<?
//--No direct access
defined('_JEXEC') or die('=;)');

include(JPATH_BASE.'/components/com_vxc/helpers/json_serializer.php');
include(JPATH_BASE.'/components/com_vxc/helpers/tablerendererhelper.php');


$maps = array();
$mapQueraL =array();
$mapQueraL['var'] = 'IND_AN_PainLocation';
$mapQueraL['name'] = 'Foot';
$mapQueraL['foot'] = '0';
$mapQueraL['imageHeight'] = 188;
$mapQueraL['imageWidth'] = 103;

$mapQueraL['image'] = JRoute::_('components/com_vxc/assets/images/footL.jpg');

$areas = array();

$areas[] = array('type'=>'circle', 'coords' => '58,20,8');
$areas[] = array('type'=>'circle', 'coords' => '22,49,6');
$areas[] = array('type'=>'circle', 'coords' => '29,40,7');
$areas[] = array('type'=>'circle', 'coords' => '34,28,6');
$areas[] = array('type'=>'circle', 'coords' => '43,21,7');
$areas[] = array('type'=>'circle', 'coords' => '63,44,8');
$areas[] = array('type'=>'circle', 'coords' => '69,61,8');
$areas[] = array('type'=>'circle', 'coords' => '43,45,9');
$areas[] = array('type'=>'circle', 'coords' => '52,56,9');
$areas[] = array('type'=>'circle', 'coords' => '29,59,9');
$areas[] = array('type'=>'circle', 'coords' => '30,78,9');
$areas[] = array('type'=>'circle', 'coords' => '50,72,9');
$areas[] = array('type'=>'circle', 'coords' => '64,80,10');
$areas[] = array('type'=>'circle', 'coords' => '70,100,11');
$areas[] = array('type'=>'circle', 'coords' => '45,90,10');
$areas[] = array('type'=>'circle', 'coords' => '34,106,10');
$areas[] = array('type'=>'circle', 'coords' => '41,126,10');
$areas[] = array('type'=>'circle', 'coords' => '69,122,11');
$areas[] = array('type'=>'circle', 'coords' => '73,141,9');
$areas[] = array('type'=>'circle', 'coords' => '57,157,10');
$areas[] = array('type'=>'circle', 'coords' => '77,159,9');
$areas[] = array('type'=>'circle', 'coords' => '65,174,10');
$areas[] = array('type'=>'circle', 'coords' => '44,169,9');
$areas[] = array('type'=>'circle', 'coords' => '54,137,9');
$areas[] = array('type'=>'circle', 'coords' => '40,147,8');
$areas[] = array('type'=>'circle', 'coords' => '53,109,10');


$mapQueraL['areas'] = $areas;

$maps['Foot0'] = $mapQueraL;

$mapQueraR =array();
$mapQueraR['var'] = 'IND_AN_PainLocation';
$mapQueraR['name'] = 'Foot';
$mapQueraR['foot'] = '1';
$mapQueraR['imageHeight'] = 188;
$mapQueraR['imageWidth'] = 103;

$mapQueraR['image'] = JRoute::_('components/com_vxc/assets/images/footR.jpg');

$areas = array();

$areas[] = array('type'=>'circle', 'coords' => '45,20,8');
$areas[] = array('type'=>'circle', 'coords' => '81,49,6');
$areas[] = array('type'=>'circle', 'coords' => '74,40,7');
$areas[] = array('type'=>'circle', 'coords' => '69,28,6');
$areas[] = array('type'=>'circle', 'coords' => '60,21,7');
$areas[] = array('type'=>'circle', 'coords' => '40,44,8');
$areas[] = array('type'=>'circle', 'coords' => '34,61,8');
$areas[] = array('type'=>'circle', 'coords' => '60,45,9');
$areas[] = array('type'=>'circle', 'coords' => '51,56,9');
$areas[] = array('type'=>'circle', 'coords' => '74,59,9');
$areas[] = array('type'=>'circle', 'coords' => '73,78,9');
$areas[] = array('type'=>'circle', 'coords' => '53,72,9');
$areas[] = array('type'=>'circle', 'coords' => '39,80,10');
$areas[] = array('type'=>'circle', 'coords' => '33,100,11');
$areas[] = array('type'=>'circle', 'coords' => '58,90,10');
$areas[] = array('type'=>'circle', 'coords' => '69,106,10');
$areas[] = array('type'=>'circle', 'coords' => '62,126,10');
$areas[] = array('type'=>'circle', 'coords' => '34,122,11');
$areas[] = array('type'=>'circle', 'coords' => '30,141,9');
$areas[] = array('type'=>'circle', 'coords' => '46,157,10');
$areas[] = array('type'=>'circle', 'coords' => '26,159,9');
$areas[] = array('type'=>'circle', 'coords' => '38,174,10');
$areas[] = array('type'=>'circle', 'coords' => '59,169,9');
$areas[] = array('type'=>'circle', 'coords' => '49,137,9');
$areas[] = array('type'=>'circle', 'coords' => '63,147,8');
$areas[] = array('type'=>'circle', 'coords' => '50,109,10');

$mapQueraR['areas'] = $areas;
			
$maps['Foot1'] = $mapQueraR;		





$mapHyperL =array();
$mapHyperL['var'] = 'IND_AN_Hypersensitivity';
$mapHyperL['name'] = 'Hyper';
$mapHyperL['foot'] = '0';
$mapHyperL['imageHeight'] = 188;
$mapHyperL['imageWidth'] = 103;

$mapHyperL['image'] = JRoute::_('components/com_vxc/assets/images/footL.jpg');

$areasHyper = array();
$areasHyper[] = array('type'=>'circle', 'coords' => '66,25,9');
$areasHyper[] = array('type'=>'circle', 'coords' => '24,78,7');
$areasHyper[] = array('type'=>'circle', 'coords' => '35,71,8');
$areasHyper[] = array('type'=>'circle', 'coords' => '45,61,7');
$areasHyper[] = array('type'=>'circle', 'coords' => '71,51,10');
$areasHyper[] = array('type'=>'circle', 'coords' => '56,56,7');
$areasHyper[] = array('type'=>'circle', 'coords' => '41,163,14');
$areasHyper[] = array('type'=>'circle', 'coords' => '79,161,14');

$mapHyperL['areas'] = $areasHyper;

$maps['Hyper0'] = $mapHyperL;

$mapHyperR =array();
$mapHyperR['var'] = 'IND_AN_Hypersensitivity';
$mapHyperR['name'] = 'Hyper';
$mapHyperR['foot'] = '1';
$mapHyperR['imageHeight'] = 188;
$mapHyperR['imageWidth'] = 103;

$mapHyperR['image'] = JRoute::_('components/com_vxc/assets/images/footR.jpg');

$areasHyper = array();

$areasHyper[] = array('type'=>'circle', 'coords' => '37,25,9');
$areasHyper[] = array('type'=>'circle', 'coords' => '79,78,7');
$areasHyper[] = array('type'=>'circle', 'coords' => '68,71,8');
$areasHyper[] = array('type'=>'circle', 'coords' => '58,61,7');
$areasHyper[] = array('type'=>'circle', 'coords' => '32,51,10');
$areasHyper[] = array('type'=>'circle', 'coords' => '47,56,7');
$areasHyper[] = array('type'=>'circle', 'coords' => '62,163,14');
$areasHyper[] = array('type'=>'circle', 'coords' => '24,161,14');

$mapHyperR['areas'] = $areasHyper;
			
$maps['Hyper1'] = $mapHyperR;			


$this->loadHelper('AtAreaMaphelper');

$helperMapArea = new AtAreaMaphelper();

$helperMapArea->setMaps($maps);






$readOnly = $this->order->readOnly;

function createFootRow()
{
	$row = array();	
	$emptyCell = new TableCell();
	$cellL = new TableCell();
	$cellR = new TableCell();
	$emptyCell->setColspan(2);
	$cellL->setClass('columnHeader');
	$cellL->addElement(TableElement::createTextElement(JText::_('Left')));
	$cellR->setClass('columnHeader');
	$cellR->addElement(TableElement::createTextElement(JText::_('Right')));	
	$row['cells'] = array($emptyCell, $cellL, $cellR);
	return $row;

}

function createAtChkRow(&$view,$atName,$text,$imageUrl='')
{
	$row = array();	
	$cells = array();
	
	// Celda de imagen
	$cell = new TableCell();		
	
	if ($imageUrl)
	{
		$img = new TableElement('image');
		$img->setSrc($imageUrl);
		$cell->addElement($img);
	}
	else
	{
		$el = new TableElement('text');
		$el->setText("&nbsp;");
		$cell->addElement($el);
	}

	$cells[] = $cell;
	
	
	// Celda de texto de atributo
	
	$cell = new TableCell();		
	
	$el = new TableElement('text');
	$el->setText($text);
	$cell->addElement($el);

	$cells[] = $cell;
	
	// Celda checkbox pie izquierdo

	$cell = new TableCell();		
	$chk = TableElement::createAttribute2NChk($view->anamnesis,$atName,0);
	$cell->addElement($chk);
	$cell->setClass('centrado');
	$cells[] = $cell;
	
	// Celda checkbox pie derecho
	
	$cell = new TableCell();		
	$chk = TableElement::createAttribute2NChk($view->anamnesis,$atName,1);
	$cell->addElement($chk);
	$cell->setClass('centrado');
	$cells[] = $cell;	
	
	$row['cells'] = $cells;
	
	return $row;


}

		

		
$imagePrefix = "/components/com_vxc/assets/images/";

$headerStyle = "font-size:200%;text-align:center;height:50px";

?>
<style>

	.indent1 
	{		
		padding-left:20px;
	}
	
	input.medida
	{
		width: 30px;
	}
	
	select.medida
	{
		width: 50px;
	}
	td.header
	{
		font-size:120%;
		font-weight:bold;
		height:30px;
		text-align:left;
		padding-left:10px;		
		vertical-align:text-top;
		padding-top:5px;
		background-color:#D0D0D0
	}
	
	td.header2
	{
		font-size:150%;
		font-weight:bold;
		height:30px;
		text-align:center;
	}
	
	td.columnHeader
	{
		font-size:150%;
		font-weight:bold;
		height:30px;
		text-align:center;
	
	}
	
	
	td table.mio 
	{
	background-color:#E0ECF8;
	}	
	
	td.centrado
	{
		text-align:center;
	}
	
</style>

<script>


function ShowDiv(div)
{
	var divObj = document.getElementById(div);
	if (!divObj) return;
	
	divObj.style.display = divObj.style.display=='block'?'none':'block';
}

function OnIndiaLoad()
{

	

}


	function AttachEvent_IndiaLoad(obj, eventName, eventHandler) {

		if(obj) {
			if(eventName.substring(0, 2) == 'on') {
				eventName = eventName.substring(2,eventName.length);
		}
			if (obj.addEventListener){
		obj.addEventListener(eventName, eventHandler, false);
		} else if (obj.attachEvent){
		obj.attachEvent('on'+eventName, eventHandler);
		}
		}
	}

	AttachEvent_IndiaLoad(window, 'onload', function() { OnIndiaLoad(); });
	


	var curPage = 0;
	
	
	function Save()
	{	
		document.mainForm.task.value = 'saveInterview';
		postForm();
	}
	
	function Confirm()
	{
		document.mainForm.task.value = 'confirmInterview';
		postForm();
	}
	
	function disableButton(butName)
	{
		var obj = document.getElementById(butName);
		if (obj)
			obj.disabled = true;	
	}
	
	function postForm()
	{
		disableButton('btnSave');
		disableButton('btnNext1');
		disableButton('btnNext2');
		document.mainForm.submit();	
	
	}
	
</script>
<?=$helperMapArea->GetJS()?>
<form  method="post" name='mainForm' id='mainForm' action="index.php" >
<?=$this->balls?>
<fieldset>
<fieldset>
	<legend><?=JText::_('Anamnesis')?></legend>
	<p style='text-align:center'>
		<input <?=$readOnly?'disabled':''?> id='btnSave'  type="button" onclick="Save();return false;" value="<?=$this->escape(JText::_('Save'))?>" />
		<input type="button" id='btnNext1' onclick="Confirm();return false;" value="<?=$this->escape(JText::_('Next'))?>" /><br/>
	</p>

	<table align='center'>
		
		<? 
			$tableAtsGeneral = array('style' => 'margin-bottom:15px;border:1px solid black;width:600px' ,
					  'align' => 'center',
					  'cellspacing' => 0,
					  'cellpadding' => 1);
					  
			$tableAts = array('style' => 'margin-bottom:15px;border:0px;width:600px' ,
					  'align' => 'center',
					  'cellspacing' => 0,
					  'cellpadding' => 1);
					  
			$tableAtsStr ='';
									
			if ($tableAtsGeneral)
			foreach($tableAtsGeneral as $key => $value)
			{
				if ($tableAtsStr) $tableAtsStr .= " ";
				$tableAtsStr.="$key='$value'";
			}											
					
		
		?>
		<tr>
			<td  colspan='3' >
			<?
			
				$tableRenderer = new TableRendererHelper();
				
				$tableRenderer->setRowColor('#E0ECF8');
				$rowColor1 = $tableRenderer->getRowColor1();
				$rowColor2 = $tableRenderer->getRowColor2();
				
			?>
			
				
				<table <?=$tableAtsStr?>  class='mio' style='background-color:<?=$rowColor2?>' >				
				
					<tr >
						<td class='header'  >1. <?=JText::_('Reason visit')?>:
							<textarea style='vertical-align:text-top;' <?=($readonly)?('disabled'):('')?> name='IND_AN_ReasonVisit' id='IND_AN_ReasonVisit' rows='5' cols='50' ><?=$this->anamnesis['IND_AN_ReasonVisit'][0]['memo_left']?></textarea>												
						</td>					
					</tr>
					
					<tr >
						<td class='header'  >2. <?=JText::_('Background')?></td>					
					</tr>
					<tr>
						<td>
							<table width=100%>					
								<tr >
									<td class='indent1'><b>a.</b> <?=JText::_('Previous injury history')?>: 
									</td>
									<td>
										<textarea style='vertical-align:text-top;' <?=($readonly)?('disabled'):('')?> name='IND_AN_PrevHistory' id='IND_AN_PrevHistory' rows='3' cols='40' ><?=$this->anamnesis['IND_AN_PrevHistory'][0]['memo_left']?></textarea>												
									</td>
								</tr>
								<tr >
									<td class='indent1'><b>b.</b> <?=JText::_('Family background')?>:
									</td>
									<td>
										<textarea style='vertical-align:text-top;' <?=($readonly)?('disabled'):('')?> name='IND_AN_FamBackground' id='IND_AN_FamBackground' rows='3' cols='40' ><?=$this->anamnesis['IND_AN_FamBackground'][0]['memo_left']?></textarea>												
									</td>
								</tr>
								<tr >
									<td class='indent1'><b>c.</b> <?=JText::_('Current and previous treatments')?>: 
									</td>
									<td>
										<textarea style='vertical-align:text-top;' <?=($readonly)?('disabled'):('')?> name='IND_AN_CurPrevTreat' id='IND_AN_CurPrevTreat' rows='3' cols='40' ><?=$this->anamnesis['IND_AN_CurPrevTreat'][0]['memo_left']?></textarea>												
									</td>
								</tr>				
							</table>
						</td>
					</tr>
					
					
					<tr >
						<td class='header'  >3. <?=JText::_('Disorders of the foot')?></td>					
					</tr>
					<tr>
						<td>
							<table>					
								<tr>
									<td class='indent1'>&nbsp;</td>
									<td class='centrado' style='width:100px'><b><?=JText::_('Left')?></b></td>
									<td class='centrado' style='width:100px'><b><?=JText::_('Right')?></b></td>
								</tr>
								<?

									$selected = array(array(),array());
									if ($this->anamnesis['IND_AN_FootDisorders'])
									foreach($this->anamnesis['IND_AN_FootDisorders'] as $value)
									{
										$selected[0][] = $value['value_left'];
										$selected[1][] = $value['value_right'];
									}

								if ($this->attypes['IND_AN_FootDisorders']->values)
									foreach($this->attypes['IND_AN_FootDisorders']->values as $value) :
									
									
								?>
								<tr>
									<td class='indent1'><?=JText::_($value['name'])?></td>
									<td class='centrado'>
										<input type='checkbox' <?=((in_array($value['id'],$selected[0]))?('checked'):(''))?> <?=($readonly)?('disabled'):('')?> name='IND_AN_FootDisorders[0][]' value="<?=$this->escape($value['id'])?>"  />
									</td>
									<td class='centrado'>
										<input type='checkbox' <?=((in_array($value['id'],$selected[1]))?('checked'):(''))?> <?=($readonly)?('disabled'):('')?> name='IND_AN_FootDisorders[1][]' value="<?=$this->escape($value['id'])?>"  />
									</td>
								</tr>											
								<? endforeach; ?>
							</table>
						</td>
					</tr>
					
					<tr >
						<td class='header' >4. <?=JText::_('Pain/Problems since when')?>: 
							<select  <?=($readonly)?('disabled'):('')?> name="IND_AN_ProblemsSince" >
									<option <?=(!$this->anamnesis['IND_AN_ProblemsSince'][0]['value_left'])?('selected'):('')?> value="">&nbsp;</option>
								<?  if ($this->attypes['IND_AN_ProblemsSince']->values)
									foreach($this->attypes['IND_AN_ProblemsSince']->values as $value) :?>
									<option <?=($value['id']==$this->anamnesis['IND_AN_ProblemsSince'][0]['value_left'])?('selected'):('')?> value="<?=$this->escape($value['id'])?>"><?=JText::_($value['name'])?></option>
								
								<? endforeach; ?>
							</select>
						</td>					
						
					</tr>
					
					<tr >
						<td class='header' >5. <?=JText::_('Intensity')?>: 
							<select  <?=($readonly)?('disabled'):('')?> name="IND_AN_PainIntensity" >
									<option <?=(!$this->anamnesis['IND_AN_PainIntensity'][0]['value_left'])?('selected'):('')?> value="">&nbsp;</option>
								<?  
									for ($i=1;$i<=5;$i++) :?>
									<option <?=($i==$this->anamnesis['IND_AN_PainIntensity'][0]['value_left'])?('selected'):('')?> value="<?=$this->escape($i)?>"><?=$i?></option>								
								<? endfor; ?>
							</select>
						</td>											
					</tr>
					
					<tr >
						<td class='header' >6. <?=JText::_('Location')?>
					</tr>
					
					
					<tr>
						<td  class='indent1'>
						   <div style='display:block'>
							<table >
								<tr>
									<th style='text-align:center'><?=JText::_('Left')?></th>
									<th style='text-align:center'><?=JText::_('Right')?></th>
								</tr>
								<tr>
									<td style='border:solid 1px black'>											
										<?=$helperMapArea->PrintAreaMap('Foot0',explode(',',$this->anamnesis['IND_AN_PainLocation'][0]['value_left']))?>																			
									</td>
									<td style='border:solid 1px black'>								
										<?=$helperMapArea->PrintAreaMap('Foot1',explode(',',$this->anamnesis['IND_AN_PainLocation'][0]['value_right']))?>
									</td>
								</tr>								
							</table>
							</div>
						</td>
					</tr>
					
					<tr >
						<td class='header' >7. <?=JText::_('Chronic complications')?></td>					
					</tr>
					<tr  style='background-color:<?=$rowColor1?>'>					
						<td style='text-align:left'  class='indent1'>					
						<table>
						<tr>
						<td>
						<?=JText::_('Diabetes')?>: 
						</td>
						<td>
							<input type='radio' name='IND_AN_Diabetes'  <?=(!$this->anamnesis['IND_AN_Diabetes'][0]['value_left']?'checked':'')?>  value="" /> <?=JText::_('None')?></br>
							<?
								if ($this->attypes['IND_AN_Diabetes']->values)
								foreach ($this->attypes['IND_AN_Diabetes']->values as $value) : ?>
								<input type='radio' value="<?=$value['id']?>"  <?=($this->anamnesis['IND_AN_Diabetes'][0]['value_left']==$value['id']?'checked':'')?> name='IND_AN_Diabetes' id='IND_AN_Diabetes<?=$value['id']?>' /> <?=JText::_($value['name'])?></br>
							<? endforeach; ?>
						</td>
						</tr>
						</table>
						</td>
					</tr>
					<tr>
						<td colspan='2'  class='indent1'>	
							<?	
		
							$complicacionesCronicasTable = array();
							
							$row = array();	
							$row['startTable'] = true;
							$row['tableId'] ='divComplicacionesCronicas';	
							$row['tableAts'] = $tableAts;
							$cell = new TableCell();	
							$chk = TableElement::createAttribute1NChk($this->anamnesis,'IND_AN_DiabeticNeuro',JText::_('Diabetic Neuropathy'));
							$cell->addElement($chk);		
							$row['cells'] = array($cell);
							$complicacionesCronicasTable[] = $row;
							
							$row = array();	
							$cell = new TableCell();	
							$chk = TableElement::createAttribute1NChk($this->anamnesis,'IND_AN_VascularDecease',JText::_('Vascular Disease'));
							$cell->addElement($chk);		
							$row['cells'] = array($cell);
							$complicacionesCronicasTable[] = $row;
							
							$row = array();	
							$cell = new TableCell();	
							$chk = TableElement::createAttribute1NChk($this->anamnesis,'IND_AN_Retinopathy',JText::_('Retinopathy'));
							$cell->addElement($chk);
							$row['cells'] = array($cell);
							$complicacionesCronicasTable[] = $row;
							
							$row = array();
							$cell = new TableCell();	
							$chk = TableElement::createAttribute1NChk($this->anamnesis,'IND_AN_Nefropathy',JText::_('Nephropathy'));
							$cell->addElement($chk);
							$row['cells'] = array($cell);
							$complicacionesCronicasTable[] = $row;
							
							$row = array();
							$cell = new TableCell();	
							$chk = TableElement::createAttribute1NChk($this->anamnesis,'IND_AN_Cardiopathy',JText::_('Cardiopathy'));
							$cell->addElement($chk);
							$row['cells'] = array($cell);
							$complicacionesCronicasTable[] = $row;
								
							echo $tableRenderer->getHTML($complicacionesCronicasTable);	
							?>
						</td>
					</tr>
					<tr >
						<td class='header' >8. <?=JText::_('Sensitivity')?></td>					
					</tr>
					<tr>
						<td>
							<table>					
								<tr>
									<td class='indent1'>&nbsp;</td>
									<td class='centrado' style='width:100px'><b><?=JText::_('Left')?></b></td>
									<td class='centrado' style='width:100px'><b><?=JText::_('Right')?></b></td>
								</tr>
								<?

									$selected = array(array(),array());
									if ($this->anamnesis['IND_AN_Sensitivity'])
									foreach($this->anamnesis['IND_AN_Sensitivity'] as $value)
									{
										$selected[0][] = $value['value_left'];
										$selected[1][] = $value['value_right'];
									}

								if ($this->attypes['IND_AN_Sensitivity'] &&$this->attypes['IND_AN_Sensitivity']->values)
									foreach($this->attypes['IND_AN_Sensitivity']->values as $value) :
									
									
								?>
								<tr>
									<td class='indent1'><?=JText::_($value['name'])?></td>
									<td class='centrado'>
										<input type='checkbox' <?=((in_array($value['id'],$selected[0]))?('checked'):(''))?> <?=($readonly)?('disabled'):('')?> name='IND_AN_Sensitivity[0][]' value="<?=$this->escape($value['id'])?>"  />
									</td>
									<td class='centrado'>
										<input type='checkbox' <?=((in_array($value['id'],$selected[1]))?('checked'):(''))?> <?=($readonly)?('disabled'):('')?> name='IND_AN_Sensitivity[1][]' value="<?=$this->escape($value['id'])?>"  />
									</td>
								</tr>											
								<? endforeach; ?>
							</table>
						</td>
					</tr>
					<tr >
						<td class='header' >9. <?=JText::_('Hypersensitivity')?></td>					
					</tr>
					
					<tr>
						<td  class='indent1'>
							 <div style='display:block'>
								<table >
									<tr>
										<th style='text-align:center'><?=JText::_('Left')?></th>
										<th style='text-align:center'><?=JText::_('Right')?></th>
									</tr>
									<tr>
										<td style='border:solid 1px black'>											
											<?=$helperMapArea->PrintAreaMap('Hyper0',explode(',',$this->anamnesis['IND_AN_Hypersensitivity'][0]['value_left']))?>																			
										</td>
										<td style='border:solid 1px black'>								
											<?=$helperMapArea->PrintAreaMap('Hyper1',explode(',',$this->anamnesis['IND_AN_Hypersensitivity'][0]['value_right']))?>
										</td>
									</tr>								
								</table>
							</div>
						</td>
					</tr>
					
					<tr >
						<td class='header' >10. <?=JText::_('Additional')?></td>					
					</tr>
					<tr  style='background-color:<?=$rowColor1?>'>					
						<td style='text-align:left'  class='indent1'>					
						<table>
							<tr>
								<td><?=JText::_('Scoliosis')?></td>
								<td><input type='text' <?=($readonly)?('disabled'):('')?> name='IND_AN_Scoliosis' value="<?=$this->escape($this->anamnesis['IND_AN_Scoliosis'][0]['value_left'])?>" /></td>
							</tr>
							<tr>
								<td><?=JText::_('Leg length discrepancy')?></td>
								<td><input type='text' <?=($readonly)?('disabled'):('')?> name='IND_AN_LegLengthDis' value="<?=$this->escape($this->anamnesis['IND_AN_LegLengthDis'][0]['value_left'])?>" /></td>
							</tr>
							<tr>
								<td><?=JText::_('Pelvic obliquity')?></td>
								<td><input type='text' <?=($readonly)?('disabled'):('')?> name='IND_AN_PelvicObli' value="<?=$this->escape($this->anamnesis['IND_AN_PelvicObli'][0]['value_left'])?>" /></td>
							</tr>
							<tr>
								<td><?=JText::_('Shoulder obliquity')?></td>
								<td><input type='text' <?=($readonly)?('disabled'):('')?> name='IND_AN_ShoulderObli' value="<?=$this->escape($this->anamnesis['IND_AN_ShoulderObli'][0]['value_left'])?>" /></td>
							</tr>
							<tr>
								<td><?=JText::_('Other')?></td>
								<td><input type='text' <?=($readonly)?('disabled'):('')?> name='IND_AN_Other' value="<?=$this->escape($this->anamnesis['IND_AN_Other'][0]['value_left'])?>" /></td>
							</tr>
						</table>
						</td>
					</tr>
					
					
					<tr >
						<td class='header'  >11. <?=JText::_('Resume Diagnosis')?>:
							<textarea style='vertical-align:text-top;' <?=($readonly)?('disabled'):('')?> name='IND_AN_ResumeDiag' id='IND_AN_ResumeDiag' rows='5' cols='50' ><?=$this->anamnesis['IND_AN_ResumeDiag'][0]['memo_left']?></textarea>												
						</td>					
					</tr>
				</table>		
				
			</td>
		</tr>
	</table>
	
	<p style='text-align:center'>
		<input type="button" id='btnNext2' onclick="Confirm();return false;" value="<?=$this->escape(JText::_('Next'))?>" /><br/>
	</p>
	
	
</fieldset>
</fieldset>
<?=$this->balls?>
	<input type="hidden" name="option" value="com_vxc" />
	<input type="hidden" name="task" value="" />
	<input type="hidden" name="step" value="<?=JRequest::getVar('step')?>" />
	<input type="hidden" name="view" value="orderinterv" />
	<input type="hidden" name="controller" value="routingorder" />	
	<input type="hidden" name="format" value="html" />
	<input type="hidden" name="orderId" value="<?=JRequest::getVar('orderId')?>" />		
</form>