<!-- BEGIN CONTENT -->
<div class="page-content-wrapper">
    <div class="page-content">
        <!-- BEGIN PAGE HEADER-->
        <h3 class="page-title">
            {$shcontrollname}
        </h3>
        <!-- END PAGE HEADER-->
        <!-- BEGIN PAGE CONTENT-->
        <div class="row">
            <div class="col-md-12">
                <div class="portlet light bg-inverse">
                    <div class="portlet-title">
                        <div class="caption">
                            <i class="icon-plus font-red-sunglo"></i>
                            <span class="caption-subject font-red-sunglo bold uppercase">Edit  In  {$shcontrollname}</span>
                        </div>
                        <div class="actions">
                            <a href="{$hosturl}/controllers/{$controllname}.php?ac=show&patientid={$patientId}" data-container="body" data-placement="top"
                               data-original-title="{$smarty.const.ad_lang_back_btn}" class="btn btn-sm blue tooltips">
                                <i class="fa fa-list"></i>Back </a>
                        </div>
                    </div>
                    <div class="portlet-body form">
                        <!-- BEGIN FORM-->
                        <div  class="form-horizontal vform">
                            <div class="form-body">
                                <div class="alert alert-danger display-hide">
                                    <button class="close" data-close="alert"></button>
                                    {$smarty.const.ad_lang_message_error}
                                </div>
                                <div class="alert alert-success display-hide">
                                    <button class="close" data-close="alert"></button>
                                    {$smarty.const.ad_lang_message_success}
                                </div>

                                <div class="row">

                                    <div class="col-md-12">
                                        <table class="table">
                                            <tr>
                                                <th>Patient name</th>
                                                <th>ID</th>
                                                <th>Age</th>
                                                <th>Sex</th>
                                                <th>Exam date</th>
                                                <th>Referral</th>
                                            </tr>
                                            <tr>
                                                <td>{$patientInfo->wifename}</td>
                                                <td>{$patientInfo->statusno}</td>
                                                <td>{$new_age_calc}</td>
                                                <td>-</td>
                                                <td>{$edit_data->exam_date}</td>
                                                <td>{$refer_doctor->name}</td>
                                            </tr>
                                        </table>
                                    </div>

                                    <input type="hidden" name="patient_id" id="patient_id" value="{$patientId}">
                                    <input type="hidden" name="colonoscopy_id" id="colonoscopy_id" value="{$edit_data->id}">

                                    <div class="col-md-12">
                                        <h4>Images Area</h4>
                                        <form action="{$hosturl}/controllers/{$controllname}.php?ac=upload" class="dropzone" id="my-great-dropzone"></form>
                                        <div class="row dropzone" >
                                            <h1>Upload images</h1>
                                            {foreach $colonoscopy_images as $single}
                                                <div class="dz-preview dz-processing dz-image-preview dz-success dz-complete">

                                                    <div class="dz-image">
                                                        <img data-dz-thumbnail="" alt="slider_image" src="{$hosturl}/../upload/colonoscopy/{$single->image}" style="width: 90px;height: 90px;">
                                                    </div>

                                                    <div class="dz-progress"><span class="dz-upload" data-dz-uploadprogress="" style="width: 100%;"></span></div>
                                                    <div class="dz-error-message"><span data-dz-errormessage=""></span></div>
                                                    <a href="javascript:" class="btn red btn-sm btn-block remove_image_item" data-id="{$single->id}">Remove </a>
                                                </div>
                                            {/foreach}
                                        </div>
                                    </div>

                                </div>

                                <input type="hidden" id="id" name="id" value="{$edit_data->id}"/>

                            </div>

                            <div class="form-actions">
                                <div class="row">
                                    <div class="col-md-offset-3 col-md-4">
                                        <button type="button" class="btn default rtn-show-patient" data-patient-id="{$patientId}" data-control="{$controllname}">Cancel</button>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <!-- END FORM-->
                    </div>
                </div>
            </div>
        </div>
        <!-- END PAGE CONTENT-->
    </div>
</div>
<!-- END CONTENT -->

<style>
    .dz-default .dz-message{
        display: none !important;
    }
</style>