<table class="table table-bordered table-responsive table-hover">
<tr>
<td colspan="2">PT's Name: <?php
echo @$patient->name;
?>
</td><td>MRN: <?php
echo @$patient->id;
?>
</td>
</tr>
<tr>
<td>Age: <?php
echo @Patient::ageCalculator(@$patient->age);
?>
</td><td>Gender: <?php
echo @Patient::Gender()[$patient->gender];
?>
</td><td>PT's ID: <?php
echo @$patient->pt_id;
?>
</td>
</tr>
<tr>
<td colspan="3">Diagnosis: <?php
echo @$diagnosis->diagnosis;
?>
</td>
</tr>
</table>
<form class="form" action="" rel="form">
<div class="form-group">
?>
</td>
<td><?php
echo $row->name;
?>
</td>
<td><?php
echo $row->pt_id;
?>
</td>
<td><?php
echo $row->age;
?>
</td>
<td><?php
echo Patient::Gender()[$row->gender];
?>
</td>
<td><?php
echo $row->phone;
?>
</td>
<td><?php
echo $row->mobile;
?>
</td>
<td><?php
echo $row->date_time;
?>
</td>
<td style="text-align: center"><?php
</div>
</div>
<div class="form-group">
<label class="mws-form-label">PT's Name</label>
<input type='text' placeholder='Name' name='name' class="form-control"/>
</div>
<div class="form-group">
<label class="mws-form-label">age</label>
<input type='text' placeholder='Age' name='age' class="form-control" />
</div>
<div class="form-group">
<label class="mws-form-label">Gender</label>
<div class="mws-form-item clearfix">
<ul class="mws-form-list inline">
<?php
foreach (Patient::Gender() as $key => $value) {
echo ' <li><input type="radio" name="gender" value="' . $key . '" id="' . $value . '"> <label for="' . $value . '">' . $value . '</label></li>';
}
?>
</ul>
</div>
</div>
<div class="form-group" id="PatientId">
<label class="mws-form-label">PT's ID</label>
<input type='text' placeholder='Patient Id' maxlength="14" name='pt_id' class="form-control PatientId"/>
<span class="glyphicon glyphicon-ok form-control-feedback c_done" aria-hidden="true"></span>
<span class="glyphicon glyphicon-remove form-control-feedback error" aria-hidden="true"></span>
</div>
<div class="form-group">
<label class="mws-form-label">Occupation</label>
<input type='text' placeholder='Occupation' name='occupation' class="form-control"/>
?>
" readonly/>
</div>
<div class="form-group">
<label class="mws-form-label">age</label>
<input type='text' placeholder='Age' name='age' class="form-control" value="<?php
echo $patient->age;
?>
" readonly />
</div>
<div class="form-group">
<label class="mws-form-label">Gender</label>
<div class="mws-form-item clearfix">
<ul class="mws-form-list inline">
<?php
echo '<li><input type="radio" name="gender" checked> <label>' . Patient::Gender()[$patient->gender] . '</label></li>';
?>
</ul>
</div>
</div>
<div class="form-group" id="PatientId">
<label class="mws-form-label">PT's ID</label>
<input type='text' placeholder='Patient Id' maxlength="14" name='pt_id' class="form-control PatientId" value="<?php
echo $patient->pt_id;
?>
" readonly/>
</div>
<div class="form-group">
<label class="mws-form-label">Occupation</label>
<input type='text' placeholder='Occupation' name='occupation' class="form-control" value="<?php
echo $patient->occupation;