<%@ include file="/includes.jsp"%>
<%@ taglib prefix="smvc" uri="http://www.springframework.org/tags/form"%>
<%@ taglib prefix="spring" uri="http://www.springframework.org/tags"%>
<%@ include file="styles.css"%>

<tiles:importAttribute />
<c:set var="readOnly" value="false"/>
<c:if test="${consultationNoteForm.view.note.locked eq true}">
	<c:set var="readOnly" value="true"/>
</c:if>
<webapp:namedList id="nl_List1to3" domain="EMDT" name="List1to3" nlFromFormDefinition="${namedListMap['EMDT']['List1to3']}"/>
<webapp:namedList id="nl_LeftorRight" domain="EMDT" name="LeftorRight" nlFromFormDefinition="${namedListMap['EMDT']['LeftorRight']}" />
<webapp:namedList id="nl_List0to5" domain="EMDT" name="List0to5"  nlFromFormDefinition="${namedListMap['EMDT']['List0to5']}"/> 
<div class="container">

	<input type="hidden" value="false" id="unsaveButtonId" />
			
		<div class="sectionSubPageTop">

		<table width="100%">
			<tr>
				<td width="50%">

					<div class="fieldSetLeftColumn">
						<span class="inputLabel">Presented by</span>
					</div>
					<div class="fieldSetRightColumn">
						<span class="inputControl">
						<webapp:namedListSpring path='value[PresentedBy]'  id="PresentedBy" disabled="${readOnly}" domain="EMDT" name="SpireEd Surgeons"
							currentValue="${consultationNoteForm.value['PresentedBy']}" nlFromFormDefinition="${namedListMap['EMDT']['SpireEd Surgeons']}"/>
						</span>
					</div>
				</td>
				<td></td>
			</tr>
		</table>


		<h2>Clinical Presentation 1</h2>


			<table>
				<tr>
					<td width="50%">
					<div class="fieldSetLeftColumn">
							<span class="inputLabel">SIDE</span>
						</div>
						<div class="fieldSetRightColumn">
			
							<span class="inputControl">
							<c:forEach var="pair" items="${nl_LeftorRight.pairIterator}" varStatus="radioCount">
									<smvc:checkbox disabled="false" path='multiValue[Side]' value="${pair.first}" id="Side${radioCount.count}" />&nbsp;<c:out value="${pair.second}"/>&nbsp;
					<%-- can put a <br/> here to make list vertical --%>
								</c:forEach>			
							</span>
						</div>
							
							
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Size (mm)</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[Size]" size="5" id="Size" /></span>
						</div>
						
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Clin C</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[ClinC]" size="10" id="ClinC" /></span>
						</div>
						


						<div class="fieldSetLeftColumn">
							<span class="inputLabel">FNA</span>
						</div>
						<div class="fieldSetRightColumn">
			
							<span class="inputControl">
							<c:forEach var="pair" items="${nl_List0to5.pairIterator}" varStatus="radioCount">
									<smvc:radiobutton disabled="false" path='multiValue[FNA]'  value="${pair.first}" id="FNA${radioCount.count}" />&nbsp;<c:out value="${pair.second}"/><c:out value="${pair.second}"/>&nbsp;
					<%-- can put a <br/> here to make list vertical --%>
								</c:forEach>
			
							</span>
						</div>




							
							
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Tumour Type</span>
						</div>
						
						<div class="fieldSetRightColumn">			
							<span class="inputControl"> <smvc:textarea path="value[TumourType]" cols="20" rows="3" id="TumourType" /></span>
						</div>


						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Grade</span>
						</div>
						<div class="fieldSetRightColumn">
			
							<span class="inputControl"> 
							<c:forEach var="pair" items="${nl_List1to3.pairIterator}" varStatus="radioCount">
									<smvc:radiobutton disabled="false" path='multiValue[Grade]'  value="${pair.first}" id="Grade${radioCount.count}" />&nbsp;<c:out value="${pair.second}"/><c:out value="${pair.second}"/>&nbsp;
					<%-- can put a <br/> here to make list vertical --%>
								</c:forEach>
			
							</span>
						</div>
			
					</td>
					
					<td width="50%">
					
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">SITE</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[Site]" size="30" id="Site" /></span>
						</div>
						
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Mamm: R</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[MammR]" size="20" id="MammR" /></span>
						</div>
						
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">USS: U</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[USSU]" size="20" id="USSU" /></span>
						</div>
						
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">DCIS</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[DCIS]" size="30" id="DCIS" /></span>
						</div>
						
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">ER</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[ER]" size="20" id="ER" /></span>
						</div>
						
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">PR</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[PR]" size="20" id="PR" /></span>
						</div>
						
					
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Her2</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[HER2]" size="20" id="HER2" /></span>
						</div>
											
					</td>
					
				</tr>			
			</table>

	</div>
	
	
	
	
	<div class="sectionSubPageTop">

			<h2>Clinical Presentation 2</h2>

			<table>
				<tr>
					<td width="50%">
					<div class="fieldSetLeftColumn">
							<span class="inputLabel">SIDE</span>
						</div>
						<div class="fieldSetRightColumn">
			
							<span class="inputControl">
							<c:forEach var="pair" items="${nl_LeftorRight.pairIterator}" varStatus="radioCount">
									<smvc:checkbox disabled="false" path='multiValue[Side2]'  value="${pair.first}" id="Side2${radioCount.count}" />&nbsp;<c:out value="${pair.second}"/><c:out value="${pair.second}"/>&nbsp;
					<%-- can put a <br/> here to make list vertical --%>
								</c:forEach>			
							</span>
						</div>
							
							
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Size (mm)</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[Size2]" size="5" id="Size2" /></span>
						</div>
						
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Clin C</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[ClinC2]" size="10" id="ClinC2" /></span>
						</div>
						


						<div class="fieldSetLeftColumn">
							<span class="inputLabel">FNA</span>
						</div>
						<div class="fieldSetRightColumn">
			
							<span class="inputControl">
							<c:forEach var="pair" items="${nl_List0to5.pairIterator}" varStatus="radioCount">
									<smvc:radiobutton disabled="false" path='multiValue[FNA2]'  value="${pair.first}" id="FNA2${radioCount.count}" />&nbsp;<c:out value="${pair.second}"/><c:out value="${pair.second}"/>&nbsp;
					<%-- can put a <br/> here to make list vertical --%>
								</c:forEach>
			
							</span>
						</div>




							
							
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Tumour Type</span>
						</div>
						
						<div class="fieldSetRightColumn">			
							<span class="inputControl"> <smvc:textarea path="value[TumourType2]" cols="20" rows="3" id="TumourType2" /></span>
						</div>


						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Grade</span>
						</div>
						<div class="fieldSetRightColumn">
			
							<span class="inputControl">
							<c:forEach var="pair" items="${nl_List1to3.pairIterator}" varStatus="radioCount">
									<smvc:radiobutton disabled="false" path='multiValue[Grade2]'  value="${pair.first}" id="Grade2${radioCount.count}" />&nbsp;<c:out value="${pair.second}"/><c:out value="${pair.second}"/>&nbsp;
					<%-- can put a <br/> here to make list vertical --%>
								</c:forEach>
			
							</span>
						</div>
			
					</td>
					
					<td width="50%">
					
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">SITE</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[Site2]" size="30" id="Site2" /></span>
						</div>
						
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Mamm: R</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[MammR2]" size="20" id="MammR2" /></span>
						</div>
						
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">USS: U</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[USSU2]" size="20" id="USSU2" /></span>
						</div>
						
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">DCIS</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[DCIS2]" size="30" id="DCIS2" /></span>
						</div>
						
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">ER</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[ER2]" size="20" id="ER2" /></span>
						</div>
						
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">PR</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[PR2]" size="20" id="PR2" /></span>
						</div>
						
					
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Her2</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[HER22]" size="20" id="HER22" /></span>
						</div>
											
					</td>
					
				</tr>			
			</table>

	</div>
	
	
	
	
	
		<div class="sectionSubPageTop">

			<h2>Clinical Presentation 3</h2>

			<table>
				<tr>
					<td width="50%">
					<div class="fieldSetLeftColumn">
							<span class="inputLabel">SIDE</span>
						</div>
						<div class="fieldSetRightColumn">
			
							<span class="inputControl"> 
							<c:forEach var="pair" items="${nl_LeftorRight.pairIterator}" varStatus="checkboxCount">
									<smvc:checkbox disabled="false" path='multiValue[Side3]'  value="${pair.first}" id="Side3${checkboxCount.count}" />&nbsp;<c:out value="${pair.second}"/><c:out value="${pair.second}"/>&nbsp;
					<%-- can put a <br/> here to make list vertical --%>
								</c:forEach>			
							</span>
						</div>
							
							
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Size (mm)</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[Size3]" size="5" id="Size3" /></span>
						</div>
						
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Clin C</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[ClinC3]" size="10" id="ClinC3" /></span>
						</div>
						


						<div class="fieldSetLeftColumn">
							<span class="inputLabel">FNA</span>
						</div>
						<div class="fieldSetRightColumn">
			
							<span class="inputControl"> 
							<c:forEach var="pair" items="${nl_List0to5.pairIterator}" varStatus="radioCount">
									<smvc:radiobutton disabled="false" path='multiValue[FNA3]'  value="${pair.first}" id="FNA3${radioCount.count}" />&nbsp;<c:out value="${pair.second}"/><c:out value="${pair.second}"/>&nbsp;
					<%-- can put a <br/> here to make list vertical --%>
								</c:forEach>
			
							</span>
						</div>




							
							
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Tumour Type</span>
						</div>
						
						<div class="fieldSetRightColumn">			
							<span class="inputControl"> <smvc:textarea path="value[TumourType3]" cols="20" rows="3" id="TumourType3" /></span>
						</div>


						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Grade</span>
						</div>
						<div class="fieldSetRightColumn">
			
							<span class="inputControl"> 
							<c:forEach var="pair" items="${nl_List1to3.pairIterator}" varStatus="radioCount">
									<smvc:radiobutton disabled="false" path='multiValue[Grade3]'  value="${pair.first}" id="Grade3${radioCount.count}" />&nbsp;<c:out value="${pair.second}"/><c:out value="${pair.second}"/>&nbsp;
					<%-- can put a <br/> here to make list vertical --%>
								</c:forEach>
			
							</span>
						</div>
			
					</td>
					
					<td width="50%">
					
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">SITE</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[Site3]" size="30" id="Site3" /></span>
						</div>
						
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Mamm: R</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[MammR3]" size="20" id="MammR3" /></span>
						</div>
						
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">USS: U</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[USSU3]" size="20" id="USSU3" /></span>
						</div>
						
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">DCIS</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[DCIS3]" size="30" id="DCIS3" /></span>
						</div>
						
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">ER</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[ER3]" size="20" id="ER3" /></span>
						</div>
						
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">PR</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[PR3]" size="20" id="PR3" /></span>
						</div>
						
					
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Her2</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[HER23]" size="20" id="HER23" /></span>
						</div>
											
					</td>
					
				</tr>			
			</table>

	</div>
	
	
	
		<div class="sectionSubPageTop">

			<h2>Investigation</h2>

			<table>
				<tr>
					<td width="50%">
							
							
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Biochemistry</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[Biochemistry]" size="40" id="Biochemistry" /></span>
						</div>


						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Liver USS</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[LiverUSS]" size="40" id="LiverUSS" /></span>
						</div>
						
						
					</td>
					<td width="50%">
							
							
						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Haematology</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[Haematology]" size="40" id="Haematology" /></span>
						</div>

						<div class="fieldSetLeftColumn">
							<span class="inputLabel">Chest X-ray</span>
						</div>
						<div class="fieldSetRightColumn">
							<span class="inputControl"><smvc:input path="value[ChestXRay]" size="40" id="ChestXRay" /></span>
						</div>
						
						
					</td>
				</tr>
						
		</table>
		
		
		
			<div class="fieldSet2Column">
				<span class="inputLabelAbove">CT C/A/P</span>
			</div>
			<div class="fieldSet2Column">
				<span class="inputControlWide"><smvc:textarea path="value[CTCAP]" cols="100" rows="5" id="CTCAP" /></span>
			</div>


			<div class="fieldSet2Column">
				<span class="inputLabelAbove">MRI</span>
			</div>
			<div class="fieldSet2Column">
				<span class="inputControlWide"><smvc:textarea path="value[MRI]" cols="100" rows="5" id="MRI" /></span>
			</div>


			<div class="fieldSet2Column">
				<span class="inputLabelAbove">Bone Scan</span>
			</div>
			<div class="fieldSet2Column">
				<span class="inputControlWide"><smvc:textarea path="value[BoneScan]" cols="100" rows="5" id="BoneScan" /></span>
			</div>
		
		
		<div class="fieldSetLeftColumn">Attach File</div>

		<div class="fieldSetRightColumn">
			<span class="inputLabel1"> <tiles:insertTemplate template="/emdt/tiles/fileContent.jsp">
					<tiles:putAttribute name="fieldName" value="InvestigationAttachedFile" />
					<tiles:putAttribute name="fieldWidth" value="0" />
					<tiles:putAttribute name="parentPage" value="standard" />
					<tiles:putAttribute name="disabled" value="false" />
				</tiles:insertTemplate>
			</span>
		</div>

	</div>




</div>

<br/>