Example #1
0
     <?php 
echo cbcell('form_mech_stretching', 'Stretching', 'fimech_stretching');
?>
     <?php 
echo cbcell('form_mech_turning', 'Twisting/Turning', 'fimech_turning');
?>
     <?php 
echo cbcell('form_mech_throwing', 'Throwing', 'fimech_throwing');
?>
     <?php 
echo cbcell('form_mech_diving', 'Diving', 'fimech_diving');
?>
    </tr>
    <tr>
     <?php 
echo cbcell('form_mech_overuse', 'Overuse', 'fimech_overuse');
?>
     <td colspan='3' nowrap>
      Other:
      <input type='text' name='form_mech_othernon' size='10'
       title='Describe other'
       value='<?php 
echo addslashes($row['fimech_othernon']);
?>
' />
     </td>
    </tr>
   </table>
  </td>
 </tr>
Example #2
0
     <?php 
echo cbcell('treat_5', 'Hospital Specialist', 'sitreat_5');
?>
     <?php 
echo cbcell('treat_6', 'Osteopath', 'sitreat_6');
?>
     <?php 
echo cbcell('treat_7', 'Chiropractor', 'sitreat_7');
?>
     <?php 
echo cbcell('treat_8', 'Sports Massage Th', 'sitreat_8');
?>
    </tr>
    <tr>
     <?php 
echo cbcell('treat_9', 'Sports Physician', 'sitreat_9');
?>
     <td colspan='3' nowrap>
      <?php 
echo cbinput('treat_10', 'sitreat_10');
?>
Other:
      <input type='text' name='treat_other' size='10'
       title='Describe other'
       value='<?php 
echo addslashes($row['sitreat_other']);
?>
' />
     </td>
    </tr>
   </table>