Physical Exam Form - Vitals.html

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	<span style="float:right">Paper Form ID: $paperFormId</span>
	<h2>PHYSICAL EXAM FORM - VITALS</h2>

	<section headerLabel="1. Encounter Details">
		<table class="baseline-aligned">
			<tr>
				<td>Date:</td>
				<td><encounterDate default="today"/></td>
				<td><pre>			</pre></td>
				<td>Location:</td>
				<td><encounterLocation default="Unknown Location" /></td>
				<td><pre>			</pre></td>
				<td>Provider:</td>
				<td><encounterProvider default="currentUser" role="Provider" /></td>
				<td><pre>			</pre></td>
				<td class="type">Type:</td>
				<td class="type"><encounterType default="VITALS" /></td>
			</tr>
		</table>
	</section>

	<section headerLabel="2. Patient Information">
		<table class="baseline-aligned">
			<tr>
				<td>Name:</td>
				<td><lookup class="value" expression="patient.personName"/></td>
				<td><pre>		</pre></td>
				<td>Manual ID:</td>
				<td><lookup class="value" complexExpression="#foreach( $patId in $patientIdentifiers.get('Old Identification Number') ) $patId #end "/></td>
				<td><pre>		</pre></td>
				<td>Auto ID:</td>
				<td><lookup class="value" complexExpression="#foreach( $patId in $patientIdentifiers.get('OpenMRS Identification Number') ) $patId #end"/></td>
				<td><pre>		</pre></td>
				<td>Gender:</td>
				<td><lookup class="value" expression="patient.gender"/></td>
			</tr>
			
		</table>
	</section>


        <section headerLabel="3. Vital Signs">
		<table class="baseline-aligned">
			<tr>
				<th style="background-color: #696969; color: #ffffff;">Question</th>
				<th style="background-color: #696969; color: #ffffff;">Answer</th>
				<th style="background-color: #696969; color: #ffffff;">Previous Answer</th>
				<th style="background-color: #696969; color: #ffffff;" class="lookup">Date Recorded</th>
			</tr>
			<tr>
				<td>Temperature(<sup>0</sup>C):</td>
				<td><obs conceptId="5088" /></td>
				<ifMode mode="ENTER">
					<td class="lookup">
						<lookup expression="fn.latestObs(5088).valueNumeric" class="value"/>
					</td>
					<td class="lookup">
						<lookup expression="fn.latestObs(5088).obsDatetime" class="value"/>
					</td>
				</ifMode>
			</tr>
			<tr>
				<td>RR:</td>
				<td><obs conceptId="5242" /></td>
				
				<ifMode mode="ENTER">
					<td class="lookup">
						<lookup expression="fn.earliestObs(5242).valueNumeric" class="value"/>
					</td>
					<td class="lookup">
						<lookup expression="fn.earliestObs(5242).obsDatetime" class="value"/>
					</td>
				</ifMode>
			</tr>
			<tr>
				<td>HR:</td>
				<td><obs conceptId="5087" /></td>
				<ifMode mode="ENTER">
					<td class="lookup">
						<lookup expression="fn.latestObs(5087).valueNumeric" class="value"/>
					</td>
					<td class="lookup">
						<lookup expression="fn.latestObs(5087).obsDatetime" class="value"/>
					</td>
				</ifMode>
			</tr>
			<tr>
				<td>Systolic / Diastolic:</td>
				<td>
                    <obs conceptId="5085" /> /
                    <obs conceptId="5086" />
                </td>
				<ifMode mode="ENTER">
					<td class="lookup">
						<lookup expression="fn.latestObs(5085).valueNumeric" class="value"/> / 
						<lookup expression="fn.latestObs(5086).valueNumeric" class="value"/>
					</td>
					<td class="lookup">
						<lookup expression="fn.latestObs(5085).obsDatetime" class="value"/> / 
						<lookup expression="fn.latestObs(5086).obsDatetime" class="value"/>
					</td>
				</ifMode>
			</tr>
			<tr>
				<td>Weight (KG):</td>
				<td><obs conceptId="5089" id="weight" /></td>
				<ifMode mode="ENTER">	
					<td class="lookup">
						<lookup expression="fn.latestObs(5089).valueNumeric" class="value"/>
					</td>
					<td class="lookup">
						<lookup expression="fn.latestObs(5089).obsDatetime" class="value"/>
					</td>
				</ifMode>
			</tr>
			<tr>
				<td>Blood Oxygen Saturation:</td>
				<td><obs conceptId="5092" /></td>
				<ifMode mode="ENTER">
					<td class="lookup">
						<lookup expression="fn.latestObs(5092).valueNumeric" class="value"/>
					</td>
					<td class="lookup">
						<lookup expression="fn.latestObs(5092).obsDatetime" class="value"/>
					</td>
				</ifMode>
			</tr>
			<tr>
				<td>Waist (CM):</td>
				<td><obs conceptId="161577" /></td>
				<ifMode mode="ENTER">
					<td class="lookup">
						<lookup expression="fn.latestObs(161577).valueNumeric" class="value"/>
					</td>
					<td class="lookup">
						<lookup expression="fn.latestObs(161577).obsDatetime" class="value"/>
					</td>
				</ifMode>
			</tr>
			<tr>
				<td>Height (CM):</td>
				<td><obs conceptId="5090" id="height" /></td>
				<ifMode mode="ENTER">
					<td class="lookup">
						<lookup expression="fn.latestObs(5090).valueNumeric" class="value"/>
					</td>
					<td class="lookup">
						<lookup expression="fn.latestObs(5090).obsDatetime" class="value"/>
					</td>
				</ifMode>
			</tr>
			<tr>
				<td>Body Mass Index:</td>
				<td><obs conceptId="1342" id="bmi" /></td>
				<ifMode mode="ENTER">	
					<td class="lookup">
						<lookup expression="fn.latestObs(1342).valueNumeric" class="value"/>
					</td>
					<td class="lookup">
						<lookup expression="fn.latestObs(1342).obsDatetime" class="value"/>
					</td>
				</ifMode>
			</tr>
			
		</table>
	</section>

	<submit/>

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