{php}html_header_show();{/php} {literal} {/literal}

Well Infant Visit

WT: HT: H.CIRC: TEMP: Years: Months:
WT%: HT%:


{foreach name=loops item=headings key=title from=$checks} {if $title eq "Genitalia"} {else} {/if} {/foreach}
{$title}{$title} {foreach item=row key=row_title from=$headings} {if !is_numeric($row_title)} {else} {/if}
   {$row_title} {html_checkboxes name="checks" options=$row selected=$well_infant->checks separator="   "} {html_checkboxes name="checks" options=$row selected=$well_infant->checks separator="   "} {if $title eq "Head"} Open CM Closed {elseif $title eq "Feeding"}
oz/Feeding,Feedings/24h {/if}
{/foreach}


History:
Formula Type:


Additional or Abnormal Findings
Assesment/Diagnosis
{/foreach}
{foreach name=loops item=headings key=title from=$checks2}
{$title} {foreach item=row key=row_title from=$headings} {if !is_numeric($row_title)} {else} {/if} {/foreach}
{$row_title} {html_checkboxes name="checks2" options=$row selected=$well_infant->checks2 separator="   "} {html_checkboxes name="checks2" options=$row selected=$well_infant->checks2 separator="   "}
PPD: HCT: LEAD:
Feeding
Advice/Referrals
RTC


{/foreach}
{foreach name=loops item=headings key=title from=$checks3}
{$title} {foreach item=row key=row_title from=$headings} {if !is_numeric($row_title)} {else} {/if} {/foreach}
{$row_title} {html_checkboxes name="checks3" options=$row selected=$well_infant->checks3 separator="   "} {html_checkboxes name="checks3" options=$row selected=$well_infant->checks3 separator="   "}
         [Don't Save]