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179 lines
6.5 KiB
179 lines
6.5 KiB
<html> |
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<head> |
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{literal} |
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<style> |
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<!-- |
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td { |
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font-size:12pt; |
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font-family:helvetica; |
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} |
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li{ |
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font-size:11pt; |
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font-family:helvetica; |
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margin-left: 15px; |
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} |
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a { |
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font-size:11pt; |
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font-family:helvetica; |
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} |
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.title { |
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font-family: sans-serif; |
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font-size: 12pt; |
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font-weight: bold; |
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text-decoration: none; |
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color: #000000; |
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} |
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.form_text{ |
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font-family: sans-serif; |
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font-size: 9pt; |
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text-decoration: none; |
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color: #000000; |
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} |
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--> |
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</style> |
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{/literal} |
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</head> |
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<body bgcolor="{$STYLE.BGCOLOR2|attr}"> |
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<p><span class="title">Circumferential and leg length measurements.</span></p> |
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<form name="soap" method="post" action="{$FORM_ACTION}/interface/forms/leg_length/save.php" |
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onsubmit="return top.restoreSession()"> |
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<table width="194" border="1" bordercolor="#000000" cellpadding="7" cellspacing="0"> |
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<col width="40"> |
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<col width="54"> |
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<col width="56"> |
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<tbody><tr valign="top"> |
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<td width="40" height="1"> |
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<p class="western" align="justify"> </p> |
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</td> |
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<td width="54"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><b>RIGHT</b></font></font></p> |
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</td> |
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<td width="56"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><b>LEFT</b></font></font></p> |
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</td> |
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</tr> |
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<tr valign="top"> |
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<td width="40" height="2"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><b>AE</b></font></font></p> |
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</td> |
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<td width="54"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><input type="text" name="AE_left" value="{$data->get_AE_left()|attr}"></font></font></p> |
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</td> |
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<td width="56"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><input type="text" name="AE_right" value="{$data->get_AE_right()|attr}"></font></font></p> |
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</td> |
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</tr> |
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<tr valign="top"> |
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<td width="40" height="2"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><b>BE</b></font></font></p> |
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</td> |
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<td width="54"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><input type="text" name="BE_left" value="{$data->get_BE_left()|attr}"></font></font></p> |
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</td> |
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<td width="56"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><input type="text" name="BE_right" value="{$data->get_BE_right()|attr}"></font></font></p> |
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</td> |
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</tr> |
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<tr valign="top"> |
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<td width="40" height="3"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><b>AK</b></font></font></p> |
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</td> |
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<td width="54"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><input type="text" name="AK_left" value="{$data->get_AK_left()|attr}"></font></font></p> |
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</td> |
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<td width="56"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><input type="text" name="AK_right" value="{$data->get_AK_right()|attr}"></font></font></p> |
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</td> |
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</tr> |
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<tr valign="top"> |
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<td width="40" height="2"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><b>K</b></font></font></p> |
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</td> |
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<td width="54"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><input type="text" name="K_left" value="{$data->get_K_left()|attr}"></font></font></p> |
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</td> |
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<td width="56"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><input type="text" name="K_right" value="{$data->get_K_right()|attr}"></font></font></p> |
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</td> |
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</tr> |
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<tr valign="top"> |
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<td width="40" height="2"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><b>BK</b></font></font></p> |
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</td> |
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<td width="54"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><input type="text" name="BK_left" value="{$data->get_BK_left()|attr}"></font></font></p> |
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</td> |
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<td width="56"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><input type="text" name="BK_right" value="{$data->get_BK_right()|attr}"></font></font></p> |
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</td> |
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</tr> |
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<tr valign="top"> |
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<td width="40" height="2"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><b>ASIS</b></font></font></p> |
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</td> |
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<td width="54"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><input type="text" name="ASIS_left" value="{$data->get_ASIS_left()|attr}"></font></font></p> |
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</td> |
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<td width="56"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><input type="text" name="ASIS_right" value="{$data->get_ASIS_right()|attr}"></font></font></p> |
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</td> |
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</tr> |
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<tr valign="top"> |
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<td width="40"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><b>UMB</b></font></font></p> |
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</td> |
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<td width="54"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><input type="text" name="UMB_left" value="{$data->get_UMB_left()|attr}"></font></font></p> |
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</td> |
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<td width="56"> |
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<p class="western" align="justify"><font face="Verdana, sans-serif"><font style="font-size: 11pt;" size="2"><input type="text" name="UMB_right" value="{$data->get_UMB_right()|attr}"></font></font></p> |
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</td> |
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</tr> |
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</tbody> |
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</table> |
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</p> |
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<table border='0' cellpadding='0' cellspacing='0' class='text'> |
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<tr class='text'> |
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<td><b>NOTES</b></td> |
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</tr> |
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<tr class='text'> |
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<td><textarea cols='80' rows='5' name='notes'>{$data->get_notes()|text}</textarea></td> |
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</tr> |
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</table> |
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<table> |
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<tr> |
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<td> |
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</td> |
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</tr> |
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<tr> |
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<td> |
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<input type="submit" name="Submit" value="Save Form"> |
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</td> |
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<td> |
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<a href="{$DONT_SAVE_LINK}" class="link">[Don't Save]</a> |
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</td> |
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</tr> |
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</table> |
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<input type="hidden" name="id" value="{$data->get_id()|attr}" /> |
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<input type="hidden" name="pid" value="{$data->get_pid()|attr}"> |
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<input type="hidden" name="process" value="true"> |
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</form> |
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</body> |
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</html>
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