
<div class="page-content-wrapper">
    <div class="page-content all">
        <div class="row">
            <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>Old Lab Requests
                        </div>
                        <div class="actions"> </div>
                    </div>
                    <div class="portlet-body" >
                        <div class="table-toolbar">   </div>

                        <div class="form-body">
                            <div class="row">
                                <div class="col-md-2">
                                    <div class="form-group form-md-line-input has-success" style="margin: 0 0 0 0;">
                                        <input type="text" class="form-control datepicker"  style=" border: 1px solid #000000;"  
                                               readonly="readonly"  id="searchValue1" 
                                               data-status="0"   value=""/>
                                        <label for="searchValue1">Date</label>
                                    </div>
                                </div>

                                <div class="col-md-3">
                                    <div class="form-group">
                                        <label class="control-label ls2">Patient No</label>
                                        <input type="text"  id="statusNoOld"  
                                               class="form-control  txtc searchPatOld positiveNo "  data-alert="no"  >
                                    </div>
                                </div>

                                <div class="col-md-5">
                                    <div class="form-group">
                                        <label class="control-label ls2">Patient Name</label>
                                        <input type="hidden" class="form-control "  
                                               id="patientIdOld"      data-dept="12"  >
                                    </div>
                                </div>
                                <div class="col-md-2">
                                    <a class="btn btn-primary btn-sm" data-dept="12"  id="searchOldRecords" style="    margin-top: 21px;" >
                                        <i class="fa fa-search"></i> Search </a>
                                </div>


                            </div>

                            <div class="row">
                                <div class="col-md-12">
                                    <span id="oldSearchError" 
                                          style="color: red ; float: right; direction: rtl;padding-right: 15px;display: none;"
                                          >حدد بيانات للبحث أولا ...............................</span>
                                </div>
                            </div>
                            <div class="row" id="resultTableDiv" >

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

</div>


<div id="printRDiv"></div>






