form_status >=5) { ?>

progress != null) { ?>
0%
form_status >=5){ if(!isset($_SESSION['editRef_stat'])){ $tab1 = 'active'; $tab2 = ''; $tab3 = ''; $tab4 = ''; $tab5 = ''; $tabPane1 = 'active in show'; $tabPane2 = ''; $tabPane3 = ''; $tabPane5 = ''; $tabPane6 = ''; } if(isset($_SESSION['editRef_stat']) && $_SESSION['editRef_stat']=='step1'){ $tab1 = ''; $tab2 = 'active'; $tab3 = ''; $tab4 = ''; $tab5 = ''; $tabPane1 = ''; $tabPane2 = 'active in show'; $tabPane3 = ''; $tabPane5 = ''; $tabPane6 = ''; } if(isset($_SESSION['editRef_stat']) && $_SESSION['editRef_stat']=='step2'){ $tab1 = ''; $tab2 = ''; $tab3 = 'active'; $tab4 = ''; $tab5 = ''; $tabPane1 = ''; $tabPane2 = ''; $tabPane3 = 'active in show'; $tabPane4 = ''; $tabPane5 = ''; } if(isset($_SESSION['editRef_stat']) && $_SESSION['editRef_stat']=='step'){ $tab1 = ''; $tab2 = ''; $tab3 = ''; $tab4 = 'active'; $tab5 = ''; $tabPane1 = ''; $tabPane2 = ''; $tabPane3 = ''; $tabPane4 = 'active in show'; $tabPane5 = ''; } if(isset($_SESSION['editRef_stat']) && $_SESSION['editRef_stat']=='step4'){ $tab1 = ''; $tab2 = ''; $tab3 = ''; $tab4 = ''; $tab5 = 'active'; $tabPane1 = ''; $tabPane2 = ''; $tabPane3 = ''; $tabPane4 = ''; $tabPane5 = 'active in show'; } } else{ if(!isset($pdata->form_status)){ $tab1 = 'active'; $tab2 = 'disabled'; $tab3 = 'disabled'; $tab4 = 'disabled'; $tab5 = 'disabled'; $tabPane1 = 'active in show'; $tabPane2 = ''; $tabPane3 = ''; $tabPane4 = ''; $tabPane5 = ''; } if(isset($pdata->form_status) && $pdata->form_status=='0'){ $tab1 = 'active'; $tab2 = 'disabled'; $tab3 = 'disabled'; $tab4 = 'disabled'; $tab5 = 'disabled'; $tabPane1 = 'active in show'; $tabPane2 = ''; $tabPane3 = ''; $tabPane4 = ''; $tabPane5 = ''; } if(isset($pdata->form_status) && $pdata->form_status=='1'){ $tab1 = ''; $tab2 = 'active'; $tab3 = ''; $tab4 = ''; $tab5 = ''; $tabPane1 = ''; $tabPane2 = 'active in show'; $tabPane3 = ''; $tabPane4 = ''; $tabPane5 = ''; } if(isset($pdata->form_status) && $pdata->form_status=='2'){ $tab1 = ''; $tab2 = ''; $tab3 = 'active'; $tab4 = ''; $tab5 = ''; $tabPane1 = ''; $tabPane2 = ''; $tabPane3 = 'active in show'; $tabPane4 = ''; $tabPane5 = ''; } if(isset($pdata->form_status) && $pdata->form_status=='3'){ $tab1 = ''; $tab2 = ''; $tab3 = ''; $tab4 = 'active'; $tab5 = ''; $tabPane1 = ''; $tabPane2 = ''; $tabPane3 = ''; $tabPane4 = 'active in show'; $tabPane5 = ''; } if(isset($pdata->form_status) && $pdata->form_status=='4'){ $tab1 = ''; $tab2 = ''; $tab3 = ''; $tab4 = ''; $tab5 = 'active'; $tabPane1 = ''; $tabPane2 = ''; $tabPane3 = ''; $tabPane4 = ''; $tabPane5 = 'active in show'; } if(isset($pdata->form_status) && $pdata->form_status>='5'){ $tab1 = 'active'; $tab2 = ''; $tab3 = ''; $tab4 = ''; $tab5 = ''; $tabPane1 = 'active in show'; $tabPane2 = ''; $tabPane3 = ''; $tabPane4 = ''; $tabPane5 = ''; } } $tabStat = json_decode($pdata->from_tab_status); ?> main_id!="") { ?>
form_status<1) { ?>
form_status >=1){echo "readonly";}?>>
*
gender == 'Male')?'checked':'' ; ?> required>
gender == 'Female')?'checked':'' ; ?> required>
gender == 'Others')?'checked':'' ; ?> required>
primary_language); ?>
*
height); $Htf = $HtFI[0]; $Hti = $HtFI[1]; ?>
Feet
inch
weight; ?>>
height); $Htf = $HtFI[0]; $Hti = $HtFI[1]; ?>
address); // echo "
"; print_r($pAdata);
                          ?>
alt_address); ?>

Advance Directive

AdvDirective == 'YES')?'checked':'' ; ?>>
AdvDirective == 'NO')?'checked':'' ; ?>>

Emergency contact

emgContactAddress); ?>
emgContactLiveswithPatient == 'YES')?'checked':'' ; ?>>
emgContactLiveswithPatient == 'NO')?'checked':'' ; ?>>
emgContactAccessToHome == 'Have keys')?'checked':'' ; ?> >
emgContactAccessToHome == 'Access to home')?'checked':'' ; ?> >

Designate Other

patient_auth_stat == '1')?'checked' : ''; ?>>
originalfilename?>

remarks?>

Delete
type_access); // var_dump($dbData); ?>
type_access); // var_dump($dbData); ?>

Payer Type

NPI
">
patient_auth_stat == '1'){ $required="required-field"; } ?>
patient_auth_stat == '1'){ echo 'required'; }?> >
[]">
_remarks[]">