$ro->coconutHidden("registrationStatus", "new");
$ro->coconutHidden("casetype", "");
$ro->coconutHidden("dateRegistered", "");
$ro->coconutHidden("firstname", "n/a");
$ro->coconutHidden("middlename", "n/a");
$ro->coconutHidden("dateRegistered", date("Y-m-d"));
$ro->coconutHidden("month", date("M"));
$ro->coconutHidden("day", date("d"));
$ro->coconutHidden("birthYear", date("Y"));
$ro->coconutHidden("from", $from);
echo "<Br><Br><Br><Br><Br>";
$ro->coconutBoxStart("600", "140");
echo "<Br>";
echo "<table border=0>";
echo "<tr>";
echo "<Td>" . $ro->coconutText("Name") . " </tD>";
echo "<td>";
$ro->coconutTextBox("lastname", "patient" . $patientNo . "_" . $registrationNo);
echo "</td>";
echo "</tr>";
echo "<tr>";
echo "<td>" . $ro->coconutText("Gender") . "</td>";
echo "<Td>";
$ro->coconutComboBoxStart_long("gender");
echo "<option value='male'>Male</option>";
echo "<option value='female'>Female</option>";
$ro->coconutComboBoxStop();
echo "</td>";
echo "</tr>";
echo "<tr>";
echo "<Td>" . $ro->coconutText("Senior") . "</tD>";
$ro->coconutHidden("civilStatus", "");
$ro->coconutHidden("room", "OPD");
$ro->coconutHidden("bloodpressure", "");
$ro->coconutHidden("patientTemperature", "");
$ro->coconutHidden("weight", "");
$ro->coconutHidden("height", "");
$ro->coconutHidden("company", "");
$ro->coconutHidden("serverTime", "");
$ro->coconutHidden("registrationStatus", "new");
$ro->coconutHidden("casetype", "");
$ro->coconutHidden("dateRegistered", "");
$ro->coconutBoxStart("500", "250");
echo "<Br>";
echo "<Table border=0>";
echo "<tr>";
echo "<Td>" . $ro->coconutText("Last Name") . "</tD>";
echo "<Td>";
$ro->coconutTextBox("lastname", $ro->getLastName_patientRecord());
echo "</td>";
echo "</tr>";
echo "<tr>";
echo "<Td>" . $ro->coconutText("First Name") . "</tD>";
echo "<Td>";
$ro->coconutTextBox("firstname", $ro->getFirstName_patientRecord());
echo "</td>";
echo "</tr>";
echo "<tr>";
echo "<Td>" . $ro->coconutText("Middle Name") . "</tD>";
echo "<Td>";
$ro->coconutTextBox("middlename", $ro->getMiddleName_patientRecord());
echo "</td>";
