echo "<script type='text/javascript' src='/ckeditor/ckeditor.js'></script>";
echo "<br>";
echo "<center><font size=4><b>PAGADIAN CITY MEDICAL CENTER</b></font></center>";
echo "<center><b><font size=3><b>LABORATORY DEPARTMENT</b></font></b></center>";
echo "<center><font size=3>Cabrera St., Pagadian City</font></center>";
echo "<center><font size=3>Tel No. 062-2143237</font></center>";
echo "<br><br>";
echo "<center>";
echo "<table border=0 cellspacing=0 cellpadding=1 width='100%' >";
echo "<tr>";
echo "<td> <b>Name:</b> " . $ro->getPatientRecord_lastName() . ", " . $ro->getPatientRecord_firstName() . "</td>";
echo "<td> <b>Age/Sex:</b> " . $ro->getPatientRecord_Age() . "/" . $ro->getPatientRecord_gender() . "</td>";
echo "<Td> <b>Date:</b> " . date("M d, Y") . "</td>";
echo "</tr>";
echo "<tr>";
echo "<td> <b>D.O.B:</b> " . $ro->getPatientRecord_birthDate() . "</td>";
echo "<Td> <b>WARD:</b> " . $ro->getRegistrationDetails_type() . "</td>";
echo "</tr>";
echo "</table>";
echo "<Br><br>";
$ro->coconutFormStart("POST", "addLabToPatient.php");
$ro->coconutHidden("registrationNo", $registrationNo);
$ro->coconutHidden("itemNo", $itemNo);
$ro->coconutHidden("chargesCode", $chargesCode);
$ro->coconutHidden("username", $username);
$ro->coconutHidden("date", date("M_d_Y"));
echo "<textarea id='result' name='result'>" . $ro->selectNow("labResultList", "template", "templateNo", $templateNo) . "</textarea>";
$ro->coconutFormStop();
?>
echo "<table border=0 cellspacing=0 cellpadding=1 width='100%' >";
echo "<tr>";
echo "<td><B>Patient ID:</b></td>";
echo "<td><input type='text' class='linez' value='" . $ro->getRegistrationDetails_patientNo() . "'></td>";
echo "<td><B>Date:</b></td>";
echo "<td><input type='text' class='linez' value='" . $ro->selectNow("labSavedResult", "date", "itemNo", $itemNo) . "@" . $ro->selectNow("labSavedResult", "time", "itemNo", $itemNo) . "'></td>";
echo "</tr>";
echo "<tr>";
echo "<td><b>Name:</b></td>";
echo "<td><input type='text' class='linez' value='" . $ro->getPatientRecord_lastName() . ", " . $ro->getPatientRecord_firstName() . " " . $ro->getPatientRecord_middleName() . "'></td>";
echo "<td><b>Age/Sex:</b></td>";
echo "<td><input type='text' class='linez' value='" . $ro->getPatientRecord_age() . "/" . $ro->getPatientRecord_gender() . "'></td>";
echo "</tr>";
echo "<tr>";
echo "<Td><b>Date of Birth:</td>";
echo "<td></b><input type='text' class='linez' value='" . $ro->getPatientRecord_birthDate() . "'></tD>";
echo "<td><b>Status:</td>";
echo "<td></b><input type='text' class='linez' value='" . $ro->getPatientRecord_civilStatus() . "'></tD>";
echo "</tr>";
echo "<tr>";
echo "<Td><b>Physician:</b></td>";
echo "<td><input type='text' class='linez' value='" . $ro->getAttendingDoc($registrationNo, "ATTENDING") . "'></tD>";
echo "<Td><b>Room:</b></td>";
echo "<td> <input type='text' class='linez' value='" . $ro->getRegistrationDetails_room() . "'></tD>";
echo "</tr>";
echo "</table>";
echo "</center>";
echo "<Br>";
echo "<center>";
echo $ro->ENCRYPT_DECRYPT($ro->doubleSelectNow_notDeleted("labSavedResult", "result", "itemNo", $itemNo, "registrationNo", $registrationNo));
echo "</center>";