<style>
    table {
        font-family: arial, sans-serif;
        border-collapse: collapse;
        width: 100%;
    }

    td, th {
        border: 1px solid #000000;
        text-align: left;
        padding: 8px;
    }

    tr:nth-child(even) {
        background-color: #dddddd;
    }
</style>
<div class="page-content-wrapper">
    <div class="page-content">
        <div class="row">
            <div class="col-md-12">
                <!-- BEGIN EXAMPLE TABLE PORTLET-->
                <div class="portlet box blue">
                    <div class="portlet-title">
                        <div class="caption">
                            <i class="fa fa-user"></i>Embryo Freezing Report
                        </div>
                    </div>
                    <div class="portlet-body">

                        <!--Begin Semen-->

                        <div class="row">


                            <div class="portlet-title tbox">
                                <div class="caption font-blue-haze col-md-6">
                                    <span class="caption-subject bold uppercase">Add</span>
                                </div>

                            </div>

                            <div class="clearfix"></div>

                            {if $patientId}
                            <form action="{$hosturl}/controllers/{$controllname}.php?ac=addit&patientid={$patientId}" method="post" enctype="multipart/form-data">
                                {else}
                                <form action="{$hosturl}/controllers/{$controllname}.php?ac=addit" method="post" enctype="multipart/form-data">
                                    {/if}
                                    <div class="form-body">
                                        <div class="col-md-12">
                                            <div class="form-group col-md-12">
                                                <div class="form-group col-md-12">
                                                    <label class="col-md-2 txtl "  for="form_control_1" >Date :</label>
                                                    <div class="col-md-3">
                                                        <input type="text" class="form-control  datepicker" required="required"  value="{$current_date}" name="date"/>
                                                    </div>
                                                </div>
                                                <div class="clearfix"></div>
                                                <label class="col-md-2 txtl" for="form_control_1">Ref.by . Prof. Dr :</label>
                                                <div class="col-md-3">
                                                    <input type="text" class="form-control " readonly required="required"  value="{if !empty($ref_dr['name'])}{$ref_dr['name']}{else}{$ref_dr}{/if}" name="ref_by"/>
                                                    <input type="hidden"  value="{if !empty($ref_dr['user_id'])}{$ref_dr['user_id']}{else}0{/if}" name="ref_by_dr_id"/>
                                                </div>
                                                <label class="col-md-2 txtl" for="form_control_1">Embryologist :</label>
                                                <div class="col-md-3">
                                                    <select class="form-control select2me" id="embryologist" name="embryologist" data-colName="name" select-tableName="awusers"  data-id="{$one.user_id}" required="required">
                                                        <option value="">choose</option>
                                                        {foreach  $embryologist as $one}
                                                        <option value="{$one.user_id}">{$one.name}</option>
                                                        {/foreach}
                                                    </select>
                                                </div>
                                            </div>
                                            <div class="clearfix"></div>
                                            <hr>
                                            <div class="form-group col-md-12">
                                                <div class="form-group col-md-12">
                                                    <label class="col-md-2 txtl" for="form_control_1">No.of Straws :</label>
                                                    <div class="col-md-2">
                                                        <input type="text" class="form-control"  value="" name="no_of_straws" id="no_of_straws"/>
                                                    </div>
                                                </div>
                                                <div class="form-group col-md-12">
                                                    <label class="col-md-2 txtl" for="form_control_1">No.of Embryos :</label>
                                                    <div class="col-md-2">
                                                        <input type="text" class="form-control "  value="" name="no_of_embryos" id="no_of_embryos"/>
                                                    </div>
                                                </div>
                                            </div>
                                            <div class="col-md-12">
                                                <label class="col-md-3 control-label" for="form_control_1">
                                                    Day of Freezing:
                                                </label>
                                                <div class="col-md-8">
                                                    <div class="col-md-2">
                                                        <div class="md-radio-list">
                                                            <div class="md-radio">
                                                                <input type="radio"  id="2d" name="days" class="md-radiobtn sradio" data-val="0" value="0">
                                                                <label for="2d">
                                                                    <span></span>
                                                                    <span class="check"></span>
                                                                    <span class="box"></span>
                                                                    2nd day</label>
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="col-md-2">
                                                        <div class="md-radio-list">
                                                            <div class="md-radio">
                                                                <input type="radio"  id="3d" name="days" class="md-radiobtn sradio" data-val="4" value="4">
                                                                <label for="3d">
                                                                    <span></span>
                                                                    <span class="check"></span>
                                                                    <span class="box"></span>
                                                                    3rd day</label>
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="col-md-2">
                                                        <div class="md-radio-list">
                                                            <div class="md-radio">
                                                                <input type="radio"  id="4d" name="days" class="md-radiobtn sradio" data-val="1" value="1">
                                                                <label for="4d">
                                                                    <span></span>
                                                                    <span class="check"></span>
                                                                    <span class="box"></span>
                                                                    4nd day</label>
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="col-md-2">
                                                        <div class="md-radio-list">
                                                            <div class="md-radio">
                                                                <input type="radio" id="5d" name="days" class="md-radiobtn sradio" data-val="2" value="2">
                                                                <label for="5d">
                                                                    <span></span>
                                                                    <span class="check"></span>
                                                                    <span class="box"></span>
                                                                    5nd day</label>
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="col-md-2">
                                                        <div class="md-radio-list">
                                                            <div class="md-radio">
                                                                <input type="radio" id="6d" name="days" class="md-radiobtn sradio" data-val="3" value="3">
                                                                <label for="6d">
                                                                    <span></span>
                                                                    <span class="check"></span>
                                                                    <span class="box"></span>
                                                                    6nd day</label>
                                                            </div>
                                                        </div>
                                                    </div>
                                                </div>
                                            </div>
                                            <div class="form-group col-md-12">
                                                <div class="form-group col-md-12">
                                                    <label class="col-md-2 txtl" for="form_control_1">notes:</label>
                                                    <div class="col-md-5">
                                                        <textarea class="form-control input-sm"  name="notes"></textarea>
                                                    </div>
                                                </div>
                                            </div>
                                            <div class="clearfix"></div>
                                            <hr>

                                            <div class="col-md-12">
                                                <div class="portlet box blue" style="width: 100%;overflow: auto;background-color:transparent;">
                                                    <div class="portlet-title" style="height: 5px;width: 116%;">
                                                        <div class="caption">
                                                            <i class="fa fa-edit"></i>Embryo
                                                        </div>
                                                    </div>
                                                    <div class="portlet-body" id="justfordrugs" >
                                                        <div class="table-toolbar">
                                                            <div class="row">
                                                                <div class="col-md-6">
                                                                    <div class="btn-group">
                                                                        <a href="javascript:;" class="btn btn green btn-sm" id="addNewembryoRow" data-tableName="embryo">
                                                                            <i class="fa fa-plus"></i> Add New</a>
                                                                    </div>
                                                                </div>
                                                                <div class="col-md-6">
                                                                </div>
                                                            </div>
                                                        </div>

                                                        <input type="hidden" id="storesController" value="1">

                                                        <table >
                                                            <thead>
                                                                <tr>
                                                                    <th  rowspan="2">
                                                                        Embryo
                                                                    </th>
                                                                    <th  colspan="2">
                                                                        1
                                                                    </th>
                                                                    <th  colspan="2">
                                                                        2
                                                                    </th>
                                                                    <th  colspan="2">
                                                                        3
                                                                    </th>
                                                                    <th  colspan="2">
                                                                        4
                                                                    </th>
                                                                    <th  colspan="2">
                                                                        5
                                                                    </th>
                                                                    <th  colspan="2">
                                                                        6
                                                                    </th>
                                                                    <th rowspan="2">
                                                                        Delete
                                                                    </th>
                                                                </tr>
                                                                <tr>

                                                                    <th style="min-width: 100px;">
                                                                        Stage

                                                                    </th>
                                                                    <th style="min-width: 100px;">
                                                                        Grade

                                                                    </th>
                                                                    <th style="min-width: 100px;">
                                                                        Stage

                                                                    </th>
                                                                    <th style="min-width: 100px;">
                                                                        Grade

                                                                    </th>
                                                                    <th style="min-width: 100px;">
                                                                        Stage

                                                                    </th>
                                                                    <th style="min-width: 100px;">
                                                                        Grade

                                                                    </th>
                                                                    <th style="min-width: 100px;">
                                                                        Stage

                                                                    </th>
                                                                    <th style="min-width: 100px;">
                                                                        Grade

                                                                    </th>
                                                                    <th style="min-width: 100px;">
                                                                        Stage

                                                                    </th>
                                                                    <th style="min-width: 100px;">
                                                                        Grade

                                                                    </th>
                                                                    <th style="min-width: 100px;">
                                                                        Stage

                                                                    </th>
                                                                    <th style="min-width: 100px;">
                                                                        Grade

                                                                    </th>

                                                                </tr>
                                                            </thead>
                                                            <tbody id="embryoContent">
                                                                {assign var=itr value=1}
                                                                <tr style="display: none">
                                                                    <td colspan="5" >
                                                                        <input type="hidden" id="embryo" value="0" name="embryo"/></td></tr>
                                                                {capture assign=itr}{$itr+1}{/capture}
                                                            </tbody>
                                                        </table>
                                                    </div>
                                                </div>
                                            </div>

                                            <div class="clearfix"></div>
                                            <hr>
                                            <div class="portlet-body check_heigt_and_make_new_class" id="justfordrugs" >
                                                <div class="table-toolbar">

                                                </div>
                                                <table class="table table-striped table-hover table-bordered" id="gyna">
                                                    <thead>
                                                        <tr>
                                                            <th class="col-md-2" >
                                                                Kit
                                                            </th>
                                                            <th class="col-md-2">
                                                                Lot No.
                                                            </th>
                                                            <th class="col-md-2">
                                                                Device
                                                            </th>

                                                            <th class="col-md-2">
                                                                Location
                                                            </th>

                                                        </tr>
                                                    </thead>
                                                    <tbody>
                                                        <tr>
                                                            <td>
                                                                <div class="col-md-12">
                                                                    <select class="form-control kitselect kit allupdateselect" id="kit" name="kit" select-tableName="kit" data-colName="kit">
                                                                        <option value="">choose</option>
                                                                        {foreach  $kits as $one}
                                                                        <option value="{$one.id}">{$one.kit}</option>
                                                                        {/foreach}

                                                                        <option value="-2" class="deleteoptincompo">Delete</option>
                                                                    </select>
                                                                </div>
                                                            </td>
                                                            <td>
                                                                <input type="text" class="form-control " name="lot_no" />
                                                            </td>
                                                            <td>
                                                                <div class="col-md-12">
                                                                    <select class="form-control deviceselect device allupdateselect" id="device" name="device" select-tableName="device" data-colName="device">
                                                                        <option value="">choose</option>
                                                                        {foreach  $devices as $one}
                                                                        <option value="{$one.id}">{$one.device}</option>
                                                                        {/foreach}

                                                                        <option value="-2" class="deleteoptincompo">Delete</option>
                                                                    </select>
                                                                </div>
                                                            </td>
                                                            <td>
                                                                <input type="text" class="form-control bp_location" name="location" />
                                                            </td>
                                                        </tr>
                                                    </tbody>
                                                </table>
                                            </div>
                                            <!--div class="col-md-12">
                                                <div class="portlet box blue">
                                                    <div class="portlet-title" style="height: 5px">
                                                        <div class="caption">
                                                            <i class="fa fa-edit"></i>Embryo Thawing
                                                        </div>
                                                    </div>
                                                    <div class="portlet-body"  >
                                                        <div class="table-toolbar">
                                                            <div class="row">
                                                                <div class="col-md-6">
                                                                    <div class="btn-group">
                                                                        <a href="javascript:;" class="btn btn green btn-sm" id="addNewthawingRow" data-tableName="embryothawing">
                                                                            <i class="fa fa-plus"></i> Add New</a>
                                                                    </div>
                                                                </div>
                                                                <div class="col-md-6">
                                                                </div>
                                                            </div>
                                                        </div>

                                                        <input type="hidden" id="storesController" value="1">
                                                        <table class="table table-striped table-hover table-bordered" >
                                                            <thead>
                                                                <tr>
                                                                    <th class="col-md-1">
                                                                        Straw
                                                                    </th >
                                                                    <th class="col-md-1">
                                                                        No Of Embryos
                                                                    </th>
                                                                    <th class="col-md-1">
                                                                        Thawing Date
                                                                    </th>

                                                                    <th class="col-md-1">
                                                                        Recovered
                                                                    </th>
                                                                    <th class="col-md-1">
                                                                        Lost
                                                                    </th>
                                                                    <th class="col-md-1">
                                                                        E.T Date
                                                                    </th>
                                                                    <th class="col-md-1">
                                                                        Embryos
                                                                    </th>

                                                                    <th class="col-md-1">
                                                                        Grades
                                                                    </th>
                                                                    <th class="col-md-1">
                                                                        Embryol oigist
                                                                    </th>
                                                                    <th class="col-md-1">
                                                                        Clinician
                                                                    </th>
                                                                    <th class="col-md-1">
                                                                        Cathetr
                                                                    </th>
                                                                    <th >
                                                                        Delete
                                                                    </th>
                                                                </tr>

                                                            </thead>
                                                            <tbody id="thawingContent">
                                                                {assign var=itr value=1}
                                                                <tr style="display: none"><td colspan="5" ><input type="hidden" id="thawitr" value="0" name="thawitr"/></td></tr>
                                                                {capture assign=itr}{$itr+1}{/capture}
                                                            </tbody>
                                                        </table>
                                                    </div>
                                                </div>
                                            </div>

                                            <div class="clearfix"></div>
                                            <hr>
                                        </div-->

                                            <div class="clearfix"></div>
                                            <br> <br>

                                            <div class="form-actions">
                                                <div class="row">
                                                    <div class="col-md-offset-2 col-md-10">
                                                        {if $patientId}
                                                        <a class="btn default" href="{$hosturl}/controllers/{$controllname}.php?ac=show&patientid={$patientId}">Cancel</a>
                                                        {else}
                                                        <a class="btn default" href="{$hosturl}/controllers/{$controllname}.php?ac=show">Cancel</a>
                                                        {/if}

                                                        <button type="submit" class="btn blue">Submit</button>

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

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

    <input type="hidden" id="embryofreezing_report" value="1">


</div>




