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  1. <?xml version="1.0" encoding="UTF-8"?>
  2. <PurcForm><Xform><xf:xforms xmlns:xf="http://www.w3.org/2002/xforms" xmlns:xsd="http://www.w3.org/2001/XMLSchema" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:jr="http://openrosa.org/javarosa">
  3. <xf:model id="openmrs_model">
  4. <xf:instance id="openmrs_model_instance">
  5. <form id="2" name="VITALS FORM" version="1.0" uuid="432b7f0f-6a89-45bb-9790-73a0c9137705" xmlns:openmrs="formentry.infopath_server_url cannot be empty/moduleServlet/formentry/forms/schema/2-1" xmlns:xd="http://schemas.microsoft.com/office/infopath/2003">
  6. <header>
  7. <enterer/>
  8. <date_entered/>
  9. <session/>
  10. <uid/>
  11. </header>
  12. <patient>
  13. <patient.birthdate openmrs_table="patient" openmrs_attribute="birthdate"/>
  14. <patient.family_name openmrs_table="patient_name" openmrs_attribute="family_name"/>
  15. <patient.given_name openmrs_table="patient_name" openmrs_attribute="given_name"/>
  16. <patient.medical_record_number openmrs_table="patient_identifier" openmrs_attribute="identifier"/>
  17. <patient.middle_name openmrs_table="patient_name" openmrs_attribute="middle_name"/>
  18. <patient.patient_id openmrs_table="patient" openmrs_attribute="patient_id"/>
  19. <patient.sex openmrs_table="patient" openmrs_attribute="gender"/>
  20. </patient>
  21. <encounter>
  22. <visit_type openmrs_concept="161230^VISIT_TYPE^99DCT" openmrs_datatype="CWE" multiple="0">
  23. <date xsi:nil="true"/>
  24. <time xsi:nil="true"/>
  25. <value xsi:nil="true"/>
  26. </visit_type>
  27. <encounter.encounter_datetime openmrs_table="encounter" openmrs_attribute="encounter_datetime" xsi:nil="true">'now()'</encounter.encounter_datetime>
  28. <encounter.location_id openmrs_table="encounter" openmrs_attribute="location_id" xsi:nil="true">1</encounter.location_id>
  29. <encounter.provider_id openmrs_table="encounter" openmrs_attribute="provider_id" xsi:nil="true" provider_id_type="PROVIDER.ID">3</encounter.provider_id>
  30. </encounter>
  31. <obs openmrs_concept="1238^MEDICAL RECORD OBSERVATIONS^99DCT" openmrs_datatype="ZZ">
  32. <height_cm openmrs_concept="5090^HEIGHT (CM)^99DCT" openmrs_datatype="NM">
  33. <date xsi:nil="true"/>
  34. <time xsi:nil="true"/>
  35. <value xsi:nil="true"/>
  36. </height_cm>
  37. <weight_kg openmrs_concept="5089^WEIGHT (KG)^99DCT" openmrs_datatype="NM">
  38. <date xsi:nil="true"/>
  39. <time xsi:nil="true"/>
  40. <value xsi:nil="true"/>
  41. </weight_kg>
  42. <temperaturecelcius openmrs_concept="5088^TEMPERATURE (C)^99DCT" openmrs_datatype="NM">
  43. <date xsi:nil="true"/>
  44. <time xsi:nil="true"/>
  45. <value xsi:nil="true"/>
  46. </temperaturecelcius>
  47. <heart_ratebeats_per_minute openmrs_concept="5087^PULSE^99DCT" openmrs_datatype="NM">
  48. <date xsi:nil="true"/>
  49. <time xsi:nil="true"/>
  50. <value xsi:nil="true"/>
  51. </heart_ratebeats_per_minute>
  52. <respiratory_ratebreaths_per_minute openmrs_concept="5242^RESPIRATORY RATE^99DCT" openmrs_datatype="NM">
  53. <date xsi:nil="true"/>
  54. <time xsi:nil="true"/>
  55. <value xsi:nil="true"/>
  56. </respiratory_ratebreaths_per_minute>
  57. <systollic_blood_pressuremm_hg openmrs_concept="5085^SYSTOLIC BLOOD PRESSURE^99DCT" openmrs_datatype="NM">
  58. <date xsi:nil="true"/>
  59. <time xsi:nil="true"/>
  60. <value xsi:nil="true"/>
  61. </systollic_blood_pressuremm_hg>
  62. <diastolic_blood_pressuremm_hg openmrs_concept="5086^DIASTOLIC BLOOD PRESSURE^99DCT" openmrs_datatype="NM">
  63. <date xsi:nil="true"/>
  64. <time xsi:nil="true"/>
  65. <value xsi:nil="true"/>
  66. </diastolic_blood_pressuremm_hg>
  67. <additional_clinical_findings openmrs_concept="161063^ADDTL_FIND^99DCT" openmrs_datatype="ST">
  68. <date xsi:nil="true"/>
  69. <time xsi:nil="true"/>
  70. <value xsi:nil="true"/>
  71. </additional_clinical_findings>
  72. <complaints openmrs_concept="161824^COMPLAINTS^99DCT" openmrs_datatype="CWE" multiple="0">
  73. <date xsi:nil="true"/>
  74. <time xsi:nil="true"/>
  75. <value xsi:nil="true"/>
  76. </complaints>
  77. </obs>
  78. <other/></form>
  79. </xf:instance>
  80. <xf:bind id="patient.birthdate" nodeset="/form/patient/patient.birthdate" type="xsd:date" locked="true()" jr:preload="patient" jr:preloadParams="birthDate" required="true()"/>
  81. <xf:bind id="patient.family_name" nodeset="/form/patient/patient.family_name" type="xsd:string" locked="true()" jr:preload="patient" jr:preloadParams="familyName" required="true()"/>
  82. <xf:bind id="patient.given_name" nodeset="/form/patient/patient.given_name" type="xsd:string" locked="true()" jr:preload="patient" jr:preloadParams="givenName" required="true()"/>
  83. <xf:bind id="patient.medical_record_number" nodeset="/form/patient/patient.medical_record_number" type="xsd:string" locked="true()" jr:preload="patient" jr:preloadParams="patientIdentifier" required="true()"/>
  84. <xf:bind id="patient.middle_name" nodeset="/form/patient/patient.middle_name" type="xsd:string" locked="true()" jr:preload="patient" jr:preloadParams="middleName"/>
  85. <xf:bind id="patient.patient_id" nodeset="/form/patient/patient.patient_id" type="xsd:int" required="true()" visible="false()" jr:preload="patient" jr:preloadParams="patientId" readonly="true()" locked="true()"/>
  86. <xf:bind id="patient.sex" nodeset="/form/patient/patient.sex" type="xsd:string" locked="true()" jr:preload="patient" jr:preloadParams="sex" required="true()"/>
  87. <xf:bind id="visit_type" nodeset="/form/encounter/visit_type/value" type="xsd:string" required="true()"/>
  88. <xf:bind id="encounter.encounter_datetime" nodeset="/form/encounter/encounter.encounter_datetime" type="xsd:dateTime" constraint=". &lt;= today()" message="Encounter date cannot be after today" required="true()"/>
  89. <xf:bind id="encounter.location_id" nodeset="/form/encounter/encounter.location_id" type="xsd:string" readonly="true()" visible="false()"/>
  90. <xf:bind id="encounter.provider_id" nodeset="/form/encounter/encounter.provider_id" type="xsd:string" readonly="true()" visible="false()"/>
  91. <xf:bind id="height_cm" nodeset="/form/obs/height_cm/value" type="xsd:decimal" relevant="/form/encounter/visit_type/value != '161059^Drug refill by txt^99DCT' and /form/encounter/visit_type/value != ''" action="enable" constraint=". &gt;= 30 and . &lt;= 255" message="Value of range, please check" required="true()"/>
  92. <xf:bind id="weight_kg" nodeset="/form/obs/weight_kg/value" type="xsd:decimal" relevant="/form/encounter/visit_type/value != '161059^Drug refill by txt^99DCT' and /form/encounter/visit_type/value != ''" action="enable" constraint=". &gt;= 1.0 and . &lt;= 150.0" message="value should be between 0.0 and 150.0 inclusive" required="true()"/>
  93. <xf:bind id="temperaturecelcius" nodeset="/form/obs/temperaturecelcius/value" type="xsd:decimal" relevant="/form/encounter/visit_type/value != '161059^Drug refill by txt^99DCT' and /form/encounter/visit_type/value != ''" action="enable" constraint=". &gt;= 21.0 and . &lt;= 42.0" message="value should be between 21.0 and 42.0 inclusive" required="true()"/>
  94. <xf:bind id="heart_ratebeats_per_minute" nodeset="/form/obs/heart_ratebeats_per_minute/value" type="xsd:decimal" relevant="/form/encounter/visit_type/value != '161059^Drug refill by txt^99DCT' and /form/encounter/visit_type/value != ''" action="enable" constraint=". &gt;= 20 and . &lt;= 200" message="value should be between 20.0 and 200.0 inclusive" required="true()"/>
  95. <xf:bind id="respiratory_ratebreaths_per_minute" nodeset="/form/obs/respiratory_ratebreaths_per_minute/value" type="xsd:decimal" relevant="/form/encounter/visit_type/value != '161059^Drug refill by txt^99DCT' and /form/encounter/visit_type/value != ''" action="enable" constraint=". &gt;= 5 and . &lt;= 70" message="value should be between 1 and 70 inclusive" required="true()"/>
  96. <xf:bind id="systollic_blood_pressuremm_hg" nodeset="/form/obs/systollic_blood_pressuremm_hg/value" type="xsd:decimal" constraint=". &gt;= 60 and . &lt; 300" message="value should be between 10 and 350 inclusive" relevant="/form/encounter/visit_type/value != '161059^Drug refill by txt^99DCT' and /form/encounter/visit_type/value != ''" action="enable" required="true()"/>
  97. <xf:bind id="diastolic_blood_pressuremm_hg" nodeset="/form/obs/diastolic_blood_pressuremm_hg/value" type="xsd:decimal" relevant="/form/encounter/visit_type/value != '161059^Drug refill by txt^99DCT' and /form/encounter/visit_type/value != ''" action="enable" constraint=". &gt;= 10 and . &lt; form/obs/systollic_blood_pressuremm_hg/value and . &lt; 140" message="value should be between 10 and 130 as well as not more than systolic BP" required="true()"/>
  98. <xf:bind id="additional_clinical_findings" nodeset="/form/obs/additional_clinical_findings/value" type="xsd:string" relevant="/form/obs/complaints/value = '1065^YES^99DCT' and /form/obs/complaints/value != ''" action="enable" constraint="length(.) &lt;= 200" message="The length of the field is more than the required length please check." required="true()"/>
  99. <xf:bind id="complaints" nodeset="/form/obs/complaints/value" type="xsd:string" relevant="/form/encounter/visit_type/value != '161059^Drug refill by txt^99DCT' and /form/encounter/visit_type/value != ''" action="enable" required="true()"/>
  100. </xf:model>
  101. <xf:group id="1">
  102. <xf:label>Page1</xf:label>
  103. <xf:input bind="patient.birthdate">
  104. <xf:label>Birth date</xf:label>
  105. </xf:input>
  106. <xf:input bind="patient.family_name">
  107. <xf:label>Family name</xf:label>
  108. </xf:input>
  109. <xf:input bind="patient.given_name">
  110. <xf:label>First name</xf:label>
  111. </xf:input>
  112. <xf:input bind="patient.medical_record_number">
  113. <xf:label>NACP number</xf:label>
  114. </xf:input>
  115. <xf:input bind="patient.middle_name">
  116. <xf:label>Middle name</xf:label>
  117. </xf:input>
  118. <xf:input bind="patient.patient_id">
  119. <xf:label>Patient Id</xf:label>
  120. </xf:input>
  121. <xf:input bind="patient.sex">
  122. <xf:label>Gender</xf:label>
  123. </xf:input>
  124. <xf:input bind="encounter.encounter_datetime">
  125. <xf:label>Visit date</xf:label>
  126. <xf:hint>The date of this visit which is exactly when this form is being filled.</xf:hint></xf:input>
  127. <xf:select1 bind="encounter.location_id">
  128. <xf:label>LOCATION ID</xf:label>
  129. <xf:item id="1"><xf:label>Unknown Location [1]</xf:label><xf:value>1</xf:value></xf:item></xf:select1>
  130. <xf:select1 bind="encounter.provider_id">
  131. <xf:label>PROVIDER ID</xf:label>
  132. <xf:item id="1">
  133. <xf:label>Claudio Zaugg [12]</xf:label>
  134. <xf:value>1</xf:value>
  135. </xf:item>
  136. <xf:item id="2">
  137. <xf:label>Lucas Gervas Shayo [13]</xf:label>
  138. <xf:value>2</xf:value>
  139. </xf:item>
  140. <xf:item id="3">
  141. <xf:label>Agata Correia Agata [3]</xf:label>
  142. <xf:value>3</xf:value>
  143. </xf:item>
  144. <xf:item id="4"><xf:label>Claudio Zaugg [4]</xf:label><xf:value>4</xf:value></xf:item><xf:item id="14">
  145. <xf:label>unknown [14]</xf:label>
  146. <xf:value>14</xf:value>
  147. </xf:item>
  148. <xf:item id="31"><xf:label>Lukag shayog gervass [31]</xf:label><xf:value>31</xf:value></xf:item><xf:item id="34"><xf:label>juma2 juma2middle juma2family [34]</xf:label><xf:value>34</xf:value></xf:item><xf:item id="8"><xf:label>Agata Correia Agata [8]</xf:label><xf:value>8</xf:value></xf:item><xf:item id="55"><xf:label>Migration User March2013 [55]</xf:label><xf:value>55</xf:value></xf:item></xf:select1>
  149. <xf:select1 bind="visit_type">
  150. <xf:label>Type of visit</xf:label>
  151. <xf:hint>Type of visit-A question on KIULARCO HIV_MRS physical_exam form</xf:hint>
  152. <xf:item concept_id="161230" id="161064^Baseline^99DCT">
  153. <xf:label>Baseline</xf:label>
  154. <xf:value>161064^Baseline^99DCT</xf:value>
  155. </xf:item>
  156. <xf:item concept_id="161230" id="161058^Drug refill by patient^99DCT">
  157. <xf:label>Drug refill by patient</xf:label>
  158. <xf:value>161058^Drug refill by patient^99DCT</xf:value>
  159. </xf:item>
  160. <xf:item concept_id="161230" id="161059^Drug refill by txt^99DCT">
  161. <xf:label>Drug refill by txt</xf:label>
  162. <xf:value>161059^Drug refill by txt^99DCT</xf:value>
  163. </xf:item>
  164. <xf:item concept_id="161230" id="161060^In-patient consultation^99DCT">
  165. <xf:label>In-patient consultation</xf:label>
  166. <xf:value>161060^In-patient consultation^99DCT</xf:value>
  167. </xf:item>
  168. <xf:item concept_id="161230" id="161061^Traced back after LTFU^99DCT">
  169. <xf:label>Traced back after LTFU</xf:label>
  170. <xf:value>161061^Traced back after LTFU^99DCT</xf:value>
  171. </xf:item>
  172. <xf:item concept_id="161230" id="161062^Visist other clinic(refill/outreach/transit)^99DCT">
  173. <xf:label>Visist other clinic(refill/outreach/transit)</xf:label>
  174. <xf:value>161062^Visist other clinic(refill/outreach/transit)^99DCT</xf:value>
  175. </xf:item>
  176. <xf:item concept_id="161230" id="161482^Unscheduled follow-up^99DCT">
  177. <xf:label>Unscheduled follow-up</xf:label>
  178. <xf:value>161482^Unscheduled follow-up^99DCT</xf:value>
  179. </xf:item>
  180. <xf:item concept_id="161230" id="161825^Scheduled follow-up/Clinical^99DCT">
  181. <xf:label>Scheduled follow-up/Clinical</xf:label>
  182. <xf:value>161825^Scheduled follow-up/Clinical^99DCT</xf:value>
  183. </xf:item>
  184. <xf:item concept_id="161230" id="161826^Scheduled follow-up/CD4^99DCT">
  185. <xf:label>Scheduled follow-up/CD4</xf:label>
  186. <xf:value>161826^Scheduled follow-up/CD4^99DCT</xf:value>
  187. </xf:item>
  188. <xf:item id="161481^Scheduled follow-up^99DCT"><xf:label>Scheduled follow-up</xf:label><xf:value>161481^Scheduled follow-up^99DCT</xf:value></xf:item></xf:select1>
  189. <xf:input bind="height_cm">
  190. <xf:label>Height (CM)</xf:label>
  191. <xf:hint>Patient's height in centimeters.</xf:hint>
  192. </xf:input>
  193. <xf:input bind="weight_kg">
  194. <xf:label>WEIGHT (KG)</xf:label>
  195. <xf:hint>Patient's weight in kilograms.</xf:hint>
  196. </xf:input>
  197. <xf:input bind="temperaturecelcius">
  198. <xf:label>Temperature (C)</xf:label>
  199. <xf:hint>Patient's temperature in degrees centigrade.</xf:hint>
  200. </xf:input>
  201. <xf:input bind="heart_ratebeats_per_minute">
  202. <xf:label>Pulse</xf:label>
  203. <xf:hint>Patient pulse rate, as measured with a peripheral oximeter.</xf:hint>
  204. </xf:input>
  205. <xf:input bind="respiratory_ratebreaths_per_minute">
  206. <xf:label>Respiratory rate</xf:label>
  207. <xf:hint>Measured respiratory rate in breaths per minute</xf:hint>
  208. </xf:input>
  209. <xf:input bind="systollic_blood_pressuremm_hg">
  210. <xf:label>Systolic blood pressure</xf:label>
  211. <xf:hint>A patient's systolic blood pressure measurement (taken with a manual cuff in either a sitting or standing position)</xf:hint>
  212. </xf:input>
  213. <xf:input bind="diastolic_blood_pressuremm_hg">
  214. <xf:label>Diastolic blood pressure</xf:label>
  215. <xf:hint>A patient's diastolic blood pressure measurement (taken with a manual cuff in either a sitting or standing position)</xf:hint>
  216. </xf:input>
  217. <xf:input bind="additional_clinical_findings">
  218. <xf:label>Additional clinical findings</xf:label>
  219. <xf:hint>additional clinic findings</xf:hint>
  220. </xf:input>
  221. <xf:select1 bind="complaints">
  222. <xf:label>COMPLAINTS</xf:label>
  223. <xf:item concept_id="161824" id="1066^NO^99DCT">
  224. <xf:label>NO</xf:label>
  225. <xf:value>1066^NO^99DCT</xf:value>
  226. </xf:item>
  227. <xf:item concept_id="161824" id="1065^YES^99DCT">
  228. <xf:label>YES</xf:label>
  229. <xf:value>1065^YES^99DCT</xf:value>
  230. </xf:item>
  231. </xf:select1>
  232. </xf:group>
  233. </xf:xforms></Xform><Layout><Form id="2"><Page Text="Page1" fontWeight="normal" fontSize="12px" fontFamily="Verdana, 'Lucida Grande', 'Trebuchet MS', Arial, Sans-Serif" Binding="Page1" Width="930px" Height="880px" backgroundColor=""><Item WidgetType="GroupBox" Binding="LEFT48pxTOP120px" Left="48px" Top="120px" Width="880px" Height="150px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif" borderStyle="solid"><Item WidgetType="Label" Text="PATIENT INFORMATION" HelpText="Header Label" Binding="LEFT48pxTOP120px" Left="0px" Top="0px" Width="100%" Height="20px" TabIndex="0" color="White" fontWeight="bold" fontSize="16px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif" backgroundColor="rgb(26, 172, 155)" textAlign="center" HeaderLabel="true"/><Item WidgetType="Label" Text="Gender" HelpText="Gender" Binding="patient/patient.sex" Left="10px" Top="90px" Height="14px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="Label" Text="Birth date" HelpText="Birth date" Binding="patient/patient.birthdate" Left="269px" Top="90px" Height="0px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="TextBox" HelpText="Gender" Binding="patient/patient.sex" Left="10px" Top="110px" Width="235px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="DatePicker" HelpText="Birth date" Binding="patient/patient.birthdate" Left="270px" Top="110px" Width="239px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="TextBox" HelpText="Family name" Binding="patient/patient.family_name" Left="599px" Top="48px" Width="235px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="Label" Text="First name" HelpText="First name" Binding="patient/patient.given_name" Left="9px" Top="31px" Height="21px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="TextBox" HelpText="First name" Binding="patient/patient.given_name" Left="9px" Top="48px" Width="235px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="Label" Text="Middle name" HelpText="Middle name" Binding="patient/patient.middle_name" Left="266px" Top="29px" Height="0px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="TextBox" HelpText="Middle name" Binding="patient/patient.middle_name" Left="268px" Top="50px" Width="311px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="Label" Text="Last name" HelpText="Family name" Binding="patient/patient.family_name" Left="599px" Top="30px" Height="9px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/></Item><Item WidgetType="Label" Text="Vitals form" HelpText="Based on physical exam" Binding="LEFT48pxTOP62px" Left="48px" Top="30px" TabIndex="0" fontWeight="bold" fontSize="20px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif" borderStyle="solid" borderWidth="1px"/><Item WidgetType="Label" Text="NACP number" HelpText="NACP number" Binding="patient/patient.medical_record_number" Left="623px" Top="40px" Height="25px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="TextBox" HelpText="NACP number" Binding="patient/patient.medical_record_number" Left="730px" Top="40px" Width="200px" Height="25px" TabIndex="43" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="Label" Text="Visit date" HelpText="The date of this visit which is exactly when this form is being filled." Binding="encounter/encounter.encounter_datetime" Left="647px" Top="80px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="DateTimeWidget" Binding="encounter/encounter.encounter_datetime" Left="730px" Top="80px" Width="200px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="Button" Text="Cancel" HelpText="cancel" Binding="cancel" Left="858px" Top="761px" Width="70px" Height="30px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="Button" Text="Submit" HelpText="submit" Binding="submit" Left="752px" Top="762px" Width="70px" Height="30px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif" Id="submit"/><Item WidgetType="GroupBox" Binding="LEFT48pxTOP290px" Left="48px" Top="290px" Width="880px" Height="450px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif" borderStyle="solid"><Item WidgetType="Label" Text="OBSERVATION" HelpText="Header Label" Binding="LEFT48pxTOP290px" Left="0px" Top="0px" Width="100%" Height="20px" TabIndex="0" color="White" fontWeight="bold" fontSize="16px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif" backgroundColor="rgb(26, 172, 155)" textAlign="center" HeaderLabel="true"/><Item WidgetType="Label" Text="Temperature (Celcius)" HelpText="Patient's temperature in degrees centigrade." Binding="obs/temperaturecelcius/value" Left="16px" Top="239px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="TextBox" HelpText="Patient's temperature in degrees centigrade." Binding="obs/temperaturecelcius/value" Left="210px" Top="234px" Width="87px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="Label" Text="Respiratory rate(breaths per minute)" HelpText="Measured respiratory rate in breaths per minute" Binding="obs/respiratory_ratebreaths_per_minute/value" Left="202px" Top="192px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="Label" Text="Heart rate(beats per minute)" HelpText="Patient pulse rate, as measured with a peripheral oximeter." Binding="obs/heart_ratebeats_per_minute/value" Left="206px" Top="152px" Height="2px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="TextBox" HelpText="Patient pulse rate, as measured with a peripheral oximeter." Binding="obs/heart_ratebeats_per_minute/value" Left="451px" Top="148px" Width="82px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="TextBox" HelpText="A patient's diastolic blood pressure measurement (taken with a manual cuff in either a sitting or standing position)" Binding="obs/diastolic_blood_pressuremm_hg/value" Left="779px" Top="183px" Width="80px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="Label" Text="Diastolic blood pressure(mm Hg)" HelpText="A patient's diastolic blood pressure measurement (taken with a manual cuff in either a sitting or standing position)" Binding="obs/diastolic_blood_pressuremm_hg/value" Left="559px" Top="188px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="Label" Text="Systolic blood pressure(mm Hg)" HelpText="A patient's systolic blood pressure measurement (taken with a manual cuff in either a sitting or standing position)" Binding="obs/systollic_blood_pressuremm_hg/value" Left="561px" Top="150px" Width="300px" Height="0px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="Label" Text="Height (cm)" HelpText="Patient's height in centimeters." Binding="obs/height_cm/value" Left="10px" Top="151px" Height="1px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="Label" Text="Weight(Kg)" HelpText="Patient's weight in kilograms." Binding="obs/weight_kg/value" Left="8px" Top="194px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="TextBox" HelpText="Patient's weight in kilograms." Binding="obs/weight_kg/value" Left="99px" Top="186px" Width="78px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="TextBox" HelpText="Patient's height in centimeters." Binding="obs/height_cm/value" Left="96px" Top="147px" Width="80px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="Label" Text="Type of visit" HelpText="Type of visit-A question on KIULARCO HIV_MRS physical_exam form" Binding="encounter/visit_type/value" Left="8px" Top="28px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,Sans-Serif"/><Item WidgetType="Label" Text="Additional clinic findings" HelpText="additional clinic findings" Binding="obs/additional_clinical_findings/value" Left="13px" Top="336px" Height="0px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="RadioButton" Text="Yes" HelpText="YES" Binding="1065^YES^99DCT" ParentBinding="obs/complaints/value" Left="248px" Top="290px" TabIndex="0" fontWeight="normal" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,Sans-Serif"/><Item WidgetType="Label" Text="Any complaints by patient" HelpText="COMPLAINTS" Binding="obs/complaints/value" Left="16px" Top="290px" Height="11px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,Sans-Serif"/><Item WidgetType="RadioButton" Text="No" HelpText="NO" Binding="1066^NO^99DCT" ParentBinding="obs/complaints/value" Left="197px" Top="290px" TabIndex="0" fontWeight="normal" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,Sans-Serif"/><Item WidgetType="TextArea" HelpText="additional clinic findings" Binding="obs/additional_clinical_findings/value" Left="188px" Top="348px" Width="652px" Height="80px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="RadioButton" Text="Visits other clinic(refill/outreach/transit)" HelpText="Visist other clinic(refill/outreach/transit)" Binding="161062^Visist other clinic(refill/outreach/transit)^99DCT" ParentBinding="encounter/visit_type/value" Left="581px" Top="85px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,Sans-Serif"/><Item WidgetType="RadioButton" Text="Scheduled follow-up/CD4" HelpText="Scheduled follow-up/CD4" Binding="161826^Scheduled follow-up/CD4^99DCT" ParentBinding="encounter/visit_type/value" Left="106px" Top="46px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,Sans-Serif"/><Item WidgetType="RadioButton" Text="Baseline" HelpText="Baseline" Binding="161064^Baseline^99DCT" ParentBinding="encounter/visit_type/value" Left="16px" Top="44px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,Sans-Serif"/><Item WidgetType="RadioButton" Text="Drug refill by txt supporter" HelpText="Drug refill by txt" Binding="161059^Drug refill by txt^99DCT" ParentBinding="encounter/visit_type/value" Left="18px" Top="82px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,Sans-Serif"/><Item WidgetType="RadioButton" Text="In-patient consultation" HelpText="In-patient consultation" Binding="161060^In-patient consultation^99DCT" ParentBinding="encounter/visit_type/value" Left="222px" Top="85px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,Sans-Serif"/><Item WidgetType="RadioButton" Text="Scheduled follow-up/Clinical" HelpText="Scheduled follow-up/Clinical" Binding="161825^Scheduled follow-up/Clinical^99DCT" ParentBinding="encounter/visit_type/value" Left="311px" Top="49px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,Sans-Serif"/><Item WidgetType="RadioButton" Text="Traced back after LTFU" HelpText="Traced back after LTFU" Binding="161061^Traced back after LTFU^99DCT" ParentBinding="encounter/visit_type/value" Left="400px" Top="87px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,Sans-Serif"/><Item WidgetType="RadioButton" Text="Unscheduled follow-up" HelpText="Unscheduled follow-up" Binding="161482^Unscheduled follow-up^99DCT" ParentBinding="encounter/visit_type/value" Left="529px" Top="51px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,Sans-Serif"/><Item WidgetType="RadioButton" Text="Drug refill by patient" HelpText="Drug refill by patient" Binding="161058^Drug refill by patient^99DCT" ParentBinding="encounter/visit_type/value" Left="709px" Top="55px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,Sans-Serif"/><Item WidgetType="TextBox" HelpText="A patient's systolic blood pressure measurement (taken with a manual cuff in either a sitting or standing position)" Binding="obs/systollic_blood_pressuremm_hg/value" Left="779px" Top="145px" Width="79px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif"/><Item WidgetType="TextBox" HelpText="Measured respiratory rate in breaths per minute" Binding="obs/respiratory_ratebreaths_per_minute/value" Left="453px" Top="186px" Width="80px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana,'Lucida Grande','Trebuchet MS',Arial,sans-serif" Id="Respiratory rate"/></Item></Page></Form></Layout><Language><LanguageText lang="en"><xform id="2"><text xpath="xforms/model[@id='openmrs_model']/instance[@id='openmrs_model_instance']/form[@name]" value="VITALS FORM"/><text xpath="xforms/group[@id='1']/label" value="Page1"/><text xpath="xforms/group[@id='1']/input[@bind='patient.birthdate']/label" value="Birth date"/><text xpath="xforms/group[@id='1']/input[@bind='patient.family_name']/label" value="Family name"/><text xpath="xforms/group[@id='1']/input[@bind='patient.given_name']/label" value="First name"/><text xpath="xforms/group[@id='1']/input[@bind='patient.medical_record_number']/label" value="NACP number"/><text xpath="xforms/group[@id='1']/input[@bind='patient.middle_name']/label" value="Middle name"/><text xpath="xforms/group[@id='1']/input[@bind='patient.patient_id']/label" value="Patient Id"/><text xpath="xforms/group[@id='1']/input[@bind='patient.sex']/label" value="Gender"/><text xpath="xforms/group[@id='1']/select1[@bind='visit_type']/label" value="Type of visit"/><text xpath="xforms/group[@id='1']/select1[@bind='visit_type']/hint" value="Type of visit-A question on KIULARCO HIV_MRS physical_exam form"/><text xpath="xforms/group[@id='1']/select1[@bind='visit_type']/item[@id='161064^Baseline^99DCT']/label" value="Baseline"/><text xpath="xforms/group[@id='1']/select1[@bind='visit_type']/item[@id='161058^Drug refill by patient^99DCT']/label" value="Drug refill by patient"/><text xpath="xforms/group[@id='1']/select1[@bind='visit_type']/item[@id='161059^Drug refill by txt^99DCT']/label" value="Drug refill by txt"/><text xpath="xforms/group[@id='1']/select1[@bind='visit_type']/item[@id='161060^In-patient consultation^99DCT']/label" value="In-patient consultation"/><text xpath="xforms/group[@id='1']/select1[@bind='visit_type']/item[@id='161061^Traced back after LTFU^99DCT']/label" value="Traced back after LTFU"/><text xpath="xforms/group[@id='1']/select1[@bind='visit_type']/item[@id='161062^Visist other clinic(refill/outreach/transit)^99DCT']/label" value="Visist other clinic(refill/outreach/transit)"/><text xpath="xforms/group[@id='1']/select1[@bind='visit_type']/item[@id='161482^Unscheduled follow-up^99DCT']/label" value="Unscheduled follow-up"/><text xpath="xforms/group[@id='1']/select1[@bind='visit_type']/item[@id='161825^Scheduled follow-up/Clinical^99DCT']/label" value="Scheduled follow-up/Clinical"/><text xpath="xforms/group[@id='1']/select1[@bind='visit_type']/item[@id='161826^Scheduled follow-up/CD4^99DCT']/label" value="Scheduled follow-up/CD4"/><text xpath="xforms/group[@id='1']/select1[@bind='visit_type']/item[@id='161481^Scheduled follow-up^99DCT']/label" value="Scheduled follow-up"/><text xpath="xforms/group[@id='1']/input[@bind='encounter.encounter_datetime']/label" value="Visit date"/><text xpath="xforms/group[@id='1']/input[@bind='encounter.encounter_datetime']/hint" value="The date of this visit which is exactly when this form is being filled."/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.location_id']/label" value="LOCATION ID"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.location_id']/item[@id='1']/label" value="Unknown Location [1]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/label" value="PROVIDER ID"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='1']/label" value="Claudio Zaugg [12]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='2']/label" value="Lucas Gervas Shayo [13]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='3']/label" value="Agata Correia Agata [3]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='4']/label" value="Claudio Zaugg [4]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='14']/label" value="unknown [14]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='31']/label" value="Lukag shayog gervass [31]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='34']/label" value="juma2 juma2middle juma2family [34]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='8']/label" value="Agata Correia Agata [8]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='55']/label" value="Migration User March2013 [55]"/><text xpath="xforms/group[@id='1']/input[@bind='height_cm']/label" value="Height (CM)"/><text xpath="xforms/group[@id='1']/input[@bind='height_cm']/hint" value="Patient's height in centimeters."/><text xpath="xforms/group[@id='1']/input[@bind='weight_kg']/label" value="WEIGHT (KG)"/><text xpath="xforms/group[@id='1']/input[@bind='weight_kg']/hint" value="Patient's weight in kilograms."/><text xpath="xforms/group[@id='1']/input[@bind='temperaturecelcius']/label" value="Temperature (C)"/><text xpath="xforms/group[@id='1']/input[@bind='temperaturecelcius']/hint" value="Patient's temperature in degrees centigrade."/><text xpath="xforms/group[@id='1']/input[@bind='heart_ratebeats_per_minute']/label" value="Pulse"/><text xpath="xforms/group[@id='1']/input[@bind='heart_ratebeats_per_minute']/hint" value="Patient pulse rate, as measured with a peripheral oximeter."/><text xpath="xforms/group[@id='1']/input[@bind='respiratory_ratebreaths_per_minute']/label" value="Respiratory rate"/><text xpath="xforms/group[@id='1']/input[@bind='respiratory_ratebreaths_per_minute']/hint" value="Measured respiratory rate in breaths per minute"/><text xpath="xforms/group[@id='1']/input[@bind='systollic_blood_pressuremm_hg']/label" value="Systolic blood pressure"/><text xpath="xforms/group[@id='1']/input[@bind='systollic_blood_pressuremm_hg']/hint" value="A patient's systolic blood pressure measurement (taken with a manual cuff in either a sitting or standing position)"/><text xpath="xforms/group[@id='1']/input[@bind='diastolic_blood_pressuremm_hg']/label" value="Diastolic blood pressure"/><text xpath="xforms/group[@id='1']/input[@bind='diastolic_blood_pressuremm_hg']/hint" value="A patient's diastolic blood pressure measurement (taken with a manual cuff in either a sitting or standing position)"/><text xpath="xforms/group[@id='1']/input[@bind='additional_clinical_findings']/label" value="Additional clinical findings"/><text xpath="xforms/group[@id='1']/input[@bind='additional_clinical_findings']/hint" value="additional clinic findings"/><text xpath="xforms/group[@id='1']/select1[@bind='complaints']/label" value="COMPLAINTS"/><text xpath="xforms/group[@id='1']/select1[@bind='complaints']/item[@id='1066^NO^99DCT']/label" value="NO"/><text xpath="xforms/group[@id='1']/select1[@bind='complaints']/item[@id='1065^YES^99DCT']/label" value="YES"/><text xpath="xforms/model[@id='openmrs_model']/bind[@id='encounter.encounter_datetime'][@message]" value="Encounter date cannot be after today"/><text xpath="xforms/model[@id='openmrs_model']/bind[@id='height_cm'][@message]" value="Value of range, please check"/><text xpath="xforms/model[@id='openmrs_model']/bind[@id='weight_kg'][@message]" value="value should be between 0.0 and 150.0 inclusive"/><text xpath="xforms/model[@id='openmrs_model']/bind[@id='temperaturecelcius'][@message]" value="value should be between 21.0 and 42.0 inclusive"/><text xpath="xforms/model[@id='openmrs_model']/bind[@id='heart_ratebeats_per_minute'][@message]" value="value should be between 20.0 and 200.0 inclusive"/><text xpath="xforms/model[@id='openmrs_model']/bind[@id='respiratory_ratebreaths_per_minute'][@message]" value="value should be between 1 and 70 inclusive"/><text xpath="xforms/model[@id='openmrs_model']/bind[@id='systollic_blood_pressuremm_hg'][@message]" value="value should be between 10 and 350 inclusive"/><text xpath="xforms/model[@id='openmrs_model']/bind[@id='diastolic_blood_pressuremm_hg'][@message]" value="value should be between 10 and 130 as well as not more than systolic BP"/><text xpath="xforms/model[@id='openmrs_model']/bind[@id='additional_clinical_findings'][@message]" value="The length of the field is more than the required length please check."/></xform><Form id="2"><text xpath="Form/Page[@Binding='null'][@Text]" value=""/></Form></LanguageText></Language></PurcForm>
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