{"id":733,"date":"2026-01-29T22:18:17","date_gmt":"2026-01-29T19:18:17","guid":{"rendered":"https:\/\/sandbox.kazikasi.digital\/utulivu\/?page_id=733"},"modified":"2026-01-30T08:19:48","modified_gmt":"2026-01-30T05:19:48","slug":"edit-lab-test","status":"publish","type":"page","link":"https:\/\/sandbox.kazikasi.digital\/utulivu\/edit-lab-test\/","title":{"rendered":"Create Lab Test"},"content":{"rendered":"<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform-theme gform-theme--foundation gform-theme--framework gform-theme--orbital' data-form-theme='orbital' data-form-index='0' id='gform_wrapper_15' style='display:none'><style>#gform_wrapper_15[data-form-index=\"0\"].gform-theme,[data-parent-form=\"15_0\"]{--gf-color-primary: #204ce5;--gf-color-primary-rgb: 32, 76, 229;--gf-color-primary-contrast: #fff;--gf-color-primary-contrast-rgb: 255, 255, 255;--gf-color-primary-darker: #001AB3;--gf-color-primary-lighter: #527EFF;--gf-color-secondary: #fff;--gf-color-secondary-rgb: 255, 255, 255;--gf-color-secondary-contrast: #112337;--gf-color-secondary-contrast-rgb: 17, 35, 55;--gf-color-secondary-darker: #F5F5F5;--gf-color-secondary-lighter: #FFFFFF;--gf-color-out-ctrl-light: rgba(17, 35, 55, 0.1);--gf-color-out-ctrl-light-rgb: 17, 35, 55;--gf-color-out-ctrl-light-darker: rgba(104, 110, 119, 0.35);--gf-color-out-ctrl-light-lighter: #F5F5F5;--gf-color-out-ctrl-dark: #585e6a;--gf-color-out-ctrl-dark-rgb: 88, 94, 106;--gf-color-out-ctrl-dark-darker: #112337;--gf-color-out-ctrl-dark-lighter: rgba(17, 35, 55, 0.65);--gf-color-in-ctrl: #fff;--gf-color-in-ctrl-rgb: 255, 255, 255;--gf-color-in-ctrl-contrast: #112337;--gf-color-in-ctrl-contrast-rgb: 17, 35, 55;--gf-color-in-ctrl-darker: #F5F5F5;--gf-color-in-ctrl-lighter: #FFFFFF;--gf-color-in-ctrl-primary: #204ce5;--gf-color-in-ctrl-primary-rgb: 32, 76, 229;--gf-color-in-ctrl-primary-contrast: #fff;--gf-color-in-ctrl-primary-contrast-rgb: 255, 255, 255;--gf-color-in-ctrl-primary-darker: #001AB3;--gf-color-in-ctrl-primary-lighter: #527EFF;--gf-color-in-ctrl-light: rgba(17, 35, 55, 0.1);--gf-color-in-ctrl-light-rgb: 17, 35, 55;--gf-color-in-ctrl-light-darker: rgba(104, 110, 119, 0.35);--gf-color-in-ctrl-light-lighter: #F5F5F5;--gf-color-in-ctrl-dark: #585e6a;--gf-color-in-ctrl-dark-rgb: 88, 94, 106;--gf-color-in-ctrl-dark-darker: #112337;--gf-color-in-ctrl-dark-lighter: rgba(17, 35, 55, 0.65);--gf-radius: 3px;--gf-font-size-secondary: 14px;--gf-font-size-tertiary: 13px;--gf-icon-ctrl-number: url(\"data:image\/svg+xml,%3Csvg width='8' height='14' viewBox='0 0 8 14' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M4 0C4.26522 5.96046e-08 4.51957 0.105357 4.70711 0.292893L7.70711 3.29289C8.09763 3.68342 8.09763 4.31658 7.70711 4.70711C7.31658 5.09763 6.68342 5.09763 6.29289 4.70711L4 2.41421L1.70711 4.70711C1.31658 5.09763 0.683417 5.09763 0.292893 4.70711C-0.0976311 4.31658 -0.097631 3.68342 0.292893 3.29289L3.29289 0.292893C3.48043 0.105357 3.73478 0 4 0ZM0.292893 9.29289C0.683417 8.90237 1.31658 8.90237 1.70711 9.29289L4 11.5858L6.29289 9.29289C6.68342 8.90237 7.31658 8.90237 7.70711 9.29289C8.09763 9.68342 8.09763 10.3166 7.70711 10.7071L4.70711 13.7071C4.31658 14.0976 3.68342 14.0976 3.29289 13.7071L0.292893 10.7071C-0.0976311 10.3166 -0.0976311 9.68342 0.292893 9.29289Z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-icon-ctrl-select: url(\"data:image\/svg+xml,%3Csvg width='10' height='6' viewBox='0 0 10 6' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M0.292893 0.292893C0.683417 -0.097631 1.31658 -0.097631 1.70711 0.292893L5 3.58579L8.29289 0.292893C8.68342 -0.0976311 9.31658 -0.0976311 9.70711 0.292893C10.0976 0.683417 10.0976 1.31658 9.70711 1.70711L5.70711 5.70711C5.31658 6.09763 4.68342 6.09763 4.29289 5.70711L0.292893 1.70711C-0.0976311 1.31658 -0.0976311 0.683418 0.292893 0.292893Z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-icon-ctrl-search: url(\"data:image\/svg+xml,%3Csvg width='640' height='640' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath d='M256 128c-70.692 0-128 57.308-128 128 0 70.691 57.308 128 128 128 70.691 0 128-57.309 128-128 0-70.692-57.309-128-128-128zM64 256c0-106.039 85.961-192 192-192s192 85.961 192 192c0 41.466-13.146 79.863-35.498 111.248l154.125 154.125c12.496 12.496 12.496 32.758 0 45.254s-32.758 12.496-45.254 0L367.248 412.502C335.862 434.854 297.467 448 256 448c-106.039 0-192-85.962-192-192z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-label-space-y-secondary: var(--gf-label-space-y-md-secondary);--gf-ctrl-border-color: #686e77;--gf-ctrl-size: var(--gf-ctrl-size-md);--gf-ctrl-label-color-primary: #112337;--gf-ctrl-label-color-secondary: #112337;--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-md);--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-md);--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-md);--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-md);--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-md);--gf-ctrl-btn-border-color-secondary: #686e77;--gf-ctrl-file-btn-bg-color-hover: #EBEBEB;--gf-field-img-choice-size: var(--gf-field-img-choice-size-md);--gf-field-img-choice-card-space: var(--gf-field-img-choice-card-space-md);--gf-field-img-choice-check-ind-size: var(--gf-field-img-choice-check-ind-size-md);--gf-field-img-choice-check-ind-icon-size: var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style><form method='post' enctype='multipart\/form-data'  id='gform_15'  action='\/utulivu\/wp-json\/wp\/v2\/pages\/733' data-formid='15' novalidate><input id=\"gpnf_session_hash_15\" type=\"hidden\" name=\"gpnf_session_hash\" value=\"701c05639a20\">\n                        <div class='gform-body gform_body'><div id='gform_fields_15' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_15_125\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_15_125'>Select Patient<\/label><div class='ginput_container ginput_container_select'><select name='input_125' id='input_15_125' class='large gfield_select'     aria-invalid=\"false\" ><option value='931' selected='selected'>Oyier Owiye #REG000473<\/option><option value='933' >Yolanda Masinde #REG000474<\/option><option value='1046' >Ahmed Msita #REG000630<\/option><option value='960' >Hefziba Amba #REG000494<\/option><option value='963' >Hamilton Ogunda #REG000509<\/option><option value='968' >Ayabonga Mxotwe #REG000549<\/option><option value='972' >Mlemba Mtalitinya #REG000560<\/option><option value='978' >Editha Joseph #REG000579<\/option><option value='982' >Husseni Athumani #REG000590<\/option><option value='1012' >Felister McDonald #REG000595<\/option><option value='1014' >Grender McDonald #REG000597<\/option><option value='1019' >Grender McDonald #REG000602<\/option><option value='1032' >Amba Oyugi #REG000624<\/option><\/select><\/div><\/div><div id=\"field_15_59\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_15_59'>Patient File ID<\/label><div class='ginput_container ginput_container_text'><input readonly='readonly' name='input_59' id='input_15_59' type='text' value='931' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_15_57\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_15_57'>Lab Tech on Duty<\/label><div class='ginput_container ginput_container_select'><select disabled='disabled' name='input_57' id='input_15_57' class='large gfield_select'     aria-invalid=\"false\" ><option value='39' selected='selected'>Demo Labtech<\/option><option value='40' >Demo Procedure<\/option><option value='5' >Labani Shabani<\/option><\/select><input type=\"hidden\" id=\"gwro_hidden_capture_15_57\" name=\"gwro_hidden_capture_15_57\" value=\"39\" class=\"gf-default-disabled\" \/><\/div><\/div><div id=\"field_15_124\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_15_124'>Type<\/label><div class='ginput_container ginput_container_text'><input readonly='readonly' name='input_124' id='input_15_124' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_15_105\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_15_105'>Name of Patient<\/label><div class='ginput_container ginput_container_text'><input readonly='readonly' name='input_105' id='input_15_105' type='text' value='Oyier Owiye' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_15_58\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_15_58'>Patient File Number<\/label><div class='ginput_container ginput_container_text'><input readonly='readonly' name='input_58' id='input_15_58' type='text' value='REG000473' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_15_106\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_15_106'>Summary of Lab\/Procedure Requests<\/label><div class='ginput_container ginput_container_textarea'><div id=\"wp-input_15_106-wrap\" class=\"wp-core-ui wp-editor-wrap tmce-active\"><link rel='stylesheet' id='dashicons-css' href='https:\/\/sandbox.kazikasi.digital\/utulivu\/wp-includes\/css\/dashicons.min.css?ver=7.0' media='all' \/>\n<link rel='stylesheet' id='editor-buttons-css' href='https:\/\/sandbox.kazikasi.digital\/utulivu\/wp-includes\/css\/editor.min.css?ver=7.0' media='all' \/>\n<div id=\"wp-input_15_106-editor-container\" class=\"wp-editor-container\"><textarea readonly='readonly' class=\"small wp-editor-area\" style=\"height: 110px\" autocomplete=\"off\" cols=\"40\" name=\"input_106\" id=\"input_15_106\">Recommendation 1: Rheumatoid factor, Laboratory Test: check for strangeness\nRecommendation 2: Blood grouping, Laboratory Test Check the blood group<\/textarea><\/div>\n<\/div>\n\n<\/div><\/div><div id=\"field_15_74\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_15_74'>Select Test 1<\/label><div class='ginput_container ginput_container_select'><select name='input_74' id='input_15_74' class='large gfield_select'     aria-invalid=\"false\" ><option value='1093' selected='selected'>AMOXYLINE CAPSULE<\/option><option value='1094' >AMPICLOX CAPSULES<\/option><option value='1095' >AMPICLOX SYRUP 100mls<\/option><option value='1096' >ARTEFAN 20\/120<\/option><option value='1097' >AZUMA 500mg<\/option><option value='1098' >PIROXICAM TAB<\/option><option value='1099' >CAPTOPRIL TABS<\/option><option value='1100' >CEFALEXINE CAPSULES 250mg<\/option><option value='1101' >CEFALEXINE SYRUP 100mls<\/option><option value='1102' >CEFTRIAXONE IV<\/option><option value='1103' >CETRIZINE TABS<\/option><option value='1104' >CIPRO TABS 500mg<\/option><option value='1105' >DICLOFENAC IV<\/option><option value='1106' >DOXY CAPS<\/option><option value='1107' >FERROLIC TABS<\/option><option value='1108' >FOLIC ACID 5mg<\/option><option value='1109' >HYDROCOTISONE INJ<\/option><option value='1110' >INFUSSION DNS 500mls<\/option><option value='1111' >INFUSSION LR 500mls<\/option><option value='1112' >INFUSSION NS 500mls<\/option><option value='1113' >SKIN DERM CREAM<\/option><option value='1114' >IV ARTESUNATE 60mg<\/option><option value='1115' >IV PANTOPRAZOLE 40mg<\/option><option value='1116' >LORATADINE 10mg TABS<\/option><option value='1117' >LOSARTAN H TABS<\/option><option value='1118' >METRONIDAZOLE GEL<\/option><option value='1119' >METRONIDAZOLE SYRUP 100mls<\/option><option value='1120' >METRONIDAZOLE TABS<\/option><option value='1121' >METOCLOPRAMIDE INJ<\/option><option value='1122' >NIFEDIPINE TABS<\/option><option value='1123' >OMEPRAZOLE CAPS<\/option><option value='1124' >ORS<\/option><option value='1125' >PANTOPRAZOLE TABS 40mls<\/option><option value='1126' >PARACETAMOL TAB<\/option><option value='1127' >PARACETAMOL SYRUP 100mls<\/option><option value='1128' >RECEL GEL 100mls<\/option><option value='1129' >RECEL GEL SYRUP 180mls<\/option><option value='1130' >SUCRAFIL O GEL 100mls<\/option><option value='1131' >VITA CARE 200mls SUSPENSION<\/option><option value='1132' >CLOTRIMAZOLE CREAM<\/option><option value='1133' >MUPIROCIN CREAM<\/option><option value='1134' >VITAMIN B COMPLEX<\/option><option value='1135' >MULTIVITAMIN SYRUP<\/option><option value='1136' >BISACODLY<\/option><option value='1137' >IV CEFTRIAXON\/SALBACTUM<\/option><option value='1138' >WOODWARD SYRUP<\/option><option value='1139' >ALBENDAZOLE TAB<\/option><option value='1140' >MEBENDAZOLE<\/option><option value='1141' >VIVIAN TAB<\/option><option value='1142' >IBUPROFEN TAB<\/option><option value='1143' >MELOXICAM TAB<\/option><option value='1144' >TRAMADOL CAP<\/option><option value='1145' >PARACETAMOL INJ<\/option><option value='1146' >PREDINISOLONE TAB<\/option><option value='1147' >CETRIZEN TAB<\/option><option value='1148' >ALLUPRINOL TAB<\/option><option value='1149' >DOMPERIDONE TAB<\/option><option value='1150' >DICLOPER TAB<\/option><option value='1151' >BETROZOLE SYRUP<\/option><option value='1152' >COUPHY SYRUP<\/option><option value='1153' >ESOMEPRAZOLE<\/option><option value='1154' >GENTAMYCINE INJ<\/option><option value='1155' >SILDENAFIL CITRATE TAB<\/option><option value='1156' >AMOCLAV SYRUP<\/option><option value='1157' >CEFALEXIN SYRUP<\/option><option value='1158' >NASAL DROP<\/option><option value='1159' >NYSTATIN SYRUP<\/option><option value='1160' >AMOXYLINE SYRUP<\/option><option value='1161' >BBE<\/option><\/select><\/div><\/div><div id=\"field_15_113\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_15_113'>Cost 1<\/label><div class='ginput_container ginput_container_number'><input name='input_113' id='input_15_113' type='number' step='any'   value='3000' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_15_108\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_15_108'>Details 1<\/label><div class='ginput_container ginput_container_textarea'><div id=\"wp-input_15_108-wrap\" class=\"wp-core-ui wp-editor-wrap tmce-active\"><div id=\"wp-input_15_108-editor-container\" class=\"wp-editor-container\"><textarea class=\"medium wp-editor-area\" style=\"height: 180px\" autocomplete=\"off\" cols=\"40\" name=\"input_108\" id=\"input_15_108\"><\/textarea><\/div>\n<\/div>\n\n<\/div><\/div><fieldset id=\"field_15_79\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Add Test 2<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_15_79'><div class='gchoice gchoice_15_79_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_79.1' type='checkbox'  value='Click to Add'  id='choice_15_79_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_15_79_1' id='label_15_79_1' class='gform-field-label gform-field-label--type-inline'>Click to Add<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_15_80\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_15_80'>Select Test 2<\/label><div class='ginput_container ginput_container_select'><select name='input_80' id='input_15_80' class='large gfield_select'     aria-invalid=\"false\" ><option value='1093' selected='selected'>AMOXYLINE CAPSULE<\/option><option value='1094' >AMPICLOX CAPSULES<\/option><option value='1095' >AMPICLOX SYRUP 100mls<\/option><option value='1096' >ARTEFAN 20\/120<\/option><option value='1097' >AZUMA 500mg<\/option><option value='1098' >PIROXICAM TAB<\/option><option value='1099' >CAPTOPRIL TABS<\/option><option value='1100' >CEFALEXINE CAPSULES 250mg<\/option><option value='1101' >CEFALEXINE SYRUP 100mls<\/option><option value='1102' >CEFTRIAXONE IV<\/option><option value='1103' >CETRIZINE TABS<\/option><option value='1104' >CIPRO TABS 500mg<\/option><option value='1105' >DICLOFENAC IV<\/option><option value='1106' >DOXY CAPS<\/option><option value='1107' >FERROLIC TABS<\/option><option value='1108' >FOLIC ACID 5mg<\/option><option value='1109' >HYDROCOTISONE INJ<\/option><option value='1110' >INFUSSION DNS 500mls<\/option><option value='1111' >INFUSSION LR 500mls<\/option><option value='1112' >INFUSSION NS 500mls<\/option><option value='1113' >SKIN DERM CREAM<\/option><option value='1114' >IV ARTESUNATE 60mg<\/option><option value='1115' >IV PANTOPRAZOLE 40mg<\/option><option value='1116' >LORATADINE 10mg TABS<\/option><option value='1117' >LOSARTAN H TABS<\/option><option value='1118' >METRONIDAZOLE GEL<\/option><option value='1119' >METRONIDAZOLE SYRUP 100mls<\/option><option value='1120' >METRONIDAZOLE TABS<\/option><option value='1121' >METOCLOPRAMIDE INJ<\/option><option value='1122' >NIFEDIPINE TABS<\/option><option value='1123' >OMEPRAZOLE CAPS<\/option><option value='1124' >ORS<\/option><option value='1125' >PANTOPRAZOLE TABS 40mls<\/option><option value='1126' >PARACETAMOL TAB<\/option><option value='1127' >PARACETAMOL SYRUP 100mls<\/option><option value='1128' >RECEL GEL 100mls<\/option><option value='1129' >RECEL GEL SYRUP 180mls<\/option><option value='1130' >SUCRAFIL O GEL 100mls<\/option><option value='1131' >VITA CARE 200mls SUSPENSION<\/option><option value='1132' >CLOTRIMAZOLE CREAM<\/option><option value='1133' >MUPIROCIN CREAM<\/option><option value='1134' >VITAMIN B COMPLEX<\/option><option value='1135' >MULTIVITAMIN SYRUP<\/option><option value='1136' >BISACODLY<\/option><option value='1137' >IV CEFTRIAXON\/SALBACTUM<\/option><option value='1138' >WOODWARD SYRUP<\/option><option value='1139' >ALBENDAZOLE TAB<\/option><option value='1140' >MEBENDAZOLE<\/option><option value='1141' >VIVIAN TAB<\/option><option value='1142' >IBUPROFEN TAB<\/option><option value='1143' >MELOXICAM TAB<\/option><option value='1144' >TRAMADOL CAP<\/option><option value='1145' >PARACETAMOL INJ<\/option><option value='1146' >PREDINISOLONE TAB<\/option><option value='1147' >CETRIZEN TAB<\/option><option value='1148' >ALLUPRINOL TAB<\/option><option value='1149' >DOMPERIDONE TAB<\/option><option value='1150' >DICLOPER TAB<\/option><option value='1151' >BETROZOLE SYRUP<\/option><option value='1152' >COUPHY SYRUP<\/option><option value='1153' >ESOMEPRAZOLE<\/option><option value='1154' >GENTAMYCINE INJ<\/option><option value='1155' >SILDENAFIL CITRATE TAB<\/option><option value='1156' >AMOCLAV SYRUP<\/option><option value='1157' >CEFALEXIN SYRUP<\/option><option value='1158' >NASAL DROP<\/option><option value='1159' >NYSTATIN SYRUP<\/option><option value='1160' >AMOXYLINE SYRUP<\/option><option value='1161' >BBE<\/option><\/select><\/div><\/div><div id=\"field_15_114\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_15_114'>Cost 2<\/label><div class='ginput_container ginput_container_number'><input name='input_114' id='input_15_114' type='number' step='any'   value='3000' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_15_109\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_15_109'>Details 2<\/label><div class='ginput_container ginput_container_textarea'><div id=\"wp-input_15_109-wrap\" class=\"wp-core-ui wp-editor-wrap tmce-active\"><div id=\"wp-input_15_109-editor-container\" class=\"wp-editor-container\"><textarea class=\"medium wp-editor-area\" style=\"height: 180px\" autocomplete=\"off\" cols=\"40\" name=\"input_109\" id=\"input_15_109\"><\/textarea><\/div>\n<\/div>\n\n<\/div><\/div><fieldset id=\"field_15_83\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Add Test 3<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_15_83'><div class='gchoice gchoice_15_83_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_83.1' type='checkbox'  value='Click to Add'  id='choice_15_83_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_15_83_1' id='label_15_83_1' class='gform-field-label gform-field-label--type-inline'>Click to Add<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_15_84\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_15_84'>Select Test 3<\/label><div class='ginput_container ginput_container_select'><select name='input_84' id='input_15_84' class='large gfield_select'     aria-invalid=\"false\" ><option value='1093' selected='selected'>AMOXYLINE CAPSULE<\/option><option value='1094' >AMPICLOX CAPSULES<\/option><option value='1095' >AMPICLOX SYRUP 100mls<\/option><option value='1096' >ARTEFAN 20\/120<\/option><option value='1097' >AZUMA 500mg<\/option><option value='1098' >PIROXICAM TAB<\/option><option value='1099' >CAPTOPRIL TABS<\/option><option value='1100' >CEFALEXINE CAPSULES 250mg<\/option><option value='1101' >CEFALEXINE SYRUP 100mls<\/option><option value='1102' >CEFTRIAXONE IV<\/option><option value='1103' >CETRIZINE TABS<\/option><option value='1104' >CIPRO TABS 500mg<\/option><option value='1105' >DICLOFENAC IV<\/option><option value='1106' >DOXY CAPS<\/option><option value='1107' >FERROLIC TABS<\/option><option value='1108' >FOLIC ACID 5mg<\/option><option value='1109' >HYDROCOTISONE INJ<\/option><option value='1110' >INFUSSION DNS 500mls<\/option><option value='1111' >INFUSSION LR 500mls<\/option><option value='1112' >INFUSSION NS 500mls<\/option><option value='1113' >SKIN DERM CREAM<\/option><option value='1114' >IV ARTESUNATE 60mg<\/option><option value='1115' >IV PANTOPRAZOLE 40mg<\/option><option value='1116' >LORATADINE 10mg TABS<\/option><option value='1117' >LOSARTAN H TABS<\/option><option value='1118' >METRONIDAZOLE GEL<\/option><option value='1119' >METRONIDAZOLE SYRUP 100mls<\/option><option value='1120' >METRONIDAZOLE TABS<\/option><option value='1121' >METOCLOPRAMIDE INJ<\/option><option value='1122' >NIFEDIPINE TABS<\/option><option value='1123' >OMEPRAZOLE CAPS<\/option><option value='1124' >ORS<\/option><option value='1125' >PANTOPRAZOLE TABS 40mls<\/option><option value='1126' >PARACETAMOL TAB<\/option><option value='1127' >PARACETAMOL SYRUP 100mls<\/option><option value='1128' >RECEL GEL 100mls<\/option><option value='1129' >RECEL GEL SYRUP 180mls<\/option><option value='1130' >SUCRAFIL O GEL 100mls<\/option><option value='1131' >VITA CARE 200mls SUSPENSION<\/option><option value='1132' >CLOTRIMAZOLE CREAM<\/option><option value='1133' >MUPIROCIN CREAM<\/option><option value='1134' >VITAMIN B COMPLEX<\/option><option value='1135' >MULTIVITAMIN SYRUP<\/option><option value='1136' >BISACODLY<\/option><option value='1137' >IV CEFTRIAXON\/SALBACTUM<\/option><option value='1138' >WOODWARD SYRUP<\/option><option value='1139' >ALBENDAZOLE TAB<\/option><option value='1140' >MEBENDAZOLE<\/option><option value='1141' >VIVIAN TAB<\/option><option value='1142' >IBUPROFEN TAB<\/option><option value='1143' >MELOXICAM TAB<\/option><option value='1144' >TRAMADOL CAP<\/option><option value='1145' >PARACETAMOL INJ<\/option><option value='1146' >PREDINISOLONE TAB<\/option><option value='1147' >CETRIZEN TAB<\/option><option value='1148' >ALLUPRINOL TAB<\/option><option value='1149' >DOMPERIDONE TAB<\/option><option value='1150' >DICLOPER TAB<\/option><option value='1151' >BETROZOLE SYRUP<\/option><option value='1152' >COUPHY SYRUP<\/option><option value='1153' >ESOMEPRAZOLE<\/option><option value='1154' >GENTAMYCINE INJ<\/option><option value='1155' >SILDENAFIL CITRATE TAB<\/option><option value='1156' >AMOCLAV SYRUP<\/option><option value='1157' >CEFALEXIN SYRUP<\/option><option value='1158' >NASAL DROP<\/option><option value='1159' >NYSTATIN SYRUP<\/option><option value='1160' >AMOXYLINE SYRUP<\/option><option value='1161' >BBE<\/option><\/select><\/div><\/div><div id=\"field_15_115\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_15_115'>Cost 3<\/label><div class='ginput_container ginput_container_number'><input name='input_115' id='input_15_115' type='number' step='any'   value='3000' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_15_110\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_15_110'>Details 3<\/label><div class='ginput_container ginput_container_textarea'><div id=\"wp-input_15_110-wrap\" class=\"wp-core-ui wp-editor-wrap tmce-active\"><div id=\"wp-input_15_110-editor-container\" class=\"wp-editor-container\"><textarea class=\"medium wp-editor-area\" style=\"height: 180px\" autocomplete=\"off\" cols=\"40\" name=\"input_110\" id=\"input_15_110\"><\/textarea><\/div>\n<\/div>\n\n<\/div><\/div><fieldset id=\"field_15_87\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Add Test 4<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_15_87'><div class='gchoice gchoice_15_87_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_87.1' type='checkbox'  value='Click to Add'  id='choice_15_87_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_15_87_1' id='label_15_87_1' class='gform-field-label gform-field-label--type-inline'>Click to Add<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_15_88\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_15_88'>Select Test 4<\/label><div class='ginput_container ginput_container_select'><select name='input_88' id='input_15_88' class='large gfield_select'     aria-invalid=\"false\" ><option value='1093' selected='selected'>AMOXYLINE CAPSULE<\/option><option value='1094' >AMPICLOX CAPSULES<\/option><option value='1095' >AMPICLOX SYRUP 100mls<\/option><option value='1096' >ARTEFAN 20\/120<\/option><option value='1097' >AZUMA 500mg<\/option><option value='1098' >PIROXICAM TAB<\/option><option value='1099' >CAPTOPRIL TABS<\/option><option value='1100' >CEFALEXINE CAPSULES 250mg<\/option><option value='1101' >CEFALEXINE SYRUP 100mls<\/option><option value='1102' >CEFTRIAXONE IV<\/option><option value='1103' >CETRIZINE TABS<\/option><option value='1104' >CIPRO TABS 500mg<\/option><option value='1105' >DICLOFENAC IV<\/option><option value='1106' >DOXY CAPS<\/option><option value='1107' >FERROLIC TABS<\/option><option value='1108' >FOLIC ACID 5mg<\/option><option value='1109' >HYDROCOTISONE INJ<\/option><option value='1110' >INFUSSION DNS 500mls<\/option><option value='1111' >INFUSSION LR 500mls<\/option><option value='1112' >INFUSSION NS 500mls<\/option><option value='1113' >SKIN DERM CREAM<\/option><option value='1114' >IV ARTESUNATE 60mg<\/option><option value='1115' >IV PANTOPRAZOLE 40mg<\/option><option value='1116' >LORATADINE 10mg TABS<\/option><option value='1117' >LOSARTAN H TABS<\/option><option value='1118' >METRONIDAZOLE GEL<\/option><option value='1119' >METRONIDAZOLE SYRUP 100mls<\/option><option value='1120' >METRONIDAZOLE TABS<\/option><option value='1121' >METOCLOPRAMIDE INJ<\/option><option value='1122' >NIFEDIPINE TABS<\/option><option value='1123' >OMEPRAZOLE CAPS<\/option><option value='1124' >ORS<\/option><option value='1125' >PANTOPRAZOLE TABS 40mls<\/option><option value='1126' >PARACETAMOL TAB<\/option><option value='1127' >PARACETAMOL SYRUP 100mls<\/option><option value='1128' >RECEL GEL 100mls<\/option><option value='1129' >RECEL GEL SYRUP 180mls<\/option><option value='1130' >SUCRAFIL O GEL 100mls<\/option><option value='1131' >VITA CARE 200mls SUSPENSION<\/option><option value='1132' >CLOTRIMAZOLE CREAM<\/option><option value='1133' >MUPIROCIN CREAM<\/option><option value='1134' >VITAMIN B COMPLEX<\/option><option value='1135' >MULTIVITAMIN SYRUP<\/option><option value='1136' >BISACODLY<\/option><option value='1137' >IV CEFTRIAXON\/SALBACTUM<\/option><option value='1138' >WOODWARD SYRUP<\/option><option value='1139' >ALBENDAZOLE TAB<\/option><option value='1140' >MEBENDAZOLE<\/option><option value='1141' >VIVIAN TAB<\/option><option value='1142' >IBUPROFEN TAB<\/option><option value='1143' >MELOXICAM TAB<\/option><option value='1144' >TRAMADOL CAP<\/option><option value='1145' >PARACETAMOL INJ<\/option><option value='1146' >PREDINISOLONE TAB<\/option><option value='1147' >CETRIZEN TAB<\/option><option value='1148' >ALLUPRINOL TAB<\/option><option value='1149' >DOMPERIDONE TAB<\/option><option value='1150' >DICLOPER TAB<\/option><option value='1151' >BETROZOLE SYRUP<\/option><option value='1152' >COUPHY SYRUP<\/option><option value='1153' >ESOMEPRAZOLE<\/option><option value='1154' >GENTAMYCINE INJ<\/option><option value='1155' >SILDENAFIL CITRATE TAB<\/option><option value='1156' >AMOCLAV SYRUP<\/option><option value='1157' >CEFALEXIN SYRUP<\/option><option value='1158' >NASAL DROP<\/option><option value='1159' >NYSTATIN SYRUP<\/option><option value='1160' >AMOXYLINE SYRUP<\/option><option value='1161' >BBE<\/option><\/select><\/div><\/div><div id=\"field_15_116\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_15_116'>Cost 4<\/label><div class='ginput_container ginput_container_number'><input name='input_116' id='input_15_116' type='number' step='any'   value='3000' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_15_111\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_15_111'>Details 4<\/label><div class='ginput_container ginput_container_textarea'><div id=\"wp-input_15_111-wrap\" class=\"wp-core-ui wp-editor-wrap tmce-active\"><div id=\"wp-input_15_111-editor-container\" class=\"wp-editor-container\"><textarea class=\"medium wp-editor-area\" style=\"height: 180px\" autocomplete=\"off\" cols=\"40\" name=\"input_111\" id=\"input_15_111\"><\/textarea><\/div>\n<\/div>\n\n<\/div><\/div><fieldset id=\"field_15_91\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Add Test 5<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_15_91'><div class='gchoice gchoice_15_91_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_91.1' type='checkbox'  value='Click to Add'  id='choice_15_91_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_15_91_1' id='label_15_91_1' class='gform-field-label gform-field-label--type-inline'>Click to Add<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_15_92\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_15_92'>Select Test 5<\/label><div class='ginput_container ginput_container_select'><select name='input_92' id='input_15_92' class='large gfield_select'     aria-invalid=\"false\" ><option value='1093' selected='selected'>AMOXYLINE CAPSULE<\/option><option value='1094' >AMPICLOX CAPSULES<\/option><option value='1095' >AMPICLOX SYRUP 100mls<\/option><option value='1096' >ARTEFAN 20\/120<\/option><option value='1097' >AZUMA 500mg<\/option><option value='1098' >PIROXICAM TAB<\/option><option value='1099' >CAPTOPRIL TABS<\/option><option value='1100' >CEFALEXINE CAPSULES 250mg<\/option><option value='1101' >CEFALEXINE SYRUP 100mls<\/option><option value='1102' >CEFTRIAXONE IV<\/option><option value='1103' >CETRIZINE TABS<\/option><option value='1104' >CIPRO TABS 500mg<\/option><option value='1105' >DICLOFENAC IV<\/option><option value='1106' >DOXY CAPS<\/option><option value='1107' >FERROLIC TABS<\/option><option value='1108' >FOLIC ACID 5mg<\/option><option value='1109' >HYDROCOTISONE INJ<\/option><option value='1110' >INFUSSION DNS 500mls<\/option><option value='1111' >INFUSSION LR 500mls<\/option><option value='1112' >INFUSSION NS 500mls<\/option><option value='1113' >SKIN DERM CREAM<\/option><option value='1114' >IV ARTESUNATE 60mg<\/option><option value='1115' >IV PANTOPRAZOLE 40mg<\/option><option value='1116' >LORATADINE 10mg TABS<\/option><option value='1117' >LOSARTAN H TABS<\/option><option value='1118' >METRONIDAZOLE GEL<\/option><option value='1119' >METRONIDAZOLE SYRUP 100mls<\/option><option value='1120' >METRONIDAZOLE TABS<\/option><option value='1121' >METOCLOPRAMIDE INJ<\/option><option value='1122' >NIFEDIPINE TABS<\/option><option value='1123' >OMEPRAZOLE CAPS<\/option><option value='1124' >ORS<\/option><option value='1125' >PANTOPRAZOLE TABS 40mls<\/option><option value='1126' >PARACETAMOL TAB<\/option><option value='1127' >PARACETAMOL SYRUP 100mls<\/option><option value='1128' >RECEL GEL 100mls<\/option><option value='1129' >RECEL GEL SYRUP 180mls<\/option><option value='1130' >SUCRAFIL O GEL 100mls<\/option><option value='1131' >VITA CARE 200mls SUSPENSION<\/option><option value='1132' >CLOTRIMAZOLE CREAM<\/option><option value='1133' >MUPIROCIN CREAM<\/option><option value='1134' >VITAMIN B COMPLEX<\/option><option value='1135' >MULTIVITAMIN SYRUP<\/option><option value='1136' >BISACODLY<\/option><option value='1137' >IV CEFTRIAXON\/SALBACTUM<\/option><option value='1138' >WOODWARD SYRUP<\/option><option value='1139' >ALBENDAZOLE TAB<\/option><option value='1140' >MEBENDAZOLE<\/option><option value='1141' >VIVIAN TAB<\/option><option value='1142' >IBUPROFEN TAB<\/option><option value='1143' >MELOXICAM TAB<\/option><option value='1144' >TRAMADOL CAP<\/option><option value='1145' >PARACETAMOL INJ<\/option><option value='1146' >PREDINISOLONE TAB<\/option><option value='1147' >CETRIZEN TAB<\/option><option value='1148' >ALLUPRINOL TAB<\/option><option value='1149' >DOMPERIDONE TAB<\/option><option value='1150' >DICLOPER TAB<\/option><option value='1151' >BETROZOLE SYRUP<\/option><option value='1152' >COUPHY SYRUP<\/option><option value='1153' >ESOMEPRAZOLE<\/option><option value='1154' >GENTAMYCINE INJ<\/option><option value='1155' >SILDENAFIL CITRATE TAB<\/option><option value='1156' >AMOCLAV SYRUP<\/option><option value='1157' >CEFALEXIN SYRUP<\/option><option value='1158' >NASAL DROP<\/option><option value='1159' >NYSTATIN SYRUP<\/option><option value='1160' >AMOXYLINE SYRUP<\/option><option value='1161' >BBE<\/option><\/select><\/div><\/div><div id=\"field_15_117\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_15_117'>Cost 5<\/label><div class='ginput_container ginput_container_number'><input name='input_117' id='input_15_117' type='number' step='any'   value='3000' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_15_112\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_15_112'>Details 5<\/label><div class='ginput_container ginput_container_textarea'><div id=\"wp-input_15_112-wrap\" class=\"wp-core-ui wp-editor-wrap tmce-active\"><div id=\"wp-input_15_112-editor-container\" class=\"wp-editor-container\"><textarea class=\"medium wp-editor-area\" style=\"height: 180px\" autocomplete=\"off\" cols=\"40\" name=\"input_112\" id=\"input_15_112\"><\/textarea><\/div>\n<\/div>\n\n<\/div><\/div><div id=\"field_15_101\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_calculation field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_15_101'>Sub Total Tests(TZS)<\/label><div class='ginput_container ginput_container_number'><input name='input_101' id='input_15_101' type='text' step='any'   value='' class='large gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_15_107\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><legend class='gfield_label gform-field-label gfield_label_before_complex' >Add Test 6<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_15_107'><div class='gchoice gchoice_15_107_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_107.1' type='checkbox'  value='Click to Add'  id='choice_15_107_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_15_107_1' id='label_15_107_1' class='gform-field-label gform-field-label--type-inline'>Click to Add<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_15_118\" class=\"gfield gfield--type-form gfield--input-type-form gform-theme__no-reset--children gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_15_118'>Items_Used<\/label><div class=\"gpnf-nested-entries-container ginput_container\">\n\n\t<table class=\"gpnf-nested-entries\">\n\n\t\t<thead>\n\t\t<tr>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-row_id\">\n\t\t\t\t\tRow ID\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-1\">\n\t\t\t\t\tSelect Product\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-3\">\n\t\t\t\t\tStock Level\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-4\">\n\t\t\t\t\tStatus\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-5\">\n\t\t\t\t\tPrice\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-6\">\n\t\t\t\t\tQuantity\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-7\">\n\t\t\t\t\tSubtotal\t\t\t\t<\/th>\n\t\t\t\t\t\t<th class=\"gpnf-row-actions\"><span class=\"screen-reader-text\">Actions<\/span><\/th>\n\t\t<\/tr>\n\t\t<\/thead>\n\n\t\t<tbody data-bind=\"visible: entries().length, foreach: entries\">\n\t\t<tr data-bind=\"attr: { 'data-entryid': id }\">\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: frow_id.label, attr: { 'data-value': frow_id.label }\"\n\t\t\t\t\tdata-heading=\"Row ID\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f1.label, attr: { 'data-value': f1.label }\"\n\t\t\t\t\tdata-heading=\"Select Product\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f3.label, attr: { 'data-value': f3.label }\"\n\t\t\t\t\tdata-heading=\"Stock Level\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f4.label, attr: { 'data-value': f4.label }\"\n\t\t\t\t\tdata-heading=\"Status\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f5.label, attr: { 'data-value': f5.label }\"\n\t\t\t\t\tdata-heading=\"Price\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f6.label, attr: { 'data-value': f6.label }\"\n\t\t\t\t\tdata-heading=\"Quantity\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f7.label, attr: { 'data-value': f7.label }\"\n\t\t\t\t\tdata-heading=\"Subtotal\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t<td class=\"gpnf-row-actions\" style=\"display: none;\" data-bind=\"visible: true\">\n\t\t\t\t<ul>\n\t\t\t\t\t<li class=\"edit\"><button type=\"button\" class=\"edit-button gform-theme-button--secondary\" data-bind=\"click: $parent.editEntry, attr: { 'aria-label': 'Edit Entry {0} where Row ID is {1}.'.gformFormat( $index() + 1, frow_id.label ) }\">Edit<\/button><\/li>\n\t\t\t\t\t\t\t\t\t\t<li class=\"delete\"><button type=\"button\" class=\"delete-button gform-theme-button--simple gform-theme-button--size-md\" data-bind=\"click: $parent.deleteEntry, attr: { 'aria-label': 'Delete Entry {0} where Row ID is {1}.'.gformFormat( $index() + 1, frow_id.label ) }\">Delete<\/button><\/li>\n\t\t\t\t<\/ul>\n\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t\t<tbody data-bind=\"visible: entries().length <= 0\">\n\t\t<tr class=\"gpnf-no-entries\" data-bind=\"visible: entries().length <= 0\" style=\"display: none;\">\n\t\t\t<td colspan=\"8\">\n\t\t\t\tThere are no <span>Entries.<\/span>\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t<\/table>\n\n\t<button type=\"button\" class=\"gpnf-add-entry\"\n\t\t        data-formid=\"15\"\n\t\t        data-nestedformid=\"16\"\n\t\t\t\tdata-bind=\"attr: { disabled: isMaxed }, css: { 'gf-default-disabled': isMaxed }\"\n\t\t\t\t>\n\t\t\t\tAdd Entry\n\t\t\t<\/button>\t\n\t\t\t<p class=\"gpnf-add-entry-max\" data-bind=\"visible: isMaxed\" style=\"display: none;\">\n\t\t\t\tMaximum number of entries reached.\n\t\t\t<\/p>\n<\/div>\n<input type=\"hidden\"\n                name=\"input_118\"\n                id=\"input_15_118\"\n                data-bind=\"value: entryIds\"\n                value=\"\" \/><\/div><div id=\"field_15_123\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_calculation field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_15_123'>Sub Total of Items (TZS)<\/label><div class='ginput_container ginput_container_number'><input name='input_123' id='input_15_123' type='text' step='any'   value='' class='large gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_15_121\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_15_121'>GRAND TOTAL (TZS)<\/label><div class='ginput_container ginput_container_number'><input name='input_121' id='input_15_121' type='number' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_15' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_15' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_15' id='gform_theme_15' value='orbital' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_15' id='gform_style_settings_15' value='{&quot;inputPrimaryColor&quot;:&quot;#204ce5&quot;}' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_15' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='15' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='ilW6\/pTTgVqIVf8eQewkbFAF\/Cljl5m6ay7Mgd1V2\/XCSaRj697oO6eQd7E\/vribcrVjAE5qxHdkLWo1EC8r2u9Zg8fRnuVzud0fr7TNhFLnPKo=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_15' value='WyJ7XCI3OS4xXCI6XCI2OGM2MzFjMzM3OGRiNjA3ZTgzMGY4YzVkODQzMGE3N1wiLFwiODMuMVwiOlwiNjhjNjMxYzMzNzhkYjYwN2U4MzBmOGM1ZDg0MzBhNzdcIixcIjg3LjFcIjpcIjY4YzYzMWMzMzc4ZGI2MDdlODMwZjhjNWQ4NDMwYTc3XCIsXCI5MS4xXCI6XCI2OGM2MzFjMzM3OGRiNjA3ZTgzMGY4YzVkODQzMGE3N1wiLFwiMTA3LjFcIjpcIjY4YzYzMWMzMzc4ZGI2MDdlODMwZjhjNWQ4NDMwYTc3XCJ9IiwiOWFjNjMxMDMxOTk1N2I3MDRlZmNjYWYyMTk3MjlkMGEiXQ==' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_15' id='gform_target_page_number_15' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_15' id='gform_source_page_number_15' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div><script>\ngform.initializeOnLoaded( function() {gformInitSpinner( 15, 'https:\/\/sandbox.kazikasi.digital\/utulivu\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', false );jQuery('#gform_ajax_frame_15').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_15');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_15').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){form_content.find('form').css('opacity', 0);jQuery('#gform_wrapper_15').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_15').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_15').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/  }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_15').val();gformInitSpinner( 15, 'https:\/\/sandbox.kazikasi.digital\/utulivu\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', false );jQuery(document).trigger('gform_page_loaded', [15, current_page]);window['gf_submitting_15'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}jQuery('#gform_wrapper_15').replaceWith(confirmation_content);jQuery(document).trigger('gform_confirmation_loaded', [15]);window['gf_submitting_15'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_15').text());}else{jQuery('#gform_15').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"15\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);        if (event && event.defaultPrevented) {                return;        }        const gformWrapperDiv = document.getElementById( \"gform_wrapper_15\" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( \"span\" );            visibilitySpan.id = \"gform_visibility_test_15\";            gformWrapperDiv.insertAdjacentElement( \"afterend\", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( \"gform_visibility_test_15\" );        let postRenderFired = false;        function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            gform.core.triggerPostRenderEvents( 15, current_page );            if ( visibilityTestDiv ) {                visibilityTestDiv.parentNode.removeChild( visibilityTestDiv );            }        }        function debounce( func, wait, immediate ) {            var timeout;            return function() {                var context = this, args = arguments;                var later = function() {                    timeout = null;                    if ( !immediate ) func.apply( context, args );                };                var callNow = immediate && !timeout;                clearTimeout( timeout );                timeout = setTimeout( later, wait );                if ( callNow ) func.apply( context, args );            };        }        const debouncedTriggerPostRender = debounce( function() {            triggerPostRender();        }, 200 );        if ( visibilityTestDiv && visibilityTestDiv.offsetParent === null ) {            const observer = new MutationObserver( ( mutations ) => {                mutations.forEach( ( mutation ) => {                    if ( mutation.type === 'attributes' && visibilityTestDiv.offsetParent !== null ) {                        debouncedTriggerPostRender();                        observer.disconnect();                    }                });            });            observer.observe( document.body, {                attributes: true,                childList: false,                subtree: true,                attributeFilter: [ 'style', 'class' ],            });        } else {            triggerPostRender();        }    } );} );\n<\/script>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"class_list":["post-733","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/sandbox.kazikasi.digital\/utulivu\/wp-json\/wp\/v2\/pages\/733","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sandbox.kazikasi.digital\/utulivu\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/sandbox.kazikasi.digital\/utulivu\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/sandbox.kazikasi.digital\/utulivu\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/sandbox.kazikasi.digital\/utulivu\/wp-json\/wp\/v2\/comments?post=733"}],"version-history":[{"count":2,"href":"https:\/\/sandbox.kazikasi.digital\/utulivu\/wp-json\/wp\/v2\/pages\/733\/revisions"}],"predecessor-version":[{"id":760,"href":"https:\/\/sandbox.kazikasi.digital\/utulivu\/wp-json\/wp\/v2\/pages\/733\/revisions\/760"}],"wp:attachment":[{"href":"https:\/\/sandbox.kazikasi.digital\/utulivu\/wp-json\/wp\/v2\/media?parent=733"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}