
<div class="page-content-wrapper" id="mydiv">
    <div class="row">
        <div class="row " style="direction: rtl;">

            <div class="col-md-12">

                <table style="width: 98%;margin: 5px auto;" cellpadding="2" class="noborder">

                    <tr>
                        <td class="txtc" style="width: 50%;">
                            {if $decleration->doctor_name eq 1}
                            <h4  class="arbfnt">اسم الدكتور :   {$doc_name->name}  </h4>
                            {/if}
                        </td>

                        <td class="txtc"   style="width: 50%;">
                            {if $decleration->date eq 1}
                            <h4  class="arbfnt">  التاريخ :   {$date}  </h4>
                            {/if}
                        </td>
                    </tr>

                    <tr>
                        <td colspan="2">
                            <h4 class="txtc" >{$decleration->title}</h4>
                        </td>
                    </tr>

                    <tr>
                        <td colspan="2">
                            <h4 class="txtc" > {$decleration->content}</h4>
                        </td>
                    </tr>

                </table>
            </div>

            <div class="col-md-4 right" >

                <table style="width: 98%;margin: 5px auto;" cellpadding="2" class="noborder">

                    {if $decleration->wife eq 0}
                    <tr>
                        <td> 
                            <h4  class="arbfnt">اسم الزوجه :  {$name}  </h4>
                        </td>
                    </tr>
                    {else if $decleration->wife eq 1}
                    <tr>
                        <td> 
                            <h4  class="arbfnt">اسم الزوجه : {$patient_details->wifename} </h4>
                        </td>
                    </tr>

                    <tr>
                        <td> 
                            <h4  class="arbfnt">الرقم القومي :  {$patient_details->wifenationalid}   </h4>
                        </td>
                    </tr>

                    <tr>
                        <td> 
                            <h4  class="arbfnt">امضاء الزوجه : 
                            </h4>
                        </td>
                    </tr>
                    {/if}

                </table>

            </div>

            <div class="col-md-4 right" >

                <table style="width: 98%;margin: 5px auto;" cellpadding="2" class="noborder">

                    {if $decleration->husband eq 0}
                    <tr>
                        <td> 
                            <h4  class="arbfnt">اسم الزوج:  {$patient_details->husdandname} </h4>
                        </td>
                    </tr>
                    {else if $decleration->husband eq 1}
                    <tr>
                        <td> 
                            <h4  class="arbfnt">اسم الزوج:   {$patient_details->husdandname}  </h4>
                        </td>
                    </tr>

                    <tr>
                        <td> 
                            <h4  class="arbfnt">الرقم القومي :   {$patient_details->husbandnationalid}    </h4>
                        </td>
                    </tr>

                    <tr>
                        <td> 
                            <h4  class="arbfnt">امضاء الزوج:</h4>
                        </td>
                    </tr>
                    {/if}

                </table>

            </div>

            <div class="col-md-4 right" >

                <table style="width: 98%;margin: 5px auto;" cellpadding="2" class="noborder">
                    <tr>
                        <td> 
                            <h4  class="arbfnt">اسم الاستقبال :  {$reception_name->name}</h4>
                        </td>
                    </tr>

                </table>
            </div>

        </div>

    </div>

</div>


<style>



    @media print {

        /* Inhaltsbreite setzen, Floats und Margins aufheben */
        /* Achtung: Die Klassen und IDs variieren von Theme zu Theme. Hier also eigene Klassen setzen */
        #content, #page {
            width: 100%; 
            margin: 0; 
            float: none;
        }

        /** Seitenränder einstellen */       
        /*  @page { margin-top: 10cm !important; margin-bottom:  10cm !important;}*/

        @page {ldelim}
        size: auto;
        margin-top: {$ProgramesettingData->above2}cm;
        margin-bottom: {$ProgramesettingData->buttom2}cm;
        {rdelim}

        blockquote {
            page-break-inside: avoid;
        }


        article a[href^="#"]:after {
            content: "";
        }


        /* Unnötige Elemente ausblenden für den Druck */

        #header-widgets, nav, aside.mashsb-container, 
        .sidebar, .mashshare-top, .mashshare-bottom, 
        .content-ads, .make-comment, .author-bio, 
        .heading, .related-posts, #decomments-form-add-comment, 
        #breadcrumbs, #footer, .post-byline, .meta-single, 
        .site-title img, .post-tags, .readability 
        {
            display: none;
        }

        .right{
            float:right;
        }
        .left{
            float:left;
        }
        .txtr{
            text-align:right;
        }
        .txtl{
            text-align:left;
        }
        .txtc{
            text-align:center;
        }


    }
</style>


