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Xform sample form1

jerome24
Feb 29th, 2024
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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="76" name="Sample form test" version="1.4" uuid="db25b38e-d487-4524-824e-4b0d3a3079f5" xmlns:openmrs="formentry.infopath_server_url cannot be empty/moduleServlet/formentry/forms/schema/76-1" 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_relative>
  21. <patient_relative.person/>
  22. <patient_relative.relationship/>
  23. </patient_relative>
  24. </patient>
  25. <encounter>
  26. <encounter.encounter_datetime openmrs_table="encounter" openmrs_attribute="encounter_datetime" xsi:nil="true">'now()'</encounter.encounter_datetime>
  27. <encounter.location_id openmrs_table="encounter" openmrs_attribute="location_id" xsi:nil="true">1</encounter.location_id>
  28. <encounter.provider_id openmrs_table="encounter" openmrs_attribute="provider_id" xsi:nil="true" provider_id_type="PROVIDER.ID">3</encounter.provider_id>
  29. </encounter>
  30. <obs openmrs_concept="1238^MEDICAL RECORD OBSERVATIONS^99DCT" openmrs_datatype="ZZ">
  31. <datetime openmrs_concept="163256^Datetime^99DCT" openmrs_datatype="TS">
  32. <date xsi:nil="true"/>
  33. <time xsi:nil="true"/>
  34. <value xsi:nil="true"/>
  35. </datetime>
  36. <received_date_time openmrs_concept="163255^RECEIVED_DATE_TIME^99DCT" openmrs_datatype="TS">
  37. <date xsi:nil="true"/>
  38. <time xsi:nil="true"/>
  39. <value xsi:nil="true"/>
  40. </received_date_time>
  41. <received_date openmrs_concept="163209^RECEIVED_DATE^99DCT" openmrs_datatype="DT">
  42. <date xsi:nil="true"/>
  43. <time xsi:nil="true"/>
  44. <value xsi:nil="true"/>
  45. </received_date>
  46. <sample_time_received openmrs_concept="163168^RECEIVED_TIME^99DCT" openmrs_datatype="TM">
  47. <date xsi:nil="true"/>
  48. <time xsi:nil="true"/>
  49. <value xsi:nil="true">'now()'</value>
  50. </sample_time_received>
  51. <date_of_test_order openmrs_concept="163193^Date of test order^99DCT" openmrs_datatype="DT">
  52. <date xsi:nil="true"/>
  53. <time xsi:nil="true"/>
  54. <value xsi:nil="true"/>
  55. </date_of_test_order>
  56. <sample_temp openmrs_concept="163166^SAMPLE_TEMP^99DCT" openmrs_datatype="NM">
  57. <date xsi:nil="true"/>
  58. <time xsi:nil="true"/>
  59. <value xsi:nil="true"/>
  60. </sample_temp>
  61. <lab_incharge openmrs_concept="163167^LAB_INCHARGE^99DCT" openmrs_datatype="ST">
  62. <date xsi:nil="true"/>
  63. <time xsi:nil="true"/>
  64. <value xsi:nil="true"/>
  65. </lab_incharge>
  66. <sample_time openmrs_concept="161068^SAMPLE_TIME^99DCT" openmrs_datatype="TM">
  67. <date xsi:nil="true"/>
  68. <time xsi:nil="true"/>
  69. <value xsi:nil="true"/>
  70. </sample_time>
  71. <sample_type_2 openmrs_concept="162301^Sample_Type_2^99DCT" openmrs_datatype="CWE" multiple="0">
  72. <date xsi:nil="true"/>
  73. <time xsi:nil="true"/>
  74. <value xsi:nil="true"/>
  75. </sample_type_2>
  76. <specify_others_2 openmrs_concept="162300^Specify Others^99DCT" openmrs_datatype="ST">
  77. <date xsi:nil="true"/>
  78. <time xsi:nil="true"/>
  79. <value xsi:nil="true"/>
  80. </specify_others_2>
  81. <specify_others openmrs_concept="162300^Specify Others^99DCT" openmrs_datatype="ST">
  82. <date xsi:nil="true"/>
  83. <time xsi:nil="true"/>
  84. <value xsi:nil="true"/>
  85. </specify_others>
  86. <sample_type openmrs_concept="162299^Sample_Type^99DCT" openmrs_datatype="CWE" multiple="0">
  87. <date xsi:nil="true"/>
  88. <time xsi:nil="true"/>
  89. <value xsi:nil="true"/>
  90. </sample_type>
  91. <sample_date openmrs_concept="161067^Sample date^99DCT" openmrs_datatype="DT">
  92. <date xsi:nil="true"/>
  93. <time xsi:nil="true"/>
  94. <value xsi:nil="true">"today()"</value>
  95. </sample_date>
  96. <sample_time_1 openmrs_concept="161068^SAMPLE_TIME^99DCT" openmrs_datatype="TM">
  97. <date xsi:nil="true"/>
  98. <time xsi:nil="true"/>
  99. <value xsi:nil="true"/>
  100. </sample_time_1>
  101. <whole_blood openmrs_concept="161066^WHOLE_BLOOD^99DCT" openmrs_datatype="CWE" multiple="0">
  102. <date xsi:nil="true"/>
  103. <time xsi:nil="true"/>
  104. <value xsi:nil="true"/>
  105. </whole_blood>
  106. <in_charge openmrs_concept="161069^IN_CHARGE^99DCT" openmrs_datatype="ST">
  107. <date xsi:nil="true"/>
  108. <time xsi:nil="true"/>
  109. <value xsi:nil="true"/>
  110. </in_charge>
  111. </obs>
  112. </form>
  113. </xf:instance>
  114. <xf:bind id="patient.birthdate" nodeset="/form/patient/patient.birthdate" type="xsd:date" locked="true()" jr:preload="patient" jr:preloadParams="birthDate"/>
  115. <xf:bind id="patient.family_name" nodeset="/form/patient/patient.family_name" type="xsd:string" locked="true()" jr:preload="patient" jr:preloadParams="familyName"/>
  116. <xf:bind id="patient.given_name" nodeset="/form/patient/patient.given_name" type="xsd:string" locked="true()" jr:preload="patient" jr:preloadParams="givenName"/>
  117. <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()"/>
  118. <xf:bind id="patient.middle_name" nodeset="/form/patient/patient.middle_name" type="xsd:string" locked="true()" jr:preload="patient" jr:preloadParams="middleName"/>
  119. <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()"/>
  120. <xf:bind id="patient.sex" nodeset="/form/patient/patient.sex" type="xsd:string" locked="true()" jr:preload="patient" jr:preloadParams="sex"/>
  121. <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()"/>
  122. <xf:bind id="encounter.location_id" nodeset="/form/encounter/encounter.location_id" type="xsd:string" readonly="true()" visible="false()"/>
  123. <xf:bind id="encounter.provider_id" nodeset="/form/encounter/encounter.provider_id" type="xsd:string" readonly="true()" visible="false()"/>
  124. <xf:bind id="sample_date" nodeset="/form/obs/sample_date/value" type="xsd:date" required="true()" constraint=". &lt;= today()" message="Date here is not allowed to be in the future"/><xf:bind id="sample_time" nodeset="/form/obs/sample_time/value" type="xsd:time" required="true()"/><xf:bind id="in_charge" nodeset="/form/obs/in_charge/value" type="xsd:string" required="true()" constraint="length(.) &lt;= 20" message="The legth of the data is out of range"/><xf:bind id="sample_type" nodeset="/form/obs/sample_type/value" type="xsd:string"/><xf:bind id="specify_others" nodeset="/form/obs/specify_others/value" type="xsd:string" relevant="/form/obs/sample_type/value = '162298^Other Material^99DCT'" action="enable" required="true()"/><xf:bind id="sample_type_2" nodeset="/form/obs/sample_type_2/value" type="xsd:string"/><xf:bind id="specify_others_2" nodeset="/form/obs/specify_others_2/value" type="xsd:string" relevant="/form/obs/sample_type_2/value = '162298^Other Material^99DCT'" action="enable" required="true()"/><xf:bind id="sample_temp" nodeset="/form/obs/sample_temp/value" type="xsd:decimal"/><xf:bind id="lab_incharge" nodeset="/form/obs/lab_incharge/value" type="xsd:string"/><xf:bind id="sample_time_received" nodeset="/form/obs/sample_time_received/value" type="xsd:dateTime" constraint=". &lt;= today()" message="Date cannot be after today"/><xf:bind id="date_of_test_order" nodeset="/form/obs/date_of_test_order/value" type="xsd:date" required="true()"/><xf:bind id="datetime" nodeset="/form/obs/datetime/value" type="xsd:dateTime"/>
  125. <xf:bind id="received_date_time" nodeset="/form/obs/received_date_time/value" type="xsd:dateTime"/>
  126. <xf:bind id="received_date" nodeset="/form/obs/received_date/value" type="xsd:date"/>
  127.  
  128.  
  129.  
  130.  
  131.  
  132.  
  133.  
  134.  
  135.  
  136.  
  137. <xf:bind id="sample_time_1" nodeset="/form/obs/sample_time_1/value" type="xsd:time"/>
  138. <xf:bind id="whole_blood" nodeset="/form/obs/whole_blood/value" type="xsd:string"/>
  139.  
  140. <xf:bind id="patient_relative" nodeset="/form/patient/patient_relative"/>
  141. <xf:bind id="patient_relative.person" nodeset="/form/patient/patient_relative/patient_relative.person" type="xsd:string"/>
  142. <xf:bind id="patient_relative.relationship" nodeset="/form/patient/patient_relative/patient_relative.relationship" type="xsd:string"/>
  143. </xf:model>
  144. <xf:group id="1">
  145. <xf:label>Page1</xf:label>
  146. <xf:input bind="patient.birthdate">
  147. <xf:label>Date of birth</xf:label>
  148. </xf:input>
  149. <xf:input bind="patient.family_name">
  150. <xf:label>Last name</xf:label>
  151. </xf:input>
  152. <xf:input bind="patient.given_name">
  153. <xf:label>First name</xf:label>
  154. </xf:input>
  155. <xf:input bind="patient.medical_record_number">
  156. <xf:label>NACP number</xf:label>
  157. </xf:input>
  158. <xf:input bind="patient.middle_name">
  159. <xf:label>Middle name</xf:label>
  160. </xf:input>
  161. <xf:input bind="patient.patient_id">
  162. <xf:label>Patient Id</xf:label>
  163. </xf:input>
  164. <xf:input bind="patient.sex">
  165. <xf:label>Sex</xf:label>
  166. </xf:input>
  167. <xf:input bind="encounter.encounter_datetime">
  168. <xf:label>ENCOUNTER DATETIME</xf:label>
  169. </xf:input>
  170. <xf:select1 bind="encounter.location_id">
  171. <xf:label>LOCATION ID</xf:label>
  172. <xf:item id="1">
  173. <xf:label>Unknown Location [1]</xf:label>
  174. <xf:value>1</xf:value>
  175. </xf:item>
  176. </xf:select1>
  177. <xf:select1 bind="encounter.provider_id">
  178. <xf:label>PROVIDER ID</xf:label>
  179. <xf:item>
  180. <xf:label>Claudio Zaugg [12]</xf:label>
  181. <xf:value>1</xf:value>
  182. </xf:item>
  183. <xf:item>
  184. <xf:label>Lucas Gervas Shayo [13]</xf:label>
  185. <xf:value>2</xf:value>
  186. </xf:item>
  187. <xf:item>
  188. <xf:label>Agata Correia Agata [3]</xf:label>
  189. <xf:value>4</xf:value>
  190. </xf:item>
  191. <xf:item>
  192. <xf:label>Maja Weisser</xf:label>
  193. <xf:value>5</xf:value>
  194. </xf:item>
  195. <xf:item>
  196. <xf:label>Herry Robert Mapesi</xf:label>
  197. <xf:value>6</xf:value>
  198. </xf:item>
  199. <xf:item>
  200. <xf:label>George Rocky Sikalengo</xf:label>
  201. <xf:value>7</xf:value>
  202. </xf:item>
  203. <xf:item>
  204. <xf:label>ANDREW KATENDE</xf:label>
  205. <xf:value>8</xf:value>
  206. </xf:item>
  207. <xf:item>
  208. <xf:label>Robert Christopher Ndege</xf:label>
  209. <xf:value>9</xf:value>
  210. </xf:item>
  211. <xf:item>
  212. <xf:label>Getrud Joseph Mollel</xf:label>
  213. <xf:value>10</xf:value>
  214. </xf:item>
  215. <xf:item>
  216. <xf:label>Ezekiel Luoga</xf:label>
  217. <xf:value>11</xf:value>
  218. </xf:item>
  219. <xf:item>
  220. <xf:label>Lilian Moshi</xf:label>
  221. <xf:value>12</xf:value>
  222. </xf:item>
  223. <xf:item>
  224. <xf:label>Vanesa Anton Vazquez</xf:label>
  225. <xf:value>13</xf:value>
  226. </xf:item>
  227. <xf:item>
  228. <xf:label>Rahel Bircher</xf:label>
  229. <xf:value>14</xf:value>
  230. </xf:item>
  231. <xf:item>
  232. <xf:label>Gidion Fue</xf:label>
  233. <xf:value>15</xf:value>
  234. </xf:item>
  235. <xf:item>
  236. <xf:label>Athuman Mtandanguo</xf:label>
  237. <xf:value>16</xf:value>
  238. </xf:item>
  239. <xf:item>
  240. <xf:label>Specioza Hwaya</xf:label>
  241. <xf:value>17</xf:value>
  242. </xf:item>
  243. <xf:item>
  244. <xf:label>Armon Arpagaus</xf:label>
  245. <xf:value>18</xf:value>
  246. </xf:item>
  247. <xf:item>
  248. <xf:label>Sambuta Aloyce [125-5]</xf:label>
  249. <xf:value>19</xf:value>
  250. </xf:item>
  251. <xf:item>
  252. <xf:label>Anna Eichenberger [129-7]</xf:label>
  253. <xf:value>20</xf:value>
  254. </xf:item>
  255. <xf:item>
  256. <xf:label>Felister Godson Kiwelu</xf:label>
  257. <xf:value>21</xf:value>
  258. </xf:item>
  259. <xf:item>
  260. <xf:label>Phamarcy CDCI [132-1]</xf:label>
  261. <xf:value>22</xf:value>
  262. </xf:item>
  263. <xf:item>
  264. <xf:label>Pharmacy one Stop [133-9]</xf:label>
  265. <xf:value>23</xf:value>
  266. </xf:item>
  267. <xf:item>
  268. <xf:label>Linn Jarte</xf:label>
  269. <xf:value>24</xf:value>
  270. </xf:item>
  271. <xf:item>
  272. <xf:label>Omary Ngome Rajab [137-0]</xf:label>
  273. <xf:value>25</xf:value>
  274. </xf:item>
  275. <xf:item>
  276. <xf:label>Laura Gimenez Letona [139-6]</xf:label>
  277. <xf:value>26</xf:value>
  278. </xf:item>
  279. <xf:item>
  280. <xf:label>Herieth wilson ismael [140-4]</xf:label>
  281. <xf:value>27</xf:value>
  282. </xf:item>
  283. <xf:item>
  284. <xf:label>Selerine John Myeya [60-4]</xf:label>
  285. <xf:value>28</xf:value>
  286. </xf:item>
  287. <xf:item>
  288. <xf:label>PHILIP SCHMASSMANN [141-2]</xf:label>
  289. <xf:value>29</xf:value>
  290. </xf:item>
  291. <xf:item>
  292. <xf:label>Elizabeth Eliet Senkoro [142-0]</xf:label>
  293. <xf:value>30</xf:value>
  294. </xf:item>
  295. <xf:item>
  296. <xf:label>Vera Hodel [143-8]</xf:label>
  297. <xf:value>31</xf:value>
  298. </xf:item>
  299. <xf:item>
  300. <xf:label>Joshua Joseph Kapungu [144-6]</xf:label>
  301. <xf:value>32</xf:value>
  302. </xf:item>
  303. <xf:item>
  304. <xf:label>Andre Hofer [146-1]</xf:label>
  305. <xf:value>33</xf:value>
  306. </xf:item>
  307. <xf:item>
  308. <xf:label>Vera Portillo [147-9]</xf:label>
  309. <xf:value>34</xf:value>
  310. </xf:item>
  311. <xf:item>
  312. <xf:label>James Okuma [148-7]</xf:label>
  313. <xf:value>35</xf:value>
  314. </xf:item>
  315. <xf:item>
  316. <xf:label>Sandra Glauser [149-5]</xf:label>
  317. <xf:value>36</xf:value>
  318. </xf:item>
  319. <xf:item>
  320. <xf:label>Raphael Magnolini [151-1]</xf:label>
  321. <xf:value>37</xf:value>
  322. </xf:item>
  323. <xf:item>
  324. <xf:label>Olivia John Kitau [152-9]</xf:label>
  325. <xf:value>38</xf:value>
  326. </xf:item>
  327. <xf:item>
  328. <xf:label>Alois Mbuta [153-7]</xf:label>
  329. <xf:value>39</xf:value>
  330. </xf:item>
  331. <xf:item>
  332. <xf:label>Paul Camille Genton [154-5]</xf:label>
  333. <xf:value>40</xf:value>
  334. </xf:item>
  335. <xf:item>
  336. <xf:label>Evarist Chiweka [19-0]</xf:label>
  337. <xf:value>41</xf:value>
  338. </xf:item>
  339. <xf:item>
  340. <xf:label>John Malugu [44-8]</xf:label>
  341. <xf:value>42</xf:value>
  342. </xf:item>
  343. <xf:item>
  344. <xf:label>Ivana Di Salvo [157-8]</xf:label>
  345. <xf:value>43</xf:value>
  346. </xf:item>
  347. <xf:item>
  348. <xf:label>Michael Charles Kasmiri [159-4]</xf:label>
  349. <xf:value>44</xf:value>
  350. </xf:item>
  351. <xf:item>
  352. <xf:label>George Frederick Mkoma [95-0]</xf:label>
  353. <xf:value>45</xf:value>
  354. </xf:item>
  355. <xf:item>
  356. <xf:label>Mary Gregory Marandu [107-3]</xf:label>
  357. <xf:value>46</xf:value>
  358. </xf:item>
  359. <xf:item>
  360. <xf:label>Asha Juma Haroub [13-3]</xf:label>
  361. <xf:value>47</xf:value>
  362. </xf:item>
  363. <xf:item>
  364. <xf:label>Bernard Gabriel Kivuma [75-2]</xf:label>
  365. <xf:value>48</xf:value>
  366. </xf:item>
  367. <xf:item>
  368. <xf:label>Jacopo Nicoletti [158-6]</xf:label>
  369. <xf:value>49</xf:value>
  370. </xf:item>
  371. <xf:item>
  372. <xf:label>Slyakus Vintan Mlembe [145-3]</xf:label>
  373. <xf:value>50</xf:value>
  374. </xf:item>
  375. <xf:item>
  376. <xf:label>George Frederick Sigalla [164-4]</xf:label>
  377. <xf:value>51</xf:value>
  378. </xf:item>
  379. <xf:item>
  380. <xf:label>Francisca Seraphin Chuwa [165-1]</xf:label>
  381. <xf:value>52</xf:value>
  382. </xf:item>
  383. <xf:item>
  384. <xf:label>Farida Bani [114-9]</xf:label>
  385. <xf:value>53</xf:value>
  386. </xf:item>
  387. <xf:item>
  388. <xf:label>Yvonne Ramesh Haridas [171-9]</xf:label>
  389. <xf:value>54</xf:value>
  390. </xf:item>
  391. <xf:item>
  392. <xf:label>Jacqueline Inoja Nkouabi [170-1]</xf:label>
  393. <xf:value>55</xf:value>
  394. </xf:item>
  395. <xf:item>
  396. <xf:label>Suzan Ngalimecha Ngahyoma [172-7]</xf:label>
  397. <xf:value>56</xf:value>
  398. </xf:item>
  399. <xf:item>
  400. <xf:label>Regina Ndaki [84-4]</xf:label>
  401. <xf:value>57</xf:value>
  402. </xf:item>
  403. <xf:item>
  404. <xf:label>Sarah Katharina Staehelin [175-0]</xf:label>
  405. <xf:value>58</xf:value>
  406. </xf:item>
  407. <xf:item>
  408. <xf:label>John Wigayi [61-2]</xf:label>
  409. <xf:value>59</xf:value>
  410. </xf:item>
  411. <xf:item>
  412. <xf:label>Mabula John [59-6]</xf:label>
  413. <xf:value>60</xf:value>
  414. </xf:item>
  415. <xf:item>
  416. <xf:label>Athuman Said Mtandanguo [64-6]</xf:label>
  417. <xf:value>61</xf:value>
  418. </xf:item>
  419. <xf:item>
  420. <xf:label>Mohamed Godfrey Mbaruku [173-5]</xf:label>
  421. <xf:value>62</xf:value>
  422. </xf:item>
  423. <xf:item>
  424. <xf:label>Juma Kupewa [176-8]</xf:label>
  425. <xf:value>63</xf:value>
  426. </xf:item>
  427. <xf:item>
  428. <xf:label>Leila Samson [85-1]</xf:label>
  429. <xf:value>64</xf:value>
  430. </xf:item>
  431. <xf:item>
  432. <xf:label>Ramadhan Katala [177-6]</xf:label>
  433. <xf:value>65</xf:value>
  434. </xf:item>
  435. <xf:item>
  436. <xf:label>Elizabeth Dotto Kagwese [179-2]</xf:label>
  437. <xf:value>66</xf:value>
  438. </xf:item>
  439. <xf:item>
  440. <xf:label>Lulu Wilson Ismael [180-0]</xf:label>
  441. <xf:value>67</xf:value>
  442. </xf:item>
  443. <xf:item>
  444. <xf:label>Rabson Namtwanga [181-8]</xf:label>
  445. <xf:value>68</xf:value>
  446. </xf:item>
  447. <xf:item>
  448. <xf:label>Belina Byabato [182-6]</xf:label>
  449. <xf:value>69</xf:value>
  450. </xf:item>
  451. <xf:item>
  452. <xf:label>Sturida Patrick [183-4]</xf:label>
  453. <xf:value>70</xf:value>
  454. </xf:item>
  455. <xf:item>
  456. <xf:label>Florent Raphael Heritier [184-2]</xf:label>
  457. <xf:value>71</xf:value>
  458. </xf:item>
  459. <xf:item>
  460. <xf:label>Happyphania Isaya Ngakongwa [167-7]</xf:label>
  461. <xf:value>72</xf:value>
  462. </xf:item>
  463. <xf:item>
  464. <xf:label>Petro Togolani Sabuni [185-9]</xf:label>
  465. <xf:value>73</xf:value>
  466. </xf:item>
  467. <xf:item>
  468. <xf:label>Cecilia Philipo Ligogo [186-7]</xf:label>
  469. <xf:value>74</xf:value>
  470. </xf:item>
  471. <xf:item>
  472. <xf:label>Selerine Myeya [46-3]</xf:label>
  473. <xf:value>75</xf:value>
  474. </xf:item>
  475. <xf:item>
  476. <xf:label>Namsifueli Julius Ley [187-5]</xf:label>
  477. <xf:value>76</xf:value>
  478. </xf:item>
  479. <xf:item>
  480. <xf:label>Bedran Topyurek [188-3]</xf:label>
  481. <xf:value>77</xf:value>
  482. </xf:item>
  483. <xf:item>
  484. <xf:label>Edgar Enzigard Martin [189-1]</xf:label>
  485. <xf:value>78</xf:value>
  486. </xf:item>
  487. <xf:item>
  488. <xf:label>Fredy Geiger [190-9]</xf:label>
  489. <xf:value>79</xf:value>
  490. </xf:item>
  491. <xf:item>
  492. <xf:label>Getruda Lenia Julius [193-3]</xf:label>
  493. <xf:value>80</xf:value>
  494. </xf:item>
  495. <xf:item>
  496. <xf:label>Florian Kasper Mury [194-1]</xf:label>
  497. <xf:value>81</xf:value>
  498. </xf:item>
  499. <xf:item>
  500. <xf:label>Sara Glanzmann [195-8]</xf:label>
  501. <xf:value>82</xf:value>
  502. </xf:item>
  503. <xf:item>
  504. <xf:label>Benjamin Yannick Bissmann [196-6]</xf:label>
  505. <xf:value>83</xf:value>
  506. </xf:item>
  507. <xf:item>
  508. <xf:label>Herry Robert Mapesi [14]</xf:label>
  509. <xf:value>3</xf:value>
  510. </xf:item>
  511. <xf:item id="1"><xf:label>Claudio Zaugg [12]</xf:label><xf:value>1</xf:value></xf:item><xf:item id="2"><xf:label>Lucas Gervas Shayo [13]</xf:label><xf:value>2</xf:value></xf:item><xf:item id="4"><xf:label>Agata Correia Agata [3]</xf:label><xf:value>4</xf:value></xf:item><xf:item id="5"><xf:label>Maja Weisser</xf:label><xf:value>5</xf:value></xf:item><xf:item id="6"><xf:label>Herry Robert Mapesi</xf:label><xf:value>6</xf:value></xf:item><xf:item id="7"><xf:label>George Rocky Sikalengo</xf:label><xf:value>7</xf:value></xf:item><xf:item id="8"><xf:label>ANDREW KATENDE</xf:label><xf:value>8</xf:value></xf:item><xf:item id="9"><xf:label>Robert Christopher Ndege</xf:label><xf:value>9</xf:value></xf:item><xf:item id="10"><xf:label>Getrud Joseph Mollel</xf:label><xf:value>10</xf:value></xf:item><xf:item id="11"><xf:label>Ezekiel Luoga</xf:label><xf:value>11</xf:value></xf:item><xf:item id="12"><xf:label>Lilian Moshi</xf:label><xf:value>12</xf:value></xf:item><xf:item id="13"><xf:label>Vanesa Anton Vazquez</xf:label><xf:value>13</xf:value></xf:item><xf:item id="14"><xf:label>Rahel Bircher</xf:label><xf:value>14</xf:value></xf:item><xf:item id="15"><xf:label>Gidion Fue</xf:label><xf:value>15</xf:value></xf:item><xf:item id="16"><xf:label>Athuman Mtandanguo</xf:label><xf:value>16</xf:value></xf:item><xf:item id="17"><xf:label>Specioza Hwaya</xf:label><xf:value>17</xf:value></xf:item><xf:item id="18"><xf:label>Armon Arpagaus</xf:label><xf:value>18</xf:value></xf:item><xf:item id="19"><xf:label>Sambuta Aloyce [125-5]</xf:label><xf:value>19</xf:value></xf:item><xf:item id="20"><xf:label>Anna Eichenberger [129-7]</xf:label><xf:value>20</xf:value></xf:item><xf:item id="21"><xf:label>Felister Godson Kiwelu</xf:label><xf:value>21</xf:value></xf:item><xf:item id="22"><xf:label>Phamarcy CDCI [132-1]</xf:label><xf:value>22</xf:value></xf:item><xf:item id="23"><xf:label>Pharmacy one Stop [133-9]</xf:label><xf:value>23</xf:value></xf:item><xf:item id="24"><xf:label>Linn Jarte</xf:label><xf:value>24</xf:value></xf:item><xf:item id="25"><xf:label>Omary Ngome Rajab [137-0]</xf:label><xf:value>25</xf:value></xf:item><xf:item id="26"><xf:label>Laura Gimenez Letona [139-6]</xf:label><xf:value>26</xf:value></xf:item><xf:item id="27"><xf:label>Herieth wilson ismael [140-4]</xf:label><xf:value>27</xf:value></xf:item><xf:item id="28"><xf:label>Selerine John Myeya [60-4]</xf:label><xf:value>28</xf:value></xf:item><xf:item id="29"><xf:label>PHILIP SCHMASSMANN [141-2]</xf:label><xf:value>29</xf:value></xf:item><xf:item id="30"><xf:label>Elizabeth Eliet Senkoro [142-0]</xf:label><xf:value>30</xf:value></xf:item><xf:item id="31"><xf:label>Vera Hodel [143-8]</xf:label><xf:value>31</xf:value></xf:item><xf:item id="32"><xf:label>Joshua Joseph Kapungu [144-6]</xf:label><xf:value>32</xf:value></xf:item><xf:item id="33"><xf:label>Andre Hofer [146-1]</xf:label><xf:value>33</xf:value></xf:item><xf:item id="34"><xf:label>Vera Portillo [147-9]</xf:label><xf:value>34</xf:value></xf:item><xf:item id="35"><xf:label>James Okuma [148-7]</xf:label><xf:value>35</xf:value></xf:item><xf:item id="36"><xf:label>Sandra Glauser [149-5]</xf:label><xf:value>36</xf:value></xf:item><xf:item id="37"><xf:label>Raphael Magnolini [151-1]</xf:label><xf:value>37</xf:value></xf:item><xf:item id="38"><xf:label>Olivia John Kitau [152-9]</xf:label><xf:value>38</xf:value></xf:item><xf:item id="39"><xf:label>Alois Mbuta [153-7]</xf:label><xf:value>39</xf:value></xf:item><xf:item id="40"><xf:label>Paul Camille Genton [154-5]</xf:label><xf:value>40</xf:value></xf:item><xf:item id="41"><xf:label>Evarist Chiweka [19-0]</xf:label><xf:value>41</xf:value></xf:item><xf:item id="42"><xf:label>John Malugu [44-8]</xf:label><xf:value>42</xf:value></xf:item><xf:item id="43"><xf:label>Ivana Di Salvo [157-8]</xf:label><xf:value>43</xf:value></xf:item><xf:item id="44"><xf:label>Michael Charles Kasmiri [159-4]</xf:label><xf:value>44</xf:value></xf:item><xf:item id="45"><xf:label>George Frederick Mkoma [95-0]</xf:label><xf:value>45</xf:value></xf:item><xf:item id="46"><xf:label>Mary Gregory Marandu [107-3]</xf:label><xf:value>46</xf:value></xf:item><xf:item id="47"><xf:label>Asha Juma Haroub [13-3]</xf:label><xf:value>47</xf:value></xf:item><xf:item id="48"><xf:label>Bernard Gabriel Kivuma [75-2]</xf:label><xf:value>48</xf:value></xf:item><xf:item id="49"><xf:label>Jacopo Nicoletti [158-6]</xf:label><xf:value>49</xf:value></xf:item><xf:item id="50"><xf:label>Slyakus Vintan Mlembe [145-3]</xf:label><xf:value>50</xf:value></xf:item><xf:item id="51"><xf:label>George Frederick Sigalla [164-4]</xf:label><xf:value>51</xf:value></xf:item><xf:item id="52"><xf:label>Francisca Seraphin Chuwa [165-1]</xf:label><xf:value>52</xf:value></xf:item><xf:item id="53"><xf:label>Farida Bani [114-9]</xf:label><xf:value>53</xf:value></xf:item><xf:item id="54"><xf:label>Yvonne Ramesh Haridas [171-9]</xf:label><xf:value>54</xf:value></xf:item><xf:item id="55"><xf:label>Jacqueline Inoja Nkouabi [170-1]</xf:label><xf:value>55</xf:value></xf:item><xf:item id="56"><xf:label>Suzan Ngalimecha Ngahyoma [172-7]</xf:label><xf:value>56</xf:value></xf:item><xf:item id="57"><xf:label>Regina Ndaki [84-4]</xf:label><xf:value>57</xf:value></xf:item><xf:item id="58"><xf:label>Sarah Katharina Staehelin [175-0]</xf:label><xf:value>58</xf:value></xf:item><xf:item id="59"><xf:label>John Wigayi [61-2]</xf:label><xf:value>59</xf:value></xf:item><xf:item id="60"><xf:label>Mabula John [59-6]</xf:label><xf:value>60</xf:value></xf:item><xf:item id="61"><xf:label>Athuman Said Mtandanguo [64-6]</xf:label><xf:value>61</xf:value></xf:item><xf:item id="62"><xf:label>Mohamed Godfrey Mbaruku [173-5]</xf:label><xf:value>62</xf:value></xf:item><xf:item id="63"><xf:label>Juma Kupewa [176-8]</xf:label><xf:value>63</xf:value></xf:item><xf:item id="64"><xf:label>Leila Samson [85-1]</xf:label><xf:value>64</xf:value></xf:item><xf:item id="65"><xf:label>Ramadhan Katala [177-6]</xf:label><xf:value>65</xf:value></xf:item><xf:item id="66"><xf:label>Elizabeth Dotto Kagwese [179-2]</xf:label><xf:value>66</xf:value></xf:item><xf:item id="67"><xf:label>Lulu Wilson Ismael [180-0]</xf:label><xf:value>67</xf:value></xf:item><xf:item id="68"><xf:label>Rabson Namtwanga [181-8]</xf:label><xf:value>68</xf:value></xf:item><xf:item id="69"><xf:label>Belina Byabato [182-6]</xf:label><xf:value>69</xf:value></xf:item><xf:item id="70"><xf:label>Sturida Patrick [183-4]</xf:label><xf:value>70</xf:value></xf:item><xf:item id="71"><xf:label>Florent Raphael Heritier [184-2]</xf:label><xf:value>71</xf:value></xf:item><xf:item id="72"><xf:label>Happyphania Isaya Ngakongwa [167-7]</xf:label><xf:value>72</xf:value></xf:item><xf:item id="73"><xf:label>Petro Togolani Sabuni [185-9]</xf:label><xf:value>73</xf:value></xf:item><xf:item id="74"><xf:label>Cecilia Philipo Ligogo [186-7]</xf:label><xf:value>74</xf:value></xf:item><xf:item id="75"><xf:label>Selerine Myeya [46-3]</xf:label><xf:value>75</xf:value></xf:item><xf:item id="76"><xf:label>Namsifueli Julius Ley [187-5]</xf:label><xf:value>76</xf:value></xf:item><xf:item id="77"><xf:label>Bedran Topyurek [188-3]</xf:label><xf:value>77</xf:value></xf:item><xf:item id="78"><xf:label>Edgar Enzigard Martin [189-1]</xf:label><xf:value>78</xf:value></xf:item><xf:item id="79"><xf:label>Fredy Geiger [190-9]</xf:label><xf:value>79</xf:value></xf:item><xf:item id="80"><xf:label>Getruda Lenia Julius [193-3]</xf:label><xf:value>80</xf:value></xf:item><xf:item id="81"><xf:label>Florian Kasper Mury [194-1]</xf:label><xf:value>81</xf:value></xf:item><xf:item id="82"><xf:label>Sara Glanzmann [195-8]</xf:label><xf:value>82</xf:value></xf:item><xf:item id="83"><xf:label>Benjamin Yannick Bissmann [196-6]</xf:label><xf:value>83</xf:value></xf:item><xf:item id="3"><xf:label>Herry Robert Mapesi [14]</xf:label><xf:value>3</xf:value></xf:item><xf:item id="100"><xf:label>Maja Weisser [100]</xf:label><xf:value>100</xf:value></xf:item><xf:item id="90"><xf:label>Julius Mkumbo [90]</xf:label><xf:value>90</xf:value></xf:item><xf:item id="96"><xf:label>ANDREW KATENDE [96]</xf:label><xf:value>96</xf:value></xf:item><xf:item id="113"><xf:label>Getrud Joseph Mollel [113]</xf:label><xf:value>113</xf:value></xf:item><xf:item id="111"><xf:label>Robert Christopher Ndege [111]</xf:label><xf:value>111</xf:value></xf:item><xf:item id="117"><xf:label>Lilian Moshi [117]</xf:label><xf:value>117</xf:value></xf:item><xf:item id="105"><xf:label>Ezekiel Luoga [105]</xf:label><xf:value>105</xf:value></xf:item><xf:item id="124"><xf:label>Vaileth Brown Nyahenza [124]</xf:label><xf:value>124</xf:value></xf:item><xf:item id="130"><xf:label>Felister Godson Kiwelu [130]</xf:label><xf:value>130</xf:value></xf:item><xf:item id="128"><xf:label>Armon Arpagaus [128]</xf:label><xf:value>128</xf:value></xf:item><xf:item id="129"><xf:label>Anna Eichenberger [129]</xf:label><xf:value>129</xf:value></xf:item><xf:item id="125"><xf:label>Ngisi Peter Masawa [125]</xf:label><xf:value>125</xf:value></xf:item><xf:item id="134"><xf:label>Linn Jarte [134]</xf:label><xf:value>134</xf:value></xf:item><xf:item id="135"><xf:label>Sauli John Epimack [135]</xf:label><xf:value>135</xf:value></xf:item><xf:item id="137"><xf:label>Omary Ngome Rajab [137]</xf:label><xf:value>137</xf:value></xf:item><xf:item id="139"><xf:label>Laura Gimenez Letona [139]</xf:label><xf:value>139</xf:value></xf:item><xf:item id="140"><xf:label>Herieth wilson ismael [140]</xf:label><xf:value>140</xf:value></xf:item><xf:item id="141"><xf:label>PHILIP SCHMASSMANN [141]</xf:label><xf:value>141</xf:value></xf:item><xf:item id="145"><xf:label>Slyakus Vintan Mlembe [145]</xf:label><xf:value>145</xf:value></xf:item><xf:item id="148"><xf:label>James Okuma [148]</xf:label><xf:value>148</xf:value></xf:item><xf:item id="163"><xf:label>Clesencia Doka [163]</xf:label><xf:value>163</xf:value></xf:item><xf:item id="152"><xf:label>Olivia John Kitau [152]</xf:label><xf:value>152</xf:value></xf:item><xf:item id="160"><xf:label>Regina Mponji [160]</xf:label><xf:value>160</xf:value></xf:item><xf:item id="170"><xf:label>Jacqueline Inoja Nkouabi [170]</xf:label><xf:value>170</xf:value></xf:item><xf:item id="172"><xf:label>Suzan Ngalimecha Ngahyoma [172]</xf:label><xf:value>172</xf:value></xf:item><xf:item id="86"><xf:label>Regina Ndaki [86]</xf:label><xf:value>86</xf:value></xf:item><xf:item id="175"><xf:label>Sarah Katharina Staehelin [175]</xf:label><xf:value>175</xf:value></xf:item><xf:item id="174"><xf:label>Jerome Lwali [174]</xf:label><xf:value>174</xf:value></xf:item><xf:item id="173"><xf:label>Mohamed Godfrey Mbaruku [173]</xf:label><xf:value>173</xf:value></xf:item><xf:item id="171"><xf:label>Yvonne Ramesh Haridas [171]</xf:label><xf:value>171</xf:value></xf:item><xf:item id="165"><xf:label>Francisca Seraphin Chuwa [165]</xf:label><xf:value>165</xf:value></xf:item><xf:item id="87"><xf:label>Leila Samson [87]</xf:label><xf:value>87</xf:value></xf:item><xf:item id="178"><xf:label>Deogratius Nzaligo [178]</xf:label><xf:value>178</xf:value></xf:item><xf:item id="179"><xf:label>Elizabeth Dotto Kagwese [179]</xf:label><xf:value>179</xf:value></xf:item><xf:item id="180"><xf:label>Lulu Wilson Ismael [180]</xf:label><xf:value>180</xf:value></xf:item><xf:item id="181"><xf:label>Rabson Namtwanga [181]</xf:label><xf:value>181</xf:value></xf:item><xf:item id="184"><xf:label>Florent Raphael Heritier [184]</xf:label><xf:value>184</xf:value></xf:item><xf:item id="167"><xf:label>Happyphania Isaya Ngakongwa [167]</xf:label><xf:value>167</xf:value></xf:item><xf:item id="106"><xf:label>Sharifa Nakapala [106]</xf:label><xf:value>106</xf:value></xf:item><xf:item id="185"><xf:label>Petro Togolani Sabuni [185]</xf:label><xf:value>185</xf:value></xf:item><xf:item id="187"><xf:label>Namsifueli Julius Ley [187]</xf:label><xf:value>187</xf:value></xf:item><xf:item id="188"><xf:label>Bedran Topyurek [188]</xf:label><xf:value>188</xf:value></xf:item><xf:item id="190"><xf:label>Fredy Geiger [190]</xf:label><xf:value>190</xf:value></xf:item><xf:item id="176"><xf:label>Juma Kupewa [176]</xf:label><xf:value>176</xf:value></xf:item><xf:item id="193"><xf:label>Getruda Lenia Julius [193]</xf:label><xf:value>193</xf:value></xf:item><xf:item id="194"><xf:label>Florian Kasper Mury [194]</xf:label><xf:value>194</xf:value></xf:item><xf:item id="195"><xf:label>Sara Glanzmann [195]</xf:label><xf:value>195</xf:value></xf:item><xf:item id="196"><xf:label>Benjamin Yannick Bissmann [196]</xf:label><xf:value>196</xf:value></xf:item></xf:select1>
  512. <xf:input bind="sample_date">
  513. <xf:label>Date of blood draw</xf:label>
  514. <xf:hint>Date of blood draw-A question on KIULARCO HIV_MRS sample form.</xf:hint>
  515. </xf:input><xf:input bind="sample_time">
  516. <xf:label>Time of blood draw</xf:label>
  517. <xf:hint>Time of blood draw-A question on KIULARCO HIV_MRS sample form.</xf:hint>
  518. </xf:input><xf:input bind="in_charge">
  519. <xf:label>Blood draw by</xf:label>
  520. <xf:hint>Blood draw by-A question on KIULARCO HIV_MRS sample form.</xf:hint>
  521. </xf:input><xf:select1 bind="sample_type">
  522. <xf:label>Sample_Type</xf:label>
  523. <xf:item concept_id="162299" id="1000^WHOLE BLOOD^99DCT">
  524. <xf:label>WHOLE BLOOD</xf:label>
  525. <xf:value>1000^WHOLE BLOOD^99DCT</xf:value>
  526. </xf:item>
  527. <xf:item concept_id="162299" id="161957^CAPILLARY_BLOOD^99DCT">
  528. <xf:label>CAPILLARY_BLOOD</xf:label>
  529. <xf:value>161957^CAPILLARY_BLOOD^99DCT</xf:value>
  530. </xf:item>
  531. <xf:item concept_id="162299" id="161751^urine_sample^99DCT">
  532. <xf:label>urine_sample</xf:label>
  533. <xf:value>161751^urine_sample^99DCT</xf:value>
  534. </xf:item>
  535. <xf:item concept_id="162299" id="159993^feces^99DCT">
  536. <xf:label>feces</xf:label>
  537. <xf:value>159993^feces^99DCT</xf:value>
  538. </xf:item>
  539. <xf:item concept_id="162299" id="1004^SPUTUM^99DCT">
  540. <xf:label>SPUTUM</xf:label>
  541. <xf:value>1004^SPUTUM^99DCT</xf:value>
  542. </xf:item>
  543. <xf:item concept_id="162299" id="161705^CSF^99DCT">
  544. <xf:label>CSF</xf:label>
  545. <xf:value>161705^CSF^99DCT</xf:value>
  546. </xf:item>
  547. <xf:item concept_id="162299" id="162298^Other Material^99DCT">
  548. <xf:label>Other Material</xf:label>
  549. <xf:value>162298^Other Material^99DCT</xf:value>
  550. </xf:item>
  551. </xf:select1><xf:input bind="specify_others">
  552. <xf:label>Specify Others</xf:label>
  553. </xf:input><xf:select1 bind="sample_type_2">
  554. <xf:label>Sample_Type_2</xf:label>
  555. <xf:item concept_id="162301" id="1000^WHOLE BLOOD^99DCT">
  556. <xf:label>WHOLE BLOOD</xf:label>
  557. <xf:value>1000^WHOLE BLOOD^99DCT</xf:value>
  558. </xf:item>
  559. <xf:item concept_id="162301" id="161957^CAPILLARY_BLOOD^99DCT">
  560. <xf:label>CAPILLARY_BLOOD</xf:label>
  561. <xf:value>161957^CAPILLARY_BLOOD^99DCT</xf:value>
  562. </xf:item>
  563. <xf:item concept_id="162301" id="161751^urine_sample^99DCT">
  564. <xf:label>urine_sample</xf:label>
  565. <xf:value>161751^urine_sample^99DCT</xf:value>
  566. </xf:item>
  567. <xf:item concept_id="162301" id="159993^feces^99DCT">
  568. <xf:label>feces</xf:label>
  569. <xf:value>159993^feces^99DCT</xf:value>
  570. </xf:item>
  571. <xf:item concept_id="162301" id="1004^SPUTUM^99DCT">
  572. <xf:label>SPUTUM</xf:label>
  573. <xf:value>1004^SPUTUM^99DCT</xf:value>
  574. </xf:item>
  575. <xf:item concept_id="162301" id="162298^Other Material^99DCT">
  576. <xf:label>Other Material</xf:label>
  577. <xf:value>162298^Other Material^99DCT</xf:value>
  578. </xf:item>
  579. </xf:select1><xf:input bind="specify_others_2">
  580. <xf:label>Specify Others</xf:label>
  581. </xf:input><xf:input bind="sample_temp">
  582. <xf:label>SAMPLE_TEMP</xf:label>
  583. <xf:hint>Sample temperature</xf:hint>
  584. </xf:input><xf:input bind="lab_incharge">
  585. <xf:label>LAB_INCHARGE</xf:label>
  586. <xf:hint>Laboratory incharge name</xf:hint>
  587. </xf:input><xf:input bind="sample_time_received">
  588. <xf:label>SAMPLE_TIME_RECEIVED</xf:label>
  589. <xf:hint>Sample time received</xf:hint>
  590. </xf:input><xf:input bind="date_of_test_order">
  591. <xf:label>Date of test order</xf:label>
  592. <xf:hint>Date of test order</xf:hint>
  593. </xf:input><xf:input bind="datetime">
  594. <xf:label>Datetime</xf:label>
  595. <xf:hint>Datetime testing concept</xf:hint>
  596. </xf:input>
  597. <xf:input bind="received_date_time">
  598. <xf:label>RECEIVED_DATE_TIME</xf:label>
  599. <xf:hint>Date-time of sample received</xf:hint>
  600. </xf:input>
  601. <xf:input bind="received_date">
  602. <xf:label>RECEIVED_DATE</xf:label>
  603. <xf:hint>Sample received date</xf:hint>
  604. </xf:input>
  605.  
  606.  
  607.  
  608.  
  609.  
  610.  
  611.  
  612.  
  613.  
  614.  
  615. <xf:input bind="sample_time_1">
  616. <xf:label>SAMPLE_TIME</xf:label>
  617. <xf:hint>Time of blood draw-A question on KIULARCO HIV_MRS sample form.</xf:hint>
  618. </xf:input>
  619. <xf:select1 bind="whole_blood">
  620. <xf:label>WHOLE_BLOOD</xf:label>
  621. <xf:hint>Whole ETDA blood-A question on KIULARCO HIV_MRS sample form.</xf:hint>
  622. <xf:item concept_id="161066" id="1066^NO^99DCT">
  623. <xf:label>NO</xf:label>
  624. <xf:value>1066^NO^99DCT</xf:value>
  625. </xf:item>
  626. <xf:item concept_id="161066" id="1065^YES^99DCT">
  627. <xf:label>YES</xf:label>
  628. <xf:value>1065^YES^99DCT</xf:value>
  629. </xf:item>
  630. </xf:select1>
  631.  
  632. <xf:group id="patient/patient_relative">
  633. <xf:label>RELATIONSHIPS</xf:label>
  634. <xf:hint>Relationships that this patient has.</xf:hint>
  635. <xf:repeat bind="patient_relative">
  636.  
  637. <xf:input bind="patient_relative.person">
  638. <xf:label>RELATIVE</xf:label>
  639. </xf:input>
  640.  
  641. <xf:select1 bind="patient_relative.relationship">
  642. <xf:item id="1A">
  643. <xf:label>is Doctor [1]</xf:label>
  644. <xf:value>1A</xf:value>
  645. </xf:item>
  646. <xf:item id="1B">
  647. <xf:label>is Patient [1]</xf:label>
  648. <xf:value>1B</xf:value>
  649. </xf:item>
  650. <xf:item id="2A">
  651. <xf:label>is Sibling [2]</xf:label>
  652. <xf:value>2A</xf:value>
  653. </xf:item>
  654. <xf:item id="3A">
  655. <xf:label>is Parent [3]</xf:label>
  656. <xf:value>3A</xf:value>
  657. </xf:item>
  658. <xf:item id="3B">
  659. <xf:label>is Child [3]</xf:label>
  660. <xf:value>3B</xf:value>
  661. </xf:item>
  662. <xf:item id="4A">
  663. <xf:label>is Aunt/Uncle [4]</xf:label>
  664. <xf:value>4A</xf:value>
  665. </xf:item>
  666. <xf:item id="4B">
  667. <xf:label>is Niece/Nephew [4]</xf:label>
  668. <xf:value>4B</xf:value>
  669. </xf:item>
  670. <xf:label>RELATIONSHIP</xf:label>
  671. </xf:select1>
  672. </xf:repeat>
  673. </xf:group>
  674. </xf:group>
  675. </xf:xforms></Xform><Layout><Form id="76"><Page Text="Page1" fontWeight="normal" fontSize="12px" fontFamily="Verdana, 'Lucida Grande', 'Trebuchet MS', Arial, Sans-Serif" Binding="Page1" Width="1100px" Height="800px" backgroundColor=""><Item WidgetType="GroupBox" Binding="LEFT48pxTOP120px" Left="48px" Top="120px" Width="880px" Height="150px" TabIndex="0" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, 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, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif" backgroundColor="rgb(26, 172, 155)" textAlign="center" HeaderLabel="true"/><Item WidgetType="Label" Text="Last name" HelpText="Last name" Binding="patient/patient.family_name" Left="10px" Top="30px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="Label" Text="First name" HelpText="First name" Binding="patient/patient.given_name" Left="250px" Top="30px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="Label" Text="Middle name" HelpText="Middle name" Binding="patient/patient.middle_name" Left="514px" Top="30px" Height="0px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="TextBox" HelpText="Last name" Binding="patient/patient.family_name" Left="10px" Top="50px" Width="216px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="TextBox" HelpText="First name" Binding="patient/patient.given_name" Left="250px" Top="50px" Width="252px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="Label" Text="Sex" HelpText="Sex" Binding="patient/patient.sex" Left="10px" Top="90px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="Label" Text="Date of birth" HelpText="Date of birth" Binding="patient/patient.birthdate" Left="250px" Top="90px" Height="25px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="TextBox" HelpText="Sex" Binding="patient/patient.sex" Left="10px" Top="110px" Width="216px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="DatePicker" HelpText="Date of birth" Binding="patient/patient.birthdate" Left="250px" Top="110px" Width="252px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="TextBox" HelpText="Middle name" Binding="patient/patient.middle_name" Left="514px" Top="50px" Width="209px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/></Item><Item WidgetType="Label" Text="Sample form" HelpText="Label" Binding="LEFT40pxTOP29px" Left="48px" Top="30px" TabIndex="0" fontWeight="bold" fontSize="20px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif" borderStyle="solid" borderWidth="1px" textAlign="center"/><Item WidgetType="TextBox" HelpText="NACP number" Binding="patient/patient.medical_record_number" Left="729px" Top="40px" Width="200px" Height="25px" TabIndex="29" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="Label" Text="NACP number" HelpText="NACP number" Binding="patient/patient.medical_record_number" Left="587px" Top="38px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="Label" Text="Date of Sample" HelpText="ENCOUNTER DATETIME" Binding="encounter/encounter.encounter_datetime" Left="589px" Top="84px" Height="1px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="Button" Text="Cancel" HelpText="cancel" Binding="cancel" Left="786px" Top="754px" Width="140px" Height="30px" TabIndex="0" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="Button" Text="Submit and Finish" HelpText="submit" Binding="submit" Left="618px" Top="755px" Width="140px" Height="30px" TabIndex="0" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif" Id="submit"/><Item WidgetType="GroupBox" Binding="LEFT48pxTOP290px" Left="48px" Top="290px" Width="880px" Height="444px" TabIndex="0" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif" borderStyle="solid"><Item WidgetType="Label" Text="SAMPLE" HelpText="Header Label" Binding="LEFT48pxTOP290px" Left="0px" Top="0px" Width="100%" Height="20px" TabIndex="0" color="white" fontWeight="bold" fontSize="16px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif" backgroundColor="rgb(26, 172, 155)" textAlign="center" HeaderLabel="true"/><Item WidgetType="Label" Text="Specify Others" HelpText="Specify Others" Binding="obs/specify_others/value" Left="509px" Top="110px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="Label" Text="Sample Type 1" HelpText="Sample_Type" Binding="obs/sample_type/value" Left="11px" Top="118px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="ListBox" HelpText="Sample_Type" Binding="obs/sample_type/value" Left="216px" Top="110px" Width="200px" Height="25px" TabIndex="8" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="Label" Text="Sample Type 2" HelpText="Sample_Type_2" Binding="obs/sample_type_2/value" Left="11px" Top="167px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="Label" Text="Specify Others" HelpText="Specify Others" Binding="obs/specify_others_2/value" Left="507px" Top="166px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="TextBox" HelpText="Specify Others" Binding="obs/specify_others/value" Left="645px" Top="109px" Width="200px" Height="25px" TabIndex="10" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="TextBox" HelpText="Specify Others" Binding="obs/specify_others_2/value" Left="645px" Top="164px" Width="200px" Height="25px" TabIndex="14" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="Label" Text="Sample Taken By" HelpText="Blood draw by-A question on KIULARCO HIV_MRS sample form." Binding="obs/in_charge/value" Left="11px" Top="220px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="Label" Text="Date of Sample" HelpText="Date of blood draw-A question on KIULARCO HIV_MRS sample form." Binding="obs/sample_date/value" Left="11px" Top="68px" Height="6px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="Label" Text="Time of sample" HelpText="Time of blood draw-A question on KIULARCO HIV_MRS sample form." Binding="obs/sample_time/value" Left="507px" Top="64px" Height="5px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="Label" Text="Date of test order" HelpText="Date of test order" Binding="obs/date_of_test_order/value" Left="11px" Top="395px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="Label" Text=" Sample received by" HelpText="Laboratory incharge name" Binding="obs/lab_incharge/value" Left="11px" Top="351px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="Label" Text=" Temperature" HelpText="Sample temperature" Binding="obs/sample_temp/value" Left="11px" Top="269px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="TimeWidget" HelpText="Time of blood draw-A question on KIULARCO HIV_MRS sample form." Binding="obs/sample_time/value" Left="646px" Top="61px" Width="200px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="DatePicker" HelpText="Date of blood draw-A question on KIULARCO HIV_MRS sample form." Binding="obs/sample_date/value" Left="218px" Top="66px" Width="200px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="TextBox" HelpText="Sample temperature" Binding="obs/sample_temp/value" Left="220px" Top="259px" Width="200px" Height="25px" TabIndex="16" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="TextBox" HelpText="Blood draw by-A question on KIULARCO HIV_MRS sample form." Binding="obs/in_charge/value" Left="218px" Top="218px" Width="627px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="DatePicker" HelpText="Date of test order" Binding="obs/date_of_test_order/value" Left="219px" Top="394px" Width="200px" Height="25px" TabIndex="22" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="TextBox" HelpText="Laboratory incharge name" Binding="obs/lab_incharge/value" Left="221px" Top="352px" Width="200px" Height="25px" TabIndex="20" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="DateTimeWidget" Binding="obs/sample_time_received/value" Left="218px" Top="304px" Width="206px" Height="30px" TabIndex="0" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="ListBox" HelpText="Sample_Type_2" Binding="obs/sample_type_2/value" Left="217px" Top="168px" Width="200px" Height="25px" TabIndex="12" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/><Item WidgetType="Label" Text=" Date-time of sample received" HelpText="Sample time received" Binding="obs/sample_time_received/value" Left="15px" Top="310px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/></Item><Item WidgetType="DateTimeWidget" Binding="encounter/encounter.encounter_datetime" Left="729px" Top="80px" Width="200px" Height="24px" TabIndex="0" fontSize="12px" fontFamily="Verdana, &quot;Lucida Grande&quot;, &quot;Trebuchet MS&quot;, Arial, sans-serif"/></Page></Form></Layout><Language><LanguageText lang="en"><xform id="76"><text xpath="xforms/model[@id='openmrs_model']/instance[@id='openmrs_model_instance']/form[@name]" value="Sample form test"/><text xpath="xforms/group[@id='1']/label" value="Page1"/><text xpath="xforms/group[@id='1']/input[@bind='patient.birthdate']/label" value="Date of birth"/><text xpath="xforms/group[@id='1']/input[@bind='patient.family_name']/label" value="Last 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="Sex"/><text xpath="xforms/group[@id='1']/input[@bind='encounter.encounter_datetime']/label" value="ENCOUNTER DATETIME"/><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='4']/label" value="Agata Correia Agata [3]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='5']/label" value="Maja Weisser"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='6']/label" value="Herry Robert Mapesi"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='7']/label" value="George Rocky Sikalengo"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='8']/label" value="ANDREW KATENDE"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='9']/label" value="Robert Christopher Ndege"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='10']/label" value="Getrud Joseph Mollel"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='11']/label" value="Ezekiel Luoga"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='12']/label" value="Lilian Moshi"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='13']/label" value="Vanesa Anton Vazquez"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='14']/label" value="Rahel Bircher"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='15']/label" value="Gidion Fue"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='16']/label" value="Athuman Mtandanguo"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='17']/label" value="Specioza Hwaya"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='18']/label" value="Armon Arpagaus"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='19']/label" value="Sambuta Aloyce [125-5]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='20']/label" value="Anna Eichenberger [129-7]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='21']/label" value="Felister Godson Kiwelu"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='22']/label" value="Phamarcy CDCI [132-1]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='23']/label" value="Pharmacy one Stop [133-9]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='24']/label" value="Linn Jarte"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='25']/label" value="Omary Ngome Rajab [137-0]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='26']/label" value="Laura Gimenez Letona [139-6]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='27']/label" value="Herieth wilson ismael [140-4]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='28']/label" value="Selerine John Myeya [60-4]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='29']/label" value="PHILIP SCHMASSMANN [141-2]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='30']/label" value="Elizabeth Eliet Senkoro [142-0]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='31']/label" value="Vera Hodel [143-8]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='32']/label" value="Joshua Joseph Kapungu [144-6]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='33']/label" value="Andre Hofer [146-1]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='34']/label" value="Vera Portillo [147-9]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='35']/label" value="James Okuma [148-7]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='36']/label" value="Sandra Glauser [149-5]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='37']/label" value="Raphael Magnolini [151-1]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='38']/label" value="Olivia John Kitau [152-9]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='39']/label" value="Alois Mbuta [153-7]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='40']/label" value="Paul Camille Genton [154-5]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='41']/label" value="Evarist Chiweka [19-0]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='42']/label" value="John Malugu [44-8]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='43']/label" value="Ivana Di Salvo [157-8]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='44']/label" value="Michael Charles Kasmiri [159-4]"/><text xpath="xforms/group[@id='1']/select1[@bind='encounter.provider_id']/item[@id='45']/label" 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xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/sample_temp/value' and @WidgetType='TextBox'][@HelpText]" value="Sample temperature"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/sample_temp/value' and @WidgetType='TextBox'][@Top]" value="259px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/sample_temp/value' and @WidgetType='TextBox'][@Left]" value="220px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/sample_temp/value' and @WidgetType='TextBox'][@Width]" value="200px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/in_charge/value' and @WidgetType='TextBox'][@HelpText]" value="Blood draw by-A question on KIULARCO HIV_MRS sample form."/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/in_charge/value' and @WidgetType='TextBox'][@Top]" value="218px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/in_charge/value' and @WidgetType='TextBox'][@Left]" value="218px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/in_charge/value' and @WidgetType='TextBox'][@Width]" value="627px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/date_of_test_order/value' and @WidgetType='DatePicker'][@HelpText]" value="Date of test order"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/date_of_test_order/value' and @WidgetType='DatePicker'][@Top]" value="394px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/date_of_test_order/value' and @WidgetType='DatePicker'][@Left]" value="219px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/date_of_test_order/value' and @WidgetType='DatePicker'][@Width]" value="200px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/lab_incharge/value' and @WidgetType='TextBox'][@HelpText]" value="Laboratory incharge name"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/lab_incharge/value' and @WidgetType='TextBox'][@Top]" value="352px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/lab_incharge/value' and @WidgetType='TextBox'][@Left]" value="221px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/lab_incharge/value' and @WidgetType='TextBox'][@Width]" value="200px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/sample_time_received/value' and @WidgetType='DateTimeWidget'][@Top]" value="304px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/sample_time_received/value' and @WidgetType='DateTimeWidget'][@Left]" value="218px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/sample_time_received/value' and @WidgetType='DateTimeWidget'][@Width]" value="206px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/sample_type_2/value' and @WidgetType='ListBox'][@HelpText]" value="Sample_Type_2"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/sample_type_2/value' and @WidgetType='ListBox'][@Top]" value="168px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/sample_type_2/value' and @WidgetType='ListBox'][@Left]" value="217px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/sample_type_2/value' and @WidgetType='ListBox'][@Width]" value="200px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/sample_time_received/value' and @WidgetType='Label'][@Text]" value=" Date-time of sample received"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/sample_time_received/value' and @WidgetType='Label'][@HelpText]" value="Sample time received"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/sample_time_received/value' and @WidgetType='Label'][@Top]" value="310px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='LEFT48pxTOP290px' and @WidgetType='GroupBox']/Item[@Binding='obs/sample_time_received/value' and @WidgetType='Label'][@Left]" value="15px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='encounter/encounter.encounter_datetime' and @WidgetType='DateTimeWidget'][@Top]" value="80px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='encounter/encounter.encounter_datetime' and @WidgetType='DateTimeWidget'][@Left]" value="729px"/><text xpath="Form/Page[@Binding='Page1']/Item[@Binding='encounter/encounter.encounter_datetime' and @WidgetType='DateTimeWidget'][@Width]" value="200px"/></Form></LanguageText></Language></PurcForm>
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