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Xform sample form

jerome24
Feb 28th, 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: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.  
  21. </patient>
  22. <encounter>
  23. <encounter.encounter_datetime openmrs_table="encounter" openmrs_attribute="encounter_datetime" xsi:nil="true">'now()'</encounter.encounter_datetime>
  24. <encounter.location_id openmrs_table="encounter" openmrs_attribute="location_id" xsi:nil="true">1</encounter.location_id>
  25. <encounter.provider_id openmrs_table="encounter" openmrs_attribute="provider_id" xsi:nil="true" provider_id_type="PROVIDER.ID">3</encounter.provider_id>
  26. </encounter>
  27. <obs openmrs_concept="1238^MEDICAL RECORD OBSERVATIONS^99DCT" openmrs_datatype="ZZ">
  28. <received_date_time openmrs_concept="163255^RECEIVED_DATE_TIME^99DCT" openmrs_datatype="TS">
  29. <date xsi:nil="true"/>
  30. <time xsi:nil="true"/>
  31. <value xsi:nil="true"/>
  32. </received_date_time>
  33. <received_date openmrs_concept="163209^RECEIVED_DATE^99DCT" openmrs_datatype="DT">
  34. <date xsi:nil="true"/>
  35. <time xsi:nil="true"/>
  36. <value xsi:nil="true"/>
  37. </received_date>
  38. <sample_time_received openmrs_concept="163168^RECEIVED_TIME^99DCT" openmrs_datatype="TM">
  39. <date xsi:nil="true"/>
  40. <time xsi:nil="true"/>
  41. <value xsi:nil="true">'now()'</value>
  42. </sample_time_received>
  43. <date_of_test_order openmrs_concept="163193^Date of test order^99DCT" openmrs_datatype="DT">
  44. <date xsi:nil="true"/>
  45. <time xsi:nil="true"/>
  46. <value xsi:nil="true"/>
  47. </date_of_test_order>
  48. <sample_temp openmrs_concept="163166^SAMPLE_TEMP^99DCT" openmrs_datatype="NM">
  49. <date xsi:nil="true"/>
  50. <time xsi:nil="true"/>
  51. <value xsi:nil="true"/>
  52. </sample_temp>
  53. <lab_incharge openmrs_concept="163167^LAB_INCHARGE^99DCT" openmrs_datatype="ST">
  54. <date xsi:nil="true"/>
  55. <time xsi:nil="true"/>
  56. <value xsi:nil="true"/>
  57. </lab_incharge>
  58. <sample_time openmrs_concept="161068^SAMPLE_TIME^99DCT" openmrs_datatype="TM">
  59. <date xsi:nil="true"/>
  60. <time xsi:nil="true"/>
  61. <value xsi:nil="true"/>
  62. </sample_time>
  63. <sample_type_2 openmrs_concept="162301^Sample_Type_2^99DCT" openmrs_datatype="CWE" multiple="0">
  64. <date xsi:nil="true"/>
  65. <time xsi:nil="true"/>
  66. <value xsi:nil="true"/>
  67. </sample_type_2>
  68. <specify_others_2 openmrs_concept="162300^Specify Others^99DCT" openmrs_datatype="ST">
  69. <date xsi:nil="true"/>
  70. <time xsi:nil="true"/>
  71. <value xsi:nil="true"/>
  72. </specify_others_2>
  73. <specify_others openmrs_concept="162300^Specify Others^99DCT" openmrs_datatype="ST">
  74. <date xsi:nil="true"/>
  75. <time xsi:nil="true"/>
  76. <value xsi:nil="true"/>
  77. </specify_others>
  78. <sample_type openmrs_concept="162299^Sample_Type^99DCT" openmrs_datatype="CWE" multiple="0">
  79. <date xsi:nil="true"/>
  80. <time xsi:nil="true"/>
  81. <value xsi:nil="true"/>
  82. </sample_type>
  83. <sample_date openmrs_concept="161067^Sample date^99DCT" openmrs_datatype="DT">
  84. <date xsi:nil="true"/>
  85. <time xsi:nil="true"/>
  86. <value xsi:nil="true">"today()"</value>
  87. </sample_date>
  88. <sample_time_1 openmrs_concept="161068^SAMPLE_TIME^99DCT" openmrs_datatype="TM">
  89. <date xsi:nil="true"/>
  90. <time xsi:nil="true"/>
  91. <value xsi:nil="true"/>
  92. </sample_time_1>
  93. <whole_blood openmrs_concept="161066^WHOLE_BLOOD^99DCT" openmrs_datatype="CWE" multiple="0">
  94. <date xsi:nil="true"/>
  95. <time xsi:nil="true"/>
  96. <value xsi:nil="true"/>
  97. </whole_blood>
  98. <in_charge openmrs_concept="161069^IN_CHARGE^99DCT" openmrs_datatype="ST">
  99. <date xsi:nil="true"/>
  100. <time xsi:nil="true"/>
  101. <value xsi:nil="true"/>
  102. </in_charge>
  103. </obs>
  104. </form>
  105. </xf:instance>
  106. <xf:bind id="patient.birthdate" nodeset="/form/patient/patient.birthdate" type="xsd:date" locked="true()" jr:preload="patient" jr:preloadParams="birthDate"/>
  107. <xf:bind id="patient.family_name" nodeset="/form/patient/patient.family_name" type="xsd:string" locked="true()" jr:preload="patient" jr:preloadParams="familyName"/>
  108. <xf:bind id="patient.given_name" nodeset="/form/patient/patient.given_name" type="xsd:string" locked="true()" jr:preload="patient" jr:preloadParams="givenName"/>
  109. <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()"/>
  110. <xf:bind id="patient.middle_name" nodeset="/form/patient/patient.middle_name" type="xsd:string" locked="true()" jr:preload="patient" jr:preloadParams="middleName"/>
  111. <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()"/>
  112. <xf:bind id="patient.sex" nodeset="/form/patient/patient.sex" type="xsd:string" locked="true()" jr:preload="patient" jr:preloadParams="sex"/>
  113. <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()"/>
  114. <xf:bind id="encounter.location_id" nodeset="/form/encounter/encounter.location_id" type="xsd:string" readonly="true()" visible="false()"/>
  115. <xf:bind id="encounter.provider_id" nodeset="/form/encounter/encounter.provider_id" type="xsd:string" readonly="true()" visible="false()"/>
  116. <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()"/>
  117.  
  118.  
  119.  
  120.  
  121.  
  122.  
  123.  
  124.  
  125.  
  126.  
  127.  
  128.  
  129.  
  130.  
  131.  
  132.  
  133.  
  134. </xf:model>
  135. <xf:group id="1">
  136. <xf:label>Page1</xf:label>
  137. <xf:input bind="patient.birthdate">
  138. <xf:label>Date of birth</xf:label>
  139. </xf:input>
  140. <xf:input bind="patient.family_name">
  141. <xf:label>Last name</xf:label>
  142. </xf:input>
  143. <xf:input bind="patient.given_name">
  144. <xf:label>First name</xf:label>
  145. </xf:input>
  146. <xf:input bind="patient.medical_record_number">
  147. <xf:label>NACP number</xf:label>
  148. </xf:input>
  149. <xf:input bind="patient.middle_name">
  150. <xf:label>Middle name</xf:label>
  151. </xf:input>
  152. <xf:input bind="patient.patient_id">
  153. <xf:label>Patient Id</xf:label>
  154. </xf:input>
  155. <xf:input bind="patient.sex">
  156. <xf:label>Sex</xf:label>
  157. </xf:input>
  158. <xf:input bind="encounter.encounter_datetime">
  159. <xf:label>ENCOUNTER DATETIME</xf:label>
  160. </xf:input>
  161. <xf:select1 bind="encounter.location_id">
  162. <xf:label>LOCATION ID</xf:label>
  163. <xf:item id="1">
  164. <xf:label>Unknown Location [1]</xf:label>
  165. <xf:value>1</xf:value>
  166. </xf:item>
  167. </xf:select1>
  168. <xf:select1 bind="encounter.provider_id">
  169. <xf:label>PROVIDER ID</xf:label>
  170. <xf:item id="1">
  171. <xf:label>Claudio Zaugg [12]</xf:label>
  172. <xf:value>1</xf:value>
  173. </xf:item>
  174. <xf:item id="2">
  175. <xf:label>Lucas Gervas Shayo [13]</xf:label>
  176. <xf:value>2</xf:value>
  177. </xf:item>
  178. <xf:item id="4">
  179. <xf:label>Agata Correia Agata [3]</xf:label>
  180. <xf:value>4</xf:value>
  181. </xf:item>
  182. <xf:item id="5">
  183. <xf:label>Maja Weisser</xf:label>
  184. <xf:value>5</xf:value>
  185. </xf:item>
  186. <xf:item id="6">
  187. <xf:label>Herry Robert Mapesi</xf:label>
  188. <xf:value>6</xf:value>
  189. </xf:item>
  190. <xf:item id="7">
  191. <xf:label>George Rocky Sikalengo</xf:label>
  192. <xf:value>7</xf:value>
  193. </xf:item>
  194. <xf:item id="8">
  195. <xf:label>ANDREW KATENDE</xf:label>
  196. <xf:value>8</xf:value>
  197. </xf:item>
  198. <xf:item id="9">
  199. <xf:label>Robert Christopher Ndege</xf:label>
  200. <xf:value>9</xf:value>
  201. </xf:item>
  202. <xf:item id="10">
  203. <xf:label>Getrud Joseph Mollel</xf:label>
  204. <xf:value>10</xf:value>
  205. </xf:item>
  206. <xf:item id="11">
  207. <xf:label>Ezekiel Luoga</xf:label>
  208. <xf:value>11</xf:value>
  209. </xf:item>
  210. <xf:item id="12">
  211. <xf:label>Lilian Moshi</xf:label>
  212. <xf:value>12</xf:value>
  213. </xf:item>
  214. <xf:item id="13">
  215. <xf:label>Vanesa Anton Vazquez</xf:label>
  216. <xf:value>13</xf:value>
  217. </xf:item>
  218. <xf:item id="14">
  219. <xf:label>Rahel Bircher</xf:label>
  220. <xf:value>14</xf:value>
  221. </xf:item>
  222. <xf:item id="15">
  223. <xf:label>Gidion Fue</xf:label>
  224. <xf:value>15</xf:value>
  225. </xf:item>
  226. <xf:item id="16">
  227. <xf:label>Athuman Mtandanguo</xf:label>
  228. <xf:value>16</xf:value>
  229. </xf:item>
  230. <xf:item id="17">
  231. <xf:label>Specioza Hwaya</xf:label>
  232. <xf:value>17</xf:value>
  233. </xf:item>
  234. <xf:item id="18">
  235. <xf:label>Armon Arpagaus</xf:label>
  236. <xf:value>18</xf:value>
  237. </xf:item>
  238. <xf:item id="19">
  239. <xf:label>Sambuta Aloyce [125-5]</xf:label>
  240. <xf:value>19</xf:value>
  241. </xf:item>
  242. <xf:item id="20">
  243. <xf:label>Anna Eichenberger [129-7]</xf:label>
  244. <xf:value>20</xf:value>
  245. </xf:item>
  246. <xf:item id="21">
  247. <xf:label>Felister Godson Kiwelu</xf:label>
  248. <xf:value>21</xf:value>
  249. </xf:item>
  250. <xf:item id="22">
  251. <xf:label>Phamarcy CDCI [132-1]</xf:label>
  252. <xf:value>22</xf:value>
  253. </xf:item>
  254. <xf:item id="23">
  255. <xf:label>Pharmacy one Stop [133-9]</xf:label>
  256. <xf:value>23</xf:value>
  257. </xf:item>
  258. <xf:item id="24">
  259. <xf:label>Linn Jarte</xf:label>
  260. <xf:value>24</xf:value>
  261. </xf:item>
  262. <xf:item id="25">
  263. <xf:label>Omary Ngome Rajab [137-0]</xf:label>
  264. <xf:value>25</xf:value>
  265. </xf:item>
  266. <xf:item id="26">
  267. <xf:label>Laura Gimenez Letona [139-6]</xf:label>
  268. <xf:value>26</xf:value>
  269. </xf:item>
  270. <xf:item id="27">
  271. <xf:label>Herieth wilson ismael [140-4]</xf:label>
  272. <xf:value>27</xf:value>
  273. </xf:item>
  274. <xf:item id="28">
  275. <xf:label>Selerine John Myeya [60-4]</xf:label>
  276. <xf:value>28</xf:value>
  277. </xf:item>
  278. <xf:item id="29">
  279. <xf:label>PHILIP SCHMASSMANN [141-2]</xf:label>
  280. <xf:value>29</xf:value>
  281. </xf:item>
  282. <xf:item id="30">
  283. <xf:label>Elizabeth Eliet Senkoro [142-0]</xf:label>
  284. <xf:value>30</xf:value>
  285. </xf:item>
  286. <xf:item id="31">
  287. <xf:label>Vera Hodel [143-8]</xf:label>
  288. <xf:value>31</xf:value>
  289. </xf:item>
  290. <xf:item id="32">
  291. <xf:label>Joshua Joseph Kapungu [144-6]</xf:label>
  292. <xf:value>32</xf:value>
  293. </xf:item>
  294. <xf:item id="33">
  295. <xf:label>Andre Hofer [146-1]</xf:label>
  296. <xf:value>33</xf:value>
  297. </xf:item>
  298. <xf:item id="34">
  299. <xf:label>Vera Portillo [147-9]</xf:label>
  300. <xf:value>34</xf:value>
  301. </xf:item>
  302. <xf:item id="35">
  303. <xf:label>James Okuma [148-7]</xf:label>
  304. <xf:value>35</xf:value>
  305. </xf:item>
  306. <xf:item id="36">
  307. <xf:label>Sandra Glauser [149-5]</xf:label>
  308. <xf:value>36</xf:value>
  309. </xf:item>
  310. <xf:item id="37">
  311. <xf:label>Raphael Magnolini [151-1]</xf:label>
  312. <xf:value>37</xf:value>
  313. </xf:item>
  314. <xf:item id="38">
  315. <xf:label>Olivia John Kitau [152-9]</xf:label>
  316. <xf:value>38</xf:value>
  317. </xf:item>
  318. <xf:item id="39">
  319. <xf:label>Alois Mbuta [153-7]</xf:label>
  320. <xf:value>39</xf:value>
  321. </xf:item>
  322. <xf:item id="40">
  323. <xf:label>Paul Camille Genton [154-5]</xf:label>
  324. <xf:value>40</xf:value>
  325. </xf:item>
  326. <xf:item id="41">
  327. <xf:label>Evarist Chiweka [19-0]</xf:label>
  328. <xf:value>41</xf:value>
  329. </xf:item>
  330. <xf:item id="42">
  331. <xf:label>John Malugu [44-8]</xf:label>
  332. <xf:value>42</xf:value>
  333. </xf:item>
  334. <xf:item id="43">
  335. <xf:label>Ivana Di Salvo [157-8]</xf:label>
  336. <xf:value>43</xf:value>
  337. </xf:item>
  338. <xf:item id="44">
  339. <xf:label>Michael Charles Kasmiri [159-4]</xf:label>
  340. <xf:value>44</xf:value>
  341. </xf:item>
  342. <xf:item id="45">
  343. <xf:label>George Frederick Mkoma [95-0]</xf:label>
  344. <xf:value>45</xf:value>
  345. </xf:item>
  346. <xf:item id="46">
  347. <xf:label>Mary Gregory Marandu [107-3]</xf:label>
  348. <xf:value>46</xf:value>
  349. </xf:item>
  350. <xf:item id="47">
  351. <xf:label>Asha Juma Haroub [13-3]</xf:label>
  352. <xf:value>47</xf:value>
  353. </xf:item>
  354. <xf:item id="48">
  355. <xf:label>Bernard Gabriel Kivuma [75-2]</xf:label>
  356. <xf:value>48</xf:value>
  357. </xf:item>
  358. <xf:item id="49">
  359. <xf:label>Jacopo Nicoletti [158-6]</xf:label>
  360. <xf:value>49</xf:value>
  361. </xf:item>
  362. <xf:item id="50">
  363. <xf:label>Slyakus Vintan Mlembe [145-3]</xf:label>
  364. <xf:value>50</xf:value>
  365. </xf:item>
  366. <xf:item id="51">
  367. <xf:label>George Frederick Sigalla [164-4]</xf:label>
  368. <xf:value>51</xf:value>
  369. </xf:item>
  370. <xf:item id="52">
  371. <xf:label>Francisca Seraphin Chuwa [165-1]</xf:label>
  372. <xf:value>52</xf:value>
  373. </xf:item>
  374. <xf:item id="53">
  375. <xf:label>Farida Bani [114-9]</xf:label>
  376. <xf:value>53</xf:value>
  377. </xf:item>
  378. <xf:item id="54">
  379. <xf:label>Yvonne Ramesh Haridas [171-9]</xf:label>
  380. <xf:value>54</xf:value>
  381. </xf:item>
  382. <xf:item id="55">
  383. <xf:label>Jacqueline Inoja Nkouabi [170-1]</xf:label>
  384. <xf:value>55</xf:value>
  385. </xf:item>
  386. <xf:item id="56">
  387. <xf:label>Suzan Ngalimecha Ngahyoma [172-7]</xf:label>
  388. <xf:value>56</xf:value>
  389. </xf:item>
  390. <xf:item id="57">
  391. <xf:label>Regina Ndaki [84-4]</xf:label>
  392. <xf:value>57</xf:value>
  393. </xf:item>
  394. <xf:item id="58">
  395. <xf:label>Sarah Katharina Staehelin [175-0]</xf:label>
  396. <xf:value>58</xf:value>
  397. </xf:item>
  398. <xf:item id="59">
  399. <xf:label>John Wigayi [61-2]</xf:label>
  400. <xf:value>59</xf:value>
  401. </xf:item>
  402. <xf:item id="60">
  403. <xf:label>Mabula John [59-6]</xf:label>
  404. <xf:value>60</xf:value>
  405. </xf:item>
  406. <xf:item id="61">
  407. <xf:label>Athuman Said Mtandanguo [64-6]</xf:label>
  408. <xf:value>61</xf:value>
  409. </xf:item>
  410. <xf:item id="62">
  411. <xf:label>Mohamed Godfrey Mbaruku [173-5]</xf:label>
  412. <xf:value>62</xf:value>
  413. </xf:item>
  414. <xf:item id="63">
  415. <xf:label>Juma Kupewa [176-8]</xf:label>
  416. <xf:value>63</xf:value>
  417. </xf:item>
  418. <xf:item id="64">
  419. <xf:label>Leila Samson [85-1]</xf:label>
  420. <xf:value>64</xf:value>
  421. </xf:item>
  422. <xf:item id="65">
  423. <xf:label>Ramadhan Katala [177-6]</xf:label>
  424. <xf:value>65</xf:value>
  425. </xf:item>
  426. <xf:item id="66">
  427. <xf:label>Elizabeth Dotto Kagwese [179-2]</xf:label>
  428. <xf:value>66</xf:value>
  429. </xf:item>
  430. <xf:item id="67">
  431. <xf:label>Lulu Wilson Ismael [180-0]</xf:label>
  432. <xf:value>67</xf:value>
  433. </xf:item>
  434. <xf:item id="68">
  435. <xf:label>Rabson Namtwanga [181-8]</xf:label>
  436. <xf:value>68</xf:value>
  437. </xf:item>
  438. <xf:item id="69">
  439. <xf:label>Belina Byabato [182-6]</xf:label>
  440. <xf:value>69</xf:value>
  441. </xf:item>
  442. <xf:item id="70">
  443. <xf:label>Sturida Patrick [183-4]</xf:label>
  444. <xf:value>70</xf:value>
  445. </xf:item>
  446. <xf:item id="71">
  447. <xf:label>Florent Raphael Heritier [184-2]</xf:label>
  448. <xf:value>71</xf:value>
  449. </xf:item>
  450. <xf:item id="72">
  451. <xf:label>Happyphania Isaya Ngakongwa [167-7]</xf:label>
  452. <xf:value>72</xf:value>
  453. </xf:item>
  454. <xf:item id="73">
  455. <xf:label>Petro Togolani Sabuni [185-9]</xf:label>
  456. <xf:value>73</xf:value>
  457. </xf:item>
  458. <xf:item id="74">
  459. <xf:label>Cecilia Philipo Ligogo [186-7]</xf:label>
  460. <xf:value>74</xf:value>
  461. </xf:item>
  462. <xf:item id="75">
  463. <xf:label>Selerine Myeya [46-3]</xf:label>
  464. <xf:value>75</xf:value>
  465. </xf:item>
  466. <xf:item id="76">
  467. <xf:label>Namsifueli Julius Ley [187-5]</xf:label>
  468. <xf:value>76</xf:value>
  469. </xf:item>
  470. <xf:item id="77">
  471. <xf:label>Bedran Topyurek [188-3]</xf:label>
  472. <xf:value>77</xf:value>
  473. </xf:item>
  474. <xf:item id="78">
  475. <xf:label>Edgar Enzigard Martin [189-1]</xf:label>
  476. <xf:value>78</xf:value>
  477. </xf:item>
  478. <xf:item id="79">
  479. <xf:label>Fredy Geiger [190-9]</xf:label>
  480. <xf:value>79</xf:value>
  481. </xf:item>
  482. <xf:item id="80">
  483. <xf:label>Getruda Lenia Julius [193-3]</xf:label>
  484. <xf:value>80</xf:value>
  485. </xf:item>
  486. <xf:item id="81">
  487. <xf:label>Florian Kasper Mury [194-1]</xf:label>
  488. <xf:value>81</xf:value>
  489. </xf:item>
  490. <xf:item id="82">
  491. <xf:label>Sara Glanzmann [195-8]</xf:label>
  492. <xf:value>82</xf:value>
  493. </xf:item>
  494. <xf:item id="83">
  495. <xf:label>Benjamin Yannick Bissmann [196-6]</xf:label>
  496. <xf:value>83</xf:value>
  497. </xf:item>
  498. <xf:item id="3">
  499. <xf:label>Herry Robert Mapesi [14]</xf:label>
  500. <xf:value>3</xf:value>
  501. </xf:item>
  502. <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>
  503. <xf:input bind="sample_date">
  504. <xf:label>Date of blood draw</xf:label>
  505. <xf:hint>Date of blood draw-A question on KIULARCO HIV_MRS sample form.</xf:hint>
  506. </xf:input><xf:input bind="sample_time">
  507. <xf:label>Time of blood draw</xf:label>
  508. <xf:hint>Time of blood draw-A question on KIULARCO HIV_MRS sample form.</xf:hint>
  509. </xf:input><xf:input bind="in_charge">
  510. <xf:label>Blood draw by</xf:label>
  511. <xf:hint>Blood draw by-A question on KIULARCO HIV_MRS sample form.</xf:hint>
  512. </xf:input><xf:select1 bind="sample_type">
  513. <xf:label>Sample_Type</xf:label>
  514. <xf:item concept_id="162299" id="1000^WHOLE BLOOD^99DCT">
  515. <xf:label>WHOLE BLOOD</xf:label>
  516. <xf:value>1000^WHOLE BLOOD^99DCT</xf:value>
  517. </xf:item>
  518. <xf:item concept_id="162299" id="161957^CAPILLARY_BLOOD^99DCT">
  519. <xf:label>CAPILLARY_BLOOD</xf:label>
  520. <xf:value>161957^CAPILLARY_BLOOD^99DCT</xf:value>
  521. </xf:item>
  522. <xf:item concept_id="162299" id="161751^urine_sample^99DCT">
  523. <xf:label>urine_sample</xf:label>
  524. <xf:value>161751^urine_sample^99DCT</xf:value>
  525. </xf:item>
  526. <xf:item concept_id="162299" id="159993^feces^99DCT">
  527. <xf:label>feces</xf:label>
  528. <xf:value>159993^feces^99DCT</xf:value>
  529. </xf:item>
  530. <xf:item concept_id="162299" id="1004^SPUTUM^99DCT">
  531. <xf:label>SPUTUM</xf:label>
  532. <xf:value>1004^SPUTUM^99DCT</xf:value>
  533. </xf:item>
  534. <xf:item concept_id="162299" id="161705^CSF^99DCT">
  535. <xf:label>CSF</xf:label>
  536. <xf:value>161705^CSF^99DCT</xf:value>
  537. </xf:item>
  538. <xf:item concept_id="162299" id="162298^Other Material^99DCT">
  539. <xf:label>Other Material</xf:label>
  540. <xf:value>162298^Other Material^99DCT</xf:value>
  541. </xf:item>
  542. </xf:select1><xf:input bind="specify_others">
  543. <xf:label>Specify Others</xf:label>
  544. </xf:input><xf:select1 bind="sample_type_2">
  545. <xf:label>Sample_Type_2</xf:label>
  546. <xf:item concept_id="162301" id="1000^WHOLE BLOOD^99DCT">
  547. <xf:label>WHOLE BLOOD</xf:label>
  548. <xf:value>1000^WHOLE BLOOD^99DCT</xf:value>
  549. </xf:item>
  550. <xf:item concept_id="162301" id="161957^CAPILLARY_BLOOD^99DCT">
  551. <xf:label>CAPILLARY_BLOOD</xf:label>
  552. <xf:value>161957^CAPILLARY_BLOOD^99DCT</xf:value>
  553. </xf:item>
  554. <xf:item concept_id="162301" id="161751^urine_sample^99DCT">
  555. <xf:label>urine_sample</xf:label>
  556. <xf:value>161751^urine_sample^99DCT</xf:value>
  557. </xf:item>
  558. <xf:item concept_id="162301" id="159993^feces^99DCT">
  559. <xf:label>feces</xf:label>
  560. <xf:value>159993^feces^99DCT</xf:value>
  561. </xf:item>
  562. <xf:item concept_id="162301" id="1004^SPUTUM^99DCT">
  563. <xf:label>SPUTUM</xf:label>
  564. <xf:value>1004^SPUTUM^99DCT</xf:value>
  565. </xf:item>
  566. <xf:item concept_id="162301" id="162298^Other Material^99DCT">
  567. <xf:label>Other Material</xf:label>
  568. <xf:value>162298^Other Material^99DCT</xf:value>
  569. </xf:item>
  570. </xf:select1><xf:input bind="specify_others_2">
  571. <xf:label>Specify Others</xf:label>
  572. </xf:input><xf:input bind="sample_temp">
  573. <xf:label>SAMPLE_TEMP</xf:label>
  574. <xf:hint>Sample temperature</xf:hint>
  575. </xf:input><xf:input bind="lab_incharge">
  576. <xf:label>LAB_INCHARGE</xf:label>
  577. <xf:hint>Laboratory incharge name</xf:hint>
  578. </xf:input><xf:input bind="sample_time_received">
  579. <xf:label>SAMPLE_TIME_RECEIVED</xf:label>
  580. <xf:hint>Sample time received</xf:hint>
  581. </xf:input><xf:input bind="date_of_test_order">
  582. <xf:label>Date of test order</xf:label>
  583. <xf:hint>Date of test order</xf:hint>
  584. </xf:input>
  585.  
  586.  
  587.  
  588.  
  589.  
  590.  
  591.  
  592.  
  593.  
  594.  
  595.  
  596.  
  597.  
  598.  
  599.  
  600. </xf:group>
  601. </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." 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@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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