td> 
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       placeholder=" Special Habits " name="hus_personal_habits"
                                                       data-colName="hus_personal_habits" data-id="{$phpersonal->id}" 
                                                       data-tableName="phpersonal" value="{$phpersonal->hus_personal_habits}"/>
                                            </td>
                                        </tr>

                                        <tr>
                                            <th> Pr . Marriage :  </th>
                                            <td> 
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       placeholder=" Pr . Marriage " name="hus_present_marriage"
                                                       data-colName="hus_present_marriage" data-id="{$phpersonal->id}" 
                                                       data-tableName="phpersonal" value="{$phpersonal->hus_present_marriage}"/>
                                            </td> 
                                            <th>Offspring's :  </th>  
                                            <td> 
                                                <input type="text" class="amrpop form-control updateElement" 
                                                       placeholder="  Offspring's " name="hus_offsprings"
                                                       data-colName="hus_offsprings" data-id="{$phpersonal->id}" 
                                                       data-tableName="phpersonal" value="{$phpersonal->hus_offsprings}"/>
                                            </td>
                                        </tr>
                                    </thead>
                                </table> 
                            </div>
                        </form>
                    </div>
                </div>
                <div class="clearfix"></div>
            </div>
        </div>
        <div class="clearfix"></div>
    </div>
</div>
