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Current File : /home/btiyawmy/public_html/login.easenup.in/Medical_Assessment.php
<?php session_start();
include 'dbconnection.php';
require_once("../patientmanager.php");
require_once("../DBManager.php");
$target_dir = "uploads/";
$filename = basename($_FILES["Upload_MLC_Slip"]["name"]);
$target_file = $target_dir . basename($_FILES["Upload_MLC_Slip"]["name"]);
$uploadOk = 1;
$imageFileType = strtolower(pathinfo($target_file,PATHINFO_EXTENSION));
if(isset($_POST['Medical_Assessment'])) 
{
    
    
   PatientManager::MedicalAssessment("$_GET[prescriptionid]","$_GET[patientid]","$_POST[Chief_Complain]","$_POST[Covid]","$_POST[Fever]","$_POST[Fever_note]","$_POST[smell]","$_POST[smell_note]","$_POST[Diarrhoea]","$_POST[Diarrhoea_note]","$_POST[Deformity]","$_POST[Deformity_note]","$_POST[Cough]","$_POST[Cough_note]","$_POST[Taste]","$_POST[Taste_note]","$_POST[Weakness]","$_POST[Weakness_note]","$_POST[Breathlessness]","$_POST[Breathlessness_note]","$_POST[Appetite]","$_POST[Appetite_note]","$_POST[Limbs]","$_POST[Limbs_note]","$_POST[Throat]","$_POST[Throat_note]","$_POST[Vomitting]","$_POST[Vomitting_note]","$_POST[Slurred_Voice]","$_POST[Slurred_Voice_note]","$_POST[Nausea]","$_POST[Nausea_note]","$_POST[Loss_Appetite]","$_POST[Loss_Appetite_note]","$_POST[Delusion]","$_POST[Delusion_note]","$_POST[Fits_Anger]","$_POST[Fits_Anger_note]","$_POST[Depression]",
       "$_POST[Depression_note]","$_POST[Memory_Loss]","$_POST[Memory_Loss_note]","$_POST[Bleeding_Disorder]","$_POST[Bleeding_Disorder_note]","$_POST[Migraine]","$_POST[Migraine_note]","$_POST[Frequent_Urination]","$_POST[Frequent_Urination_note]","$_POST[Swollen_Join]","$_POST[Swollen_Join_note]","$_POST[Weight_Gain]","$_POST[Weight_Gain_note]","$_POST[weight_loss]","$_POST[weight_loss_note]","$_POST[Body_pain]","$_POST[Body_pain_note]","$_POST[Physical_Injury]","$_POST[Physical_Injury_note]","$_POST[Other_Symptoms]","$_POST[Other_Symptoms_note]","$_POST[RED_EYE]","$_POST[RED_EYE_note]","$_POST[Swollen_Eye]","$_POST[Swollen_Eye_note]","$_POST[Conjunctiva]","$_POST[Conjunctiva_note]","$_POST[Itchiness]","$_POST[Itchiness_note]","$_POST[Dislocated]","$_POST[Dislocated_note]","$_POST[Blur_Vision]","$_POST[Blur_Vision_note]","$_POST[Partial_Blindness]","$_POST[Partial_Blindness_note]","$_POST[Blindness]","$_POST[Blindness_note]","$_POST[enteredby]","$_POST[start_time]");
}
?>
<?php
$DisplayForm=True;
$sql ="SELECT * FROM request_for_admissionfinal WHERE prescriptionid='$_GET[prescriptionid]'";
		$qsql = mysqli_query($con,$sql);
		if($rh = mysqli_fetch_array($qsql))
		{
$DisplayForm=False;
echo "<script>window.location='showrequestforadmission.php?prescriptionid=$_GET[prescriptionid]&patientid=$_GET[patientid]'</script>";
}
if($DisplayForm)
{
?>
<!DOCTYPE html>
<html lang="en">
<head><meta charset="euc-kr">
    <link rel="stylesheet" href="../plugins/select2/css/select2.min.css">
  <link rel="stylesheet" href="../plugins/select2-bootstrap4-theme/select2-bootstrap4.min.css">
  
  <style>
       .box{
              display: none;
     }
    
    .box2{
              display: none;
    
    }
            
       .center {
   border: 1px solid grey;
   text-align:;
}
    .center2 {
   border: 5px solid grey;
   text-align:;
}
  </style>
  <script src="https://code.jquery.com/jquery-3.5.1.min.js"></script>
<script>
$(document).ready(function(){
    $("select").change(function(){
        $(this).find("option:selected").each(function(){
            var optionValue = $(this).attr("value");
            if(optionValue){
                $(".box").not("." + optionValue).hide();
                $("." + optionValue).show();
            } else{
                $(".box").hide();
            }
        });
    }).change();
});
</script>
<script>
$(document).ready(function(){
    $("select").change(function(){
        $(this).find("option:selected").each(function(){
            var optionValue = $(this).attr("value");
            if(optionValue){
                $(".box2").not("." + optionValue).hide();
                $("." + optionValue).show();
            } else{
                $(".box2").hide();
            }
        });
    }).change();
});


  function myFunction2021() {
  var checkBox = document.getElementById("myCheck2021");
  var text = document.getElementById("text2021");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}
  
  
  function myFunctionFever12() {
  var checkBox = document.getElementById("myCheckFever12");
  var text = document.getElementById("textFever12");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}  

  function myFunctionsmell() {
  var checkBox = document.getElementById("myChecksmell");
  var text = document.getElementById("textsmell");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}  

  function myFunctionDiarrhoea() {
  var checkBox = document.getElementById("myCheckDiarrhoea");
  var text = document.getElementById("textDiarrhoea");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
} 

function myFunctionDeformity() {
  var checkBox = document.getElementById("myCheckDeformity");
  var text = document.getElementById("textDeformity");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
} 

function myFunctionCough() {
  var checkBox = document.getElementById("myCheckCough");
  var text = document.getElementById("textCough");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
} 

function myFunctionTaste() {
  var checkBox = document.getElementById("myCheckTaste");
  var text = document.getElementById("textTaste");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
} 

function myFunctionWeakness() {
  var checkBox = document.getElementById("myCheckWeakness");
  var text = document.getElementById("textWeakness");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
} 

function myFunctionBreathlessness() {
  var checkBox = document.getElementById("myCheckBreathlessness");
  var text = document.getElementById("textBreathlessness");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
} 

function myFunctionAppetite() {
  var checkBox = document.getElementById("myCheckAppetite");
  var text = document.getElementById("textAppetite");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
} 

function myFunctionLimbs() {
  var checkBox = document.getElementById("myCheckLimbs");
  var text = document.getElementById("textLimbs");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
} 

function myFunctionThroat() {
  var checkBox = document.getElementById("myCheckThroat");
  var text = document.getElementById("textThroat");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
} 

function myFunctionVomitting() {
  var checkBox = document.getElementById("myCheckVomitting");
  var text = document.getElementById("textVomitting");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
} 

function myFunctionSlurred_Voice() {
  var checkBox = document.getElementById("myCheckSlurred_Voice");
  var text = document.getElementById("textSlurred_Voice");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
} 

function myFunctionNausea() {
  var checkBox = document.getElementById("myCheckNausea");
  var text = document.getElementById("textNausea");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
} 
function myFunctionLoss_Appetite() {
  var checkBox = document.getElementById("myCheckLoss_Appetite");
  var text = document.getElementById("textLoss_Appetite");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
} 
function myFunctionDelusion() {
  var checkBox = document.getElementById("myCheckDelusion");
  var text = document.getElementById("textDelusion");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
} 


function myFunctionFits_Anger() {
  var checkBox = document.getElementById("myCheckFits_Anger");
  var text = document.getElementById("textFits_Anger");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
} 

function myFunctionDepression() {
  var checkBox = document.getElementById("myCheckDepression");
  var text = document.getElementById("textDepression");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
} 


function myFunctionMemory_Loss() {
  var checkBox = document.getElementById("myCheckMemory_Loss");
  var text = document.getElementById("textMemory_Loss");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}


function myFunctionBleeding_Disorder() {
  var checkBox = document.getElementById("myCheckBleeding_Disorder");
  var text = document.getElementById("textBleeding_Disorder");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}

function myFunctionMigraine() {
  var checkBox = document.getElementById("myCheckMigraine");
  var text = document.getElementById("textMigraine");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}


function myFunctionFrequent_Urination() {
  var checkBox = document.getElementById("myCheckFrequent_Urination");
  var text = document.getElementById("textFrequent_Urination");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}


function myFunctionSwollen_Join() {
  var checkBox = document.getElementById("myCheckSwollen_Join");
  var text = document.getElementById("textSwollen_Join");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}


function myFunctionWeight_Gain() {
  var checkBox = document.getElementById("myCheckWeight_Gain");
  var text = document.getElementById("textWeight_Gain");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}


function myFunctionweight_loss() {
  var checkBox = document.getElementById("myCheckweight_loss");
  var text = document.getElementById("textweight_loss");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}

function myFunctionBody_pain() {
  var checkBox = document.getElementById("myCheckBody_pain");
  var text = document.getElementById("textBody_pain");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}

function myFunctionPhysical_Injury() {
  var checkBox = document.getElementById("myCheckPhysical_Injury");
  var text = document.getElementById("textPhysical_Injury");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}

function myFunctionRED_EYE() {
  var checkBox = document.getElementById("myCheckRED_EYE");
  var text = document.getElementById("textRED_EYE");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}
function myFunctionSwollen_Eye() {
  var checkBox = document.getElementById("myCheckSwollen_Eye");
  var text = document.getElementById("textSwollen_Eye");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}

function myFunctionConjunctiva() {
  var checkBox = document.getElementById("myCheckConjunctiva");
  var text = document.getElementById("textConjunctiva");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}

function myFunctionItchiness() {
  var checkBox = document.getElementById("myCheckItchiness");
  var text = document.getElementById("textItchiness");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}

function myFunctionDislocated() {
  var checkBox = document.getElementById("myCheckDislocated");
  var text = document.getElementById("textDislocated");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}

function myFunctionBlur_Vision() {
  var checkBox = document.getElementById("myCheckBlur_Vision");
  var text = document.getElementById("textBlur_Vision");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}

function myFunctionPartial_Blindness() {
  var checkBox = document.getElementById("myCheckPartial_Blindness");
  var text = document.getElementById("textPartial_Blindness");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}

function myFunctionBlindness() {
  var checkBox = document.getElementById("myCheckBlindness");
  var text = document.getElementById("textBlindness");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}


function myFunctionOcular() {
  var checkBox = document.getElementById("myCheckOcular");
  var text = document.getElementById("textOcular");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}
function myFunctionSystemic() {
  var checkBox = document.getElementById("myCheckSystemic");
  var text = document.getElementById("textSystemic");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}


function myFunctionwatering() {
  var checkBox = document.getElementById("myCheckwatering");
  var text = document.getElementById("textwatering");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}
</script>
<script>


function MAFunction1031() {
  var checkBox = document.getElementById("MACheck1031");
  var text = document.getElementById("text10311");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}
function MAFunction1032() {
  var checkBox = document.getElementById("MACheck1032");
  var text = document.getElementById("text10321");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}


function MAFunction1033() {
  var checkBox = document.getElementById("MACheck1033");
  var text = document.getElementById("text10331");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}

function MAFunction1034() {
  var checkBox = document.getElementById("MACheck1034");
  var text = document.getElementById("text10341");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}

function MAFunction1030() {
  var checkBox = document.getElementById("MACheck1030");
  var text = document.getElementById("text10301");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}


function HeadFunction1031() {
  var checkBox = document.getElementById("HeadCheck1031");
  var text = document.getElementById("Headtext10331");
  if (checkBox.checked == true){
    text.style.display = "block";
  } else {
     text.style.display = "none";
  }
}

</script>
<script src="https://ajax.googleapis.com/ajax/libs/jquery/3.1.1/jquery.min.js"></script>

     <script type="text/javascript">
$(document).ready(function(){
    $('#MAForm').submit(function() {
     $('#loaderImg').show(); 
      return true;
    });
});
  </script>
<style>
      #loaderImg {
         position: absolute;
         top: 0;
         bottom: 0;
         left: 0;
         right: 0; 
         margin: auto;
         border: 10px solid grey;
         border-radius: 50%;
         border-top: 10px solid black;
         width: 100px;
         height: 100px;
         animation: spin 1s linear infinite;
      }
      @keyframes spin {
         0% {
            -webkit-transform: rotate(0deg);
            transform: rotate(0deg);
         }
         100% {
            -webkit-transform: rotate(360deg);
            transform: rotate(360deg);
         }
      }
   </style>
     <style>
   
     .switch {
  position: relative;
  display: inline-block;
  width: 90px;
  height: 34px;
}

.switch input {display:none;}

.slider {
  position: absolute;
  cursor: pointer;
  top: 0;
  left: 0;
  right: 0;
  bottom: 0;
  background-color: #ca2222;
  -webkit-transition: .4s;
  transition: .4s;
   border-radius: 34px;
}

.slider:before {
  position: absolute;
  content: "";
  height: 26px;
  width: 26px;
  left: 4px;
  bottom: 4px;
  background-color: white;
  -webkit-transition: .4s;
  transition: .4s;
  border-radius: 50%;
}

input:checked + .slider {
  background-color: #2ab934;
}

input:focus + .slider {
  box-shadow: 0 0 1px #2196F3;
}

input:checked + .slider:before {
  -webkit-transform: translateX(26px);
  -ms-transform: translateX(26px);
  transform: translateX(55px);
}

/*------ ADDED CSS ---------*/
.slider:after
{
 content:'No';
 color: white;
 display: block;
 position: absolute;
 transform: translate(-50%,-50%);
 top: 50%;
 left: 50%;
 font-size: 10px;
 font-family: Verdana, sans-serif;
}

input:checked + .slider:after
{  
  content:'Yes';
}



.center {
   border: 1px solid grey;
   text-align:;
}
table {
  width: 100%;
}

</style>
   <div class='center'>
      
<form name="Medical_Assessment" method="post" id="MAForm" >
      
      

      
      
      
      
      
      
      
      
      
      
    <?php
    include 'dbconnection.php';
$sql ="SELECT * FROM addaspatient WHERE prescriptionid='$_GET[prescriptionid]' AND patientid='$_GET[patientid]'";
		$qsql = mysqli_query($con,$sql);
		while($rs = mysqli_fetch_array($qsql))
		{
		   
$usertype=$rs['typevisit'];
if($usertype == 'OPD'){
    echo " <h3 align='center'>Medical Assessment  ";
} else{
    echo " <h3 align='center'>Initial Assessment  ";
}
}

$tat=$con->query("SELECT * FROM `tat` WHERE prescriptionid='$_GET[prescriptionid]' AND patientid='$_GET[patientid]'");
$rtat = mysqli_fetch_array($tat);

echo "<input type='hidden' name='start_time' id='start_time' value='$rtat[start_time]'>";

?>

  <div class="checkbox">
    <input name="Chief_Complain" value='on' type="hidden">
<h4 align='center'>Chief Complain</h4></div>

 
 <table id="example2" class="table table-bordered table-hover"> 
 
 <tr>
     <td colspan='3'>      
  <div class="checkbox"> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;  
 <span style="font-size: 20px"> Body Pain</span>
  <label class="switch">
  <input name="fall_risk" type="checkbox" id="MACheck1030" onclick="MAFunction1030()">
  <span class="slider"></span>
</label>

  
</div>
  <div id="text10301" style="display:none">
      <table id="example2" class="table table-bordered table-hover"> 
        <tr><td>
            <span style="font-size: 20px">Head and Neck </span></h3></td><td><label class="switch">
  <input name="low_fall_risk"  id="MACheck1031" onclick="MAFunction1031()" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
<tr><td>
            <span style="font-size: 20px">Upper Extremity</span></h3></td><td><label class="switch">
  <input name="high_fall_risk" type="checkbox" id="MACheck1032" onclick="MAFunction1032()" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>


<tr><td>
            <span style="font-size: 20px">Torso</span></h3></td><td><label class="switch">
  <input name="high_fall_risk" type="checkbox" id="MACheck1033" onclick="MAFunction1033()" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>


<tr><td>
            <span style="font-size: 20px">Lower Extremity</span></h3></td><td><label class="switch">
  <input name="high_fall_risk" type="checkbox" id="MACheck1034" onclick="MAFunction1034()" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
 
</table>
<script src="https://code.jquery.com/jquery-3.5.1.min.js"></script>
<script>
$(document).ready(function(){
    $("select").change(function(){
        $(this).find("option:selected").each(function(){
            var optionValue = $(this).attr("value");
            if(optionValue){
                $(".box").not("." + optionValue).hide();
                $("." + optionValue).show();
            } else{
                $(".box").hide();
            }
        });
    }).change();
});
</script>
<style>
    .box{
        color: #fff;
        padding: 0px;
        display: none;
        margin-top: 0px;
    }
    .Right{ background: #fff; }
    .Left{ background: #fff; }
    .Both{ background: #fff; }
    
   /* The container */

    
</style>
      </div>
      <div id="text10311" style="display:none">
         <table id="example2" class="table table-bordered table-hover"> 
        <tr><td>
            <span style="font-size: 20px"> Head</span></h3></td><td><label class="switch">
  <input name="implement_low" type="checkbox" id="HeadCheck1031" onclick="HeadFunction1031()">
  <span class="slider"></span>
</label>

 <div id="Headtext10331" style="display:none">
    <select style='font-size:15px;'>
            <option>Choose</option>
            <option value="Right">Right</option>
            <option value="Left">Left</option>
            <option value="Both">Both</option>
        </select>
     
     <div class="Right box">
       
<div class="card">
  <div class="rating-container">
  
    <div class="rating">
     

        <label for="super-happy">
      <input type="radio" name="rating" class="super-happy" id="super-happy" value="1" />
      <svg viewBox="0 0 24 24"><path d="M12,17.5C14.33,17.5 16.3,16.04 17.11,14H6.89C7.69,16.04 9.67,17.5 12,17.5M8.5,11A1.5,1.5 0 0,0 10,9.5A1.5,1.5 0 0,0 8.5,8A1.5,1.5 0 0,0 7,9.5A1.5,1.5 0 0,0 8.5,11M15.5,11A1.5,1.5 0 0,0 17,9.5A1.5,1.5 0 0,0 15.5,8A1.5,1.5 0 0,0 14,9.5A1.5,1.5 0 0,0 15.5,11M12,20A8,8 0 0,1 4,12A8,8 0 0,1 12,4A8,8 0 0,1 20,12A8,8 0 0,1 12,20M12,2C6.47,2 2,6.5 2,12A10,10 0 0,0 12,22A10,10 0 0,0 22,12A10,10 0 0,0 12,2Z" /></svg>
      </label>

        <label for="happy">
      <input type="radio" name="rating" class="happy" id="happy" value="2" checked />
      <svg xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" version="1.1" width="100%" height="100%" viewBox="0 0 24 24"><path d="M20,12A8,8 0 0,0 12,4A8,8 0 0,0 4,12A8,8 0 0,0 12,20A8,8 0 0,0 20,12M22,12A10,10 0 0,1 12,22A10,10 0 0,1 2,12A10,10 0 0,1 12,2A10,10 0 0,1 22,12M10,9.5C10,10.3 9.3,11 8.5,11C7.7,11 7,10.3 7,9.5C7,8.7 7.7,8 8.5,8C9.3,8 10,8.7 10,9.5M17,9.5C17,10.3 16.3,11 15.5,11C14.7,11 14,10.3 14,9.5C14,8.7 14.7,8 15.5,8C16.3,8 17,8.7 17,9.5M12,17.23C10.25,17.23 8.71,16.5 7.81,15.42L9.23,14C9.68,14.72 10.75,15.23 12,15.23C13.25,15.23 14.32,14.72 14.77,14L16.19,15.42C15.29,16.5 13.75,17.23 12,17.23Z" /></svg>
      </label>

        <label for="neutral">
      <input type="radio" name="rating" class="neutral" id="neutral" value="3" />
      <svg xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" version="1.1" width="100%" height="100%" viewBox="0 0 24 24"><path d="M8.5,11A1.5,1.5 0 0,1 7,9.5A1.5,1.5 0 0,1 8.5,8A1.5,1.5 0 0,1 10,9.5A1.5,1.5 0 0,1 8.5,11M15.5,11A1.5,1.5 0 0,1 14,9.5A1.5,1.5 0 0,1 15.5,8A1.5,1.5 0 0,1 17,9.5A1.5,1.5 0 0,1 15.5,11M12,20A8,8 0 0,0 20,12A8,8 0 0,0 12,4A8,8 0 0,0 4,12A8,8 0 0,0 12,20M12,2A10,10 0 0,1 22,12A10,10 0 0,1 12,22C6.47,22 2,17.5 2,12A10,10 0 0,1 12,2M9,14H15A1,1 0 0,1 16,15A1,1 0 0,1 15,16H9A1,1 0 0,1 8,15A1,1 0 0,1 9,14Z" /></svg>
      </label>

        <label for="sad">
      <input type="radio" name="rating" class="sad" id="sad" value="4" />
      <svg xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" version="1.1" width="100%" height="100%" viewBox="0 0 24 24"><path d="M20,12A8,8 0 0,0 12,4A8,8 0 0,0 4,12A8,8 0 0,0 12,20A8,8 0 0,0 20,12M22,12A10,10 0 0,1 12,22A10,10 0 0,1 2,12A10,10 0 0,1 12,2A10,10 0 0,1 22,12M15.5,8C16.3,8 17,8.7 17,9.5C17,10.3 16.3,11 15.5,11C14.7,11 14,10.3 14,9.5C14,8.7 14.7,8 15.5,8M10,9.5C10,10.3 9.3,11 8.5,11C7.7,11 7,10.3 7,9.5C7,8.7 7.7,8 8.5,8C9.3,8 10,8.7 10,9.5M12,14C13.75,14 15.29,14.72 16.19,15.81L14.77,17.23C14.32,16.5 13.25,16 12,16C10.75,16 9.68,16.5 9.23,17.23L7.81,15.81C8.71,14.72 10.25,14 12,14Z" /></svg>
      </label>

        <label for="super-sad">
      <input type="radio" name="rating" class="super-sad" id="super-sad" value="5" />
      <svg viewBox="0 0 24 24"><path d="M12,2C6.47,2 2,6.47 2,12C2,17.53 6.47,22 12,22A10,10 0 0,0 22,12C22,6.47 17.5,2 12,2M12,20A8,8 0 0,1 4,12A8,8 0 0,1 12,4A8,8 0 0,1 20,12A8,8 0 0,1 12,20M16.18,7.76L15.12,8.82L14.06,7.76L13,8.82L14.06,9.88L13,10.94L14.06,12L15.12,10.94L16.18,12L17.24,10.94L16.18,9.88L17.24,8.82L16.18,7.76M7.82,12L8.88,10.94L9.94,12L11,10.94L9.94,9.88L11,8.82L9.94,7.76L8.88,8.82L7.82,7.76L6.76,8.82L7.82,9.88L6.76,10.94L7.82,12M12,14C9.67,14 7.69,15.46 6.89,17.5H17.11C16.31,15.46 14.33,14 12,14Z" /></svg>
      </label>

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




     </div>
            <div class="Left box"><h4>Pain Assessment</h4> 
 <label class="container"> <i class="fa fa-smile-o" aria-hidden="true"></i>
  <input type="radio" checked="checked" name="radio">
  <span class="checkmark"></span>
</label>


<label class="container"><i class="fa fa-meh-o" aria-hidden="true"></i>
  <input type="radio" name="radio">
  <span class="checkmark"></span>
</label>
           <label class="container"> <i class="fa fa-frown-o" aria-hidden="true"></i>
  <input type="radio" name="radio">
  <span class="checkmark"></span>
</label>   </div>
    <div class="Both box"><h4>Pain Assessment</h4> 
 <label class="container"> <i class="fa fa-smile-o" aria-hidden="true"></i>
  <input type="radio" checked="checked" name="radio">
  <span class="checkmark"></span>
</label>


<label class="container"><i class="fa fa-meh-o" aria-hidden="true"></i>
  <input type="radio" name="radio">
  <span class="checkmark"></span>
</label>
           <label class="container"> <i class="fa fa-frown-o" aria-hidden="true"></i>
  <input type="radio" name="radio">
  <span class="checkmark"></span>
</label>   </div>
      
 </div>
</td>
</tr>
<tr><td>
            <span style="font-size: 20px">Forehead 
 </span></h3></td><td><label class="switch">
  <input name="Complete_paralysis" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>

<!--///////////////-->
<tr><td>
            <span style="font-size: 20px">Eyes 
 </span></h3></td><td><label class="switch">
  <input name="Complete_paralysis" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
<tr><td>
            <span style="font-size: 20px">Ear 
 </span></h3></td><td><label class="switch">
  <input name="Complete_paralysis" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
<tr><td>
            <span style="font-size: 20px">Nose  
 </span></h3></td><td><label class="switch">
  <input name="Complete_paralysis" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
<tr><td>
            <span style="font-size: 20px">Mouth  
 </span></h3></td><td><label class="switch">
  <input name="Complete_paralysis" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
<tr><td>
            <span style="font-size: 20px">Cheek 
 </span></h3></td><td><label class="switch">
  <input name="Complete_paralysis" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
<tr><td>
            <span style="font-size: 20px">Chin  
 </span></h3></td><td><label class="switch">
  <input name="Complete_paralysis" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
<tr><td>
            <span style="font-size: 20px">Jaw 
 </span></h3></td><td><label class="switch">
  <input name="Complete_paralysis" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
<tr><td>
            <span style="font-size: 20px">Neck 
 </span></h3></td><td><label class="switch">
  <input name="Complete_paralysis" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
<!--////////////////-->

</table>
          </div>
           <div id="text10321" style="display:none">
           <table id="example2" class="table table-bordered table-hover"> 
        <tr><td>
            <span style="font-size: 20px">Shoulder  </span></h3></td><td><label class="switch">
  <input name="History_more" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
<tr><td>
            <span style="font-size: 20px">Arm </span></h3></td><td><label class="switch">
  <input name="Patient_experienced" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
<tr><td>
            <span style="font-size: 20px">Elbow </span></h3></td><td><label class="switch">
  <input name="deemed_high" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
<!--///////////////////-->
<tr><td>
            <span style="font-size: 20px">Forearm </span></h3></td><td><label class="switch">
  <input name="deemed_high" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>

<tr><td>
            <span style="font-size: 20px">Wrist  </span></h3></td><td><label class="switch">
  <input name="deemed_high" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>

<tr><td>
            <span style="font-size: 20px">Hand </span></h3></td><td><label class="switch">
  <input name="deemed_high" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
</table>
  </div> 
  
   <div id="text10331" style="display:none">
           <table id="example2" class="table table-bordered table-hover"> 
        <tr><td>
            <span style="font-size: 20px">Nape  </span></h3></td><td><label class="switch">
  <input name="History_more" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
<tr><td>
            <span style="font-size: 20px">Shoulder Blade </span></h3></td><td><label class="switch">
  <input name="Patient_experienced" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
<tr><td>
            <span style="font-size: 20px">Armpit </span></h3></td><td><label class="switch">
  <input name="deemed_high" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>



<tr><td>
            <span style="font-size: 20px">Back  </span></h3></td><td><label class="switch">
  <input name="deemed_high" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>

<tr><td>
            <span style="font-size: 20px">Chest </span></h3></td><td><label class="switch">
  <input name="deemed_high" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
<tr><td>
            <span style="font-size: 20px">Breast  </span></h3></td><td><label class="switch">
  <input name="deemed_high" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>

<tr><td>
            <span style="font-size: 20px">Upper Abdomen </span></h3></td><td><label class="switch">
  <input name="deemed_high" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>

<tr><td>
            <span style="font-size: 20px">Umbilical  </span></h3></td><td><label class="switch">
  <input name="deemed_high" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>

<tr><td>
            <span style="font-size: 20px">Lower Abdomen </span></h3></td><td><label class="switch">
  <input name="deemed_high" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>

<tr><td>
            <span style="font-size: 20px">Vulva  </span></h3></td><td><label class="switch">
  <input name="deemed_high" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>

<tr><td>
            <span style="font-size: 20px">Penis  </span></h3></td><td><label class="switch">
  <input name="deemed_high" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
<tr><td>
            <span style="font-size: 20px">Scrotum  </span></h3></td><td><label class="switch">
  <input name="deemed_high" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>


</table>
  </div>
  
  
   <div id="text10341" style="display:none">
           <table id="example2" class="table table-bordered table-hover"> 
        <tr><td>
            <span style="font-size: 20px">Buttock  </span></h3></td><td><label class="switch">
  <input name="History_more" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
<tr><td>
            <span style="font-size: 20px">Hip  </span></h3></td><td><label class="switch">
  <input name="Patient_experienced" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
<tr><td>
            <span style="font-size: 20px">Thigh </span></h3></td><td><label class="switch">
  <input name="deemed_high" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>

<tr><td>
            <span style="font-size: 20px">Knee </span></h3></td><td><label class="switch">
  <input name="deemed_high" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>


<tr><td>
            <span style="font-size: 20px">Calf  </span></h3></td><td><label class="switch">
  <input name="deemed_high" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>

<tr><td>
            <span style="font-size: 20px">Leg   </span></h3></td><td><label class="switch">
  <input name="deemed_high" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>

<tr><td>
            <span style="font-size: 20px">Ankle   </span></h3></td><td><label class="switch">
  <input name="deemed_high" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>

<tr><td>
            <span style="font-size: 20px">Foot   </span></h3></td><td><label class="switch">
  <input name="deemed_high" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>

<tr><td>
            <span style="font-size: 20px">Heel   </span></h3></td><td><label class="switch">
  <input name="deemed_high" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>

</table>
  </div>
  
  
  
  
  </td>










 </tr>
        <tr><td>
            <span style="font-size: 20px">Fever</span></h3></td><td ><label class="switch"><input name="Fever" type="checkbox" id="myCheckFever12" onclick="myFunctionFever12()">
  <span class="slider"></span>
</label>
</td>
<td  id='textFever12' style="display:none"><input type='text' name='Fever_note'></td>
</tr>

<tr>
<td ><span style="font-size: 20px">Loss <br> of Smell</span></h3></td><td ><label class="switch">
  <input name="smell" type="checkbox" id="myChecksmell" onclick="myFunctionsmell()">
  <span class="slider"></span>
</label>
</td>
<td  id='textsmell' style="display:none"><input type='text' name='smell_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Diarrhoea </span></h3></td><td ><label class="switch">
  <input name="Diarrhoea" type="checkbox" id="myCheckDiarrhoea" onclick="myFunctionDiarrhoea()">
  <span class="slider"></span>
</label>
</td>
<td  id='textDiarrhoea' style="display:none"><input type='text' name='Diarrhoea_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Facial <br>Deformity</span></h3></td><td ><label class="switch">
  <input name="Deformity" type="checkbox" id="myCheckDeformity" onclick="myFunctionDeformity()">
  <span class="slider"></span>
</label>
</td>
<td  id='textDeformity' style="display:none"><input type='text' name='Deformity_note'></td>
</tr>
   <tr><td >
            <span style="font-size: 20px">Cough  </span></h3></td><td ><label class="switch">
  <input name="Cough" type="checkbox" id="myCheckCough" onclick="myFunctionCough()">
  <span class="slider"></span>
</label>
</td>
<td  id='textCough' style="display:none"><input type='text' name='Cough_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Loss <br>of Taste</span></h3><td ><label class="switch">
  <input name="Taste" type="checkbox" id="myCheckTaste" onclick="myFunctionTaste()">
  <span class="slider"></span>
</label>
</td>
<td  id='textTaste' style="display:none"><input type='text' name='Taste_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Weakness </span></h3><td ><label class="switch">
  <input name="Weakness" type="checkbox" id="myCheckWeakness" onclick="myFunctionWeakness()">
  <span class="slider"></span>
</label>
</td>
<td  id='textWeakness' style="display:none"><input type='text' name='Weakness_note'></td>
</tr>
<tr>
<td >
            <span style="font-size: 20px">Breathle<br>ssness</span></h3><td ><label class="switch">
  <input name="Breathlessness" type="checkbox" id="myCheckBreathlessness" onclick="myFunctionBreathlessness()">
  <span class="slider"></span>
</label>
</td>
<td  id='textBreathlessness' style="display:none"><input type='text' name='Breathlessness_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Shivering</span></h3><td ><label class="switch">
  <input name="Appetite" type="checkbox" id="myCheckAppetite" onclick="myFunctionAppetite()">
  <span class="slider"></span>
</label>
</td>
<td  id='textAppetite' style="display:none"><input type='text' name='Appetite_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Power <br>Loss in <br>Limbs </span></h3><td ><label class="switch">
  <input name="Limbs" type="checkbox" id="myCheckLimbs" onclick="myFunctionLimbs()">
  <span class="slider"></span>
</label>
</td>

<td  id='textLimbs' style="display:none"><input type='text' name='Limbs_note'></td>
</tr>
 <tr><td >
            <span style="font-size: 20px">Sore <br>Throat  </span></h3><td ><label class="switch">
  <input name="Throat" type="checkbox" id="myCheckThroat" onclick="myFunctionThroat()">
  <span class="slider"></span>
</label>
</td><td  id='textThroat' style="display:none"><input type='text' name='Throat_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Vomitting</span></h3><td ><label class="switch">
  <input name="Vomitting" type="checkbox" id="myCheckVomitting" onclick="myFunctionVomitting()">
  <span class="slider"></span>
</label>
</td><td  id='textVomitting' style="display:none"><input type='text' name='Vomitting_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Slurred <br>Voice </span></h3><td ><label class="switch">
  <input name="Slurred_Voice" type="checkbox" id="myCheckSlurred_Voice" onclick="myFunctionSlurred_Voice()">
  <span class="slider"></span>
</label>
</td>
<td  id='textSlurred_Voice' style="display:none"><input type='text' name='Slurred_Voice_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Nausea </span></h3><td ><label class="switch">
  <input name="Nausea" type="checkbox" id="myCheckNausea" onclick="myFunctionNausea()">
  <span class="slider"></span>
</label>
</td><td  id='textNausea' style="display:none"><input type='text' name='Nausea_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Loss of <br>Appetite</span></h3><td ><label class="switch">
  <input name="Loss_Appetite" type="checkbox" id="myCheckLoss_Appetite" onclick="myFunctionLoss_Appetite()">
  <span class="slider"></span>
</label>
</td><td  id='textLoss_Appetite' style="display:none"><input type='text' name='Loss_Appetite_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Delusion </span></h3><td ><label class="switch">
  <input name="Delusion" type="checkbox" id="myCheckDelusion" onclick="myFunctionDelusion()">
  <span class="slider"></span>
</label>
</td><td  id='textDelusion' style="display:none"><input type='text' name='Delusion_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Fits of<br> Anger</span></h3><td ><label class="switch">
  <input name="Fits_Anger" type="checkbox" id="myCheckFits_Anger" onclick="myFunctionFits_Anger()">
  <span class="slider"></span>
</label>
</td><td  id='textFits_Anger' style="display:none"><input type='text' name='Fits_Anger_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Depression </span></h3><td ><label class="switch">
  <input name="Depression" type="checkbox" id="myCheckDepression" onclick="myFunctionDepression()">
  <span class="slider"></span>
</label>
</td><td  id='textDepression' style="display:none"><input type='text' name='Depression_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Memory Loss </span></h3><td ><label class="switch">
  <input name="Memory_Loss" type="checkbox" id="myCheckMemory_Loss" onclick="myFunctionMemory_Loss()">
  <span class="slider"></span>
</label>
</td><td  id='textMemory_Loss' style="display:none"><input type='text' name='Memory_Loss_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Bleeding <br>Disorder </span></h3><td ><label class="switch">
  <input name="Bleeding_Disorder" type="checkbox" id="myCheckBleeding_Disorder" onclick="myFunctionBleeding_Disorder()">
  <span class="slider"></span>
</label>
</td><td  id='textBleeding_Disorder' style="display:none"><input type='text' name='Bleeding_Disorder_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Migraine </span></h3><td ><label class="switch">
  <input name="Migraine" type="checkbox" id="myCheckMigraine" onclick="myFunctionMigraine()">
  <span class="slider"></span>
</label>
</td><td  id='textMigraine' style="display:none"><input type='text' name='Migraine_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Frequent <br>Urination </span></h3><td ><label class="switch">
  <input name="Frequent_Urination" type="checkbox" id="myCheckFrequent_Urination" onclick="myFunctionFrequent_Urination()">
  <span class="slider"></span>
</label>
</td><td  id='textFrequent_Urination' style="display:none"><input type='text' name='Frequent_Urination_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Swollen Join </span></h3><td ><label class="switch">
  <input name="Swollen_Join" type="checkbox" id="myCheckSwollen_Join" onclick="myFunctionSwollen_Join()">
  <span class="slider"></span>
</label>
</td><td  id='textSwollen_Join' style="display:none"><input type='text' name='Swollen_Join_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Weight Gain </span></h3><td ><label class="switch">
  <input name="Weight_Gain" type="checkbox" id="myCheckWeight_Gain" onclick="myFunctionWeight_Gain()">
  <span class="slider"></span>
</label>
</td><td  id='textWeight_Gain' style="display:none"><input type='text' name='Weight_Gain_note'></td>
</tr>

<tr>
<td ><span style="font-size: 20px">Weight loss</span></h3><td ><label class="switch">
  <input name="weight_loss" type="checkbox" id="myCheckweight_loss" onclick="myFunctionweight_loss()">
  <span class="slider"></span>
</label>
</td> <td  id='textweight_loss' style="display:none"><input type='text' name='weight loss_note'></td> </tr>
<tr>
<td ><span style="font-size: 20px">Body pain </span></h3><td ><label class="switch">
  <input name="Body_pain" type="checkbox" id="myCheckBody_pain" onclick="myFunctionBody_pain()">
  <span class="slider"></span>
</label>
</td><td  id='textBody_pain' style="display:none"><input type='text' name='Body_pain_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Physical <br>Injury </span></h3><td ><label class="switch">
  <input name="Physical_Injury" type="checkbox" id="myCheckPhysical_Injury" onclick="myFunctionPhysical_Injury()">
  <span class="slider"></span>
</label>
</td><td  id='textPhysical_Injury' style="display:none"><input type='text' name='Physical_Injury_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Other <br>Symptoms </span></h3>
    </td>
    <td>
<input type='text' name='Other_Symptoms' placeholder='Other Symptoms'>
</td>
</tr>

<?php
session_start();
require_once('../LoginManager.php');
require_once('../DBManager.php');
$sql ="SELECT * FROM addaspatient WHERE prescriptionid='$_GET[prescriptionid]' AND patientid='$_GET[patientid]'";
		$qsql = mysqli_query($con,$sql);
		if($rs = mysqli_fetch_array($qsql))
		{
if(Eye_Care==$rs[casetype])
{
?> 
     <tr>
<td ><span style="font-size: 20px">RED EYE</span></h3><td ><label class="switch">
  <input name="RED_EYE" type="checkbox" id="myCheckRED_EYE" onclick="myFunctionRED_EYE()">
  <span class="slider"></span>
</label>
</td><td  id='textRED_EYE' style="display:none"><input type='text' name='RED_EYE_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Swollen Eye  </span></h3><td ><label class="switch">
  <input name="Swollen_Eye" type="checkbox" id="myCheckSwollen_Eye" onclick="myFunctionSwollen_Eye()">
  <span class="slider"></span>
</label>
</td><td  id='textSwollen_Eye' style="display:none"><input type='text' name='Physical_Injury_note'></td>
</tr>

   <tr>
<td ><span style="font-size: 20px">Conjunctiva </span></h3><td ><label class="switch">
  <input name="Conjunctiva" type="checkbox" id="myCheckConjunctiva" onclick="myFunctionConjunctiva()">
  <span class="slider"></span>
</label>
</td><td  id='textConjunctiva' style="display:none"><input type='text' name='Physical_Injury_note'></td>
</tr>

<tr>
<td ><span style="font-size: 20px">Eyes <br>Itchiness   </span></h3><td ><label class="switch">
  <input name="Itchiness" type="checkbox" id="myCheckItchiness" onclick="myFunctionItchiness()">
  <span class="slider"></span>
</label>
</td><td  id='textItchiness' style="display:none"><input type='text' name='Physical_Injury_note'></td>
</tr>
   <tr>
<td ><span style="font-size: 20px">Dislocated <br>Eyes</span></h3><td ><label class="switch">
  <input name="Dislocated" type="checkbox" id="myCheckDislocated" onclick="myFunctionDislocated()">
  <span class="slider"></span>
</label>
</td><td  id='textDislocated' style="display:none"><input type='text' name='Physical_Injury_note'></td>
</tr>
   <tr>
<td ><span style="font-size: 20px">Watering Eyes</span></h3><td ><label class="switch">
  <input name="watering" type="checkbox" id="myCheckwatering" onclick="myFunctionwatering()">
  <span class="slider"></span>
</label>
</td><td  id='textwatering' style="display:none"><input type='text' name='watering_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Blur Vision   </span></h3><td ><label class="switch">
  <input name="Blur_Vision" type="checkbox" id="myCheckBlur_Vision" onclick="myFunctionBlur_Vision()">
  <span class="slider"></span>
</label>
</td><td  id='textBlur_Vision' style="display:none"><input type='text' name='Physical_Injury_note'></td>
</tr>
   <tr>
<td ><span style="font-size: 20px">Partial Blindness </span></h3><td ><label class="switch">
  <input name="Partial_Blindness" type="checkbox" id="myCheckPartial_Blindness" onclick="myFunctionPartial_Blindness()">
  <span class="slider"></span>
</label>
</td>
<td  id='textPartial_Blindness' style="display:none"><input type='text' name='Partial_Blindness_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Blindness    </span></h3><td ><label class="switch">
  <input name="Blindness" type="checkbox" id="myCheckBlindness" onclick="myFunctionBlindness()">
  <span class="slider"></span>
</label>
</td>
<td  id='textBlindness' style="display:none"><input type='text' name='Blindness_note'></td>
</tr>

<tr>
<td ><span style="font-size: 20px">Ocular History  </span></h3><td ><label class="switch">
  <input id="myCheck2021" onclick="myFunction2021()" name="Disease_History" type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
</table>
  <div id="text2021" style="display:none">
      <table id="example2" class="table table-bordered table-hover"> 
      <tr>
<td ><span style="font-size: 20px">Left Eye </span></h3><td ><label class="switch">
  <input  name="Systemic" type="checkbox" id="myCheckSystemic" onclick="myFunctionSystemic()">
  <span class="slider"></span>
</label>
</td>
<td  id='textSystemic' style="display:none"><input type='text' name='Systemic_note'></td>
</tr>
<tr>
<td ><span style="font-size: 20px">Right Eye  </span></h3><td ><label class="switch">
  <input name="Ocular" type="checkbox" id="myCheckOcular" onclick="myFunctionOcular()">
  <span class="slider"></span>
</label>
</td>
<td  id='textOcular' style="display:none"><input type='text' name='Systemic_note'></td>
</tr>
</table>
</div>
<?php
}
}
?>



					      <table id="example2" class="table table-bordered table-hover"> 
                  <thead>
                    </tr>
              
              </thead>
                  
                   </tbody>
  <tfoot>
          </tfoot>
        </table>   
       
                         <script>
function vitals(id) {
  var x = document.getElementById(id);
  if (x.className.indexOf("w3-show") == -1) {
    x.className += " w3-show";
  } else { 
    x.className = x.className.replace(" w3-show", "");
  }
}
</script>

<input type="submit" name="Medical_Assessment" value="Submit">
<br><br>
</div>

</form>

<script src="../plugins/select2/js/select2.full.min.js"></script>
<script>
  $(function () {
    //Initialize Select2 Elements
    $('.select2').select2()

    //Initialize Select2 Elements
    $('.select2bs4').select2({
      theme: 'bootstrap4'
    })
    </script>
 <link rel="stylesheet" href="https://www.w3schools.com/w3css/4/w3.css">
  <script src="https://code.jquery.com/jquery-3.5.1.min.js"></script>



<script src="https://ajax.googleapis.com/ajax/libs/jquery/3.3.1/jquery.min.js"></script>



<?php
}
?>
</body>
</html> 
<style>
  
@import url('https://fonts.googleapis.com/css?family=Roboto');





.card {
  display: -webkit-box;
  display: -ms-flexbox;
  display: flex;
  margin: auto;
  -webkit-box-shadow: 0 0.5rem 1rem rgba(0, 0, 16, 0.19), 0 0.3rem 0.3rem rgba(0, 0, 16, 0.23);
  box-shadow: 0 0.5rem 1rem rgba(0, 0, 16, 0.19), 0 0.3rem 0.3rem rgba(0, 0, 16, 0.23);
  background-color: rgb(255, 255, 255);
  padding: 0.8rem;
  width: 33rem;
}

.rating-container {
  display: -webkit-box;
  display: -ms-flexbox;
  display: flex;
  -webkit-box-pack: justify;
  -ms-flex-pack: justify;
  justify-content: space-between;
  padding: 0.4rem 0.8rem;
  width: 100%;
}

.rating-text p {
  color: rgba(0, 0, 16, 0.8);
  font-size: 1.3rem;
  padding: 0.3rem;
}

.rating {
  background-color: rgba(0, 0, 16, 0.8);
  padding: 0.4rem 0.4rem 0.1rem 0.4rem;
  border-radius: 2.2rem;
}

svg {
  fill: rgb(242, 242, 242);
  height: 3.6rem;
  width: 3.6rem;
  margin: 0.2rem;
}

.rating-form-2 svg {
  height: 3rem;
  width: 3rem;
  margin: 0.5rem;
}

#radios label {
  position: relative;
}

input[type="radio"] {
  position: absolute;
  opacity: 0;
}

input[type="radio"] + svg {
  -webkit-transition: all 0.2s;
  transition: all 0.2s;
}

input + svg {
  cursor: pointer;
}

input[class="super-happy"]:hover + svg,
input[class="super-happy"]:checked + svg,
input[class="super-happy"]:focus + svg {
  fill: rgb(0, 109, 217);
}

input[class="happy"]:hover + svg,
input[class="happy"]:checked + svg,
input[class="happy"]:focus + svg {
  fill: rgb(0, 204, 79);
}

input[class="neutral"]:hover + svg,
input[class="neutral"]:checked + svg,
input[class="neutral"]:focus + svg {
  fill: rgb(232, 214, 0);
}

input[class="sad"]:hover + svg,
input[class="sad"]:checked + svg,
input[class="sad"]:focus + svg {
  fill: rgb(229, 132, 0);
}

input[class="super-sad"]:hover + svg,
input[class="super-sad"]:checked + svg,
input[class="super-sad"]:focus + svg {
  fill: rgb(239, 42, 16);
}




@media screen and (max-width: 650px) and (max-height: 700px) {
  
}

@media screen and (max-height: 700px) {
  
}

@media screen and (max-width: 650px) {
  
}

@media screen and (max-width: 450px) and (max-height: 550px) {
  
}

@media screen and (max-height: 550px) {
  
}

@media screen and (max-width: 450px) {
 
}

@media screen and (max-width: 400px) and (max-height: 500px) {
  
}

@media screen and (max-height: 500px) {
  
}

@media screen and (max-width: 400px) {
 
}




</style>
Anon7 - 2022
AnonSec Team