{"action":"created","comment":{"url":"https://api.github.com/repos/LibreEHR/LibreEHR/pulls/comments/74515170","id":74515170,"diff_hunk":"@@ -0,0 +1,667 @@\n+<?php\n+//by Art Eaton\n+include_once(\"../../globals.php\");\n+include_once(\"$srcdir/api.inc\");\n+formHeader(\"Form: button_ros\");\n+?>\n+\n+<form method=post action=\"<?echo $rootdir;?>/forms/button_ros/save.php?mode=new\" name=\"my_form\">\n+\n+ \n+<?php\n+$tempquery = \"SELECT date FROM form_encounter WHERE encounter = $encounter\";\n+ $datequery = sqlStatement($tempquery);\n+$encdate = SqlFetchArray($datequery);\n+\n+$old_date = strtotime($encdate['date']);\n+$todays_date = strtotime(date(\"Ymd\"));\n+if($old_date+(86400) < $todays_date) {\n+echo xlt('It is not permitted to enter a Review of Systems form in an encounter that is dated earlier than 3 days prior to today\\'s date.');\n+} else {\n+?>\n+<a href=\"javascript:top.restoreSession();document.my_form.submit();\" class=\"link_submit\">[<?php echo xlt('Save');?>]</a>\n+<a href=\"<?php echo $GLOBALS['form_exit_url']; ?>\" class=\"link_submit\"\n+ onclick=\"top.restoreSession()\">[<?php echo xlt('Don\\'t Save');?>]</a>\n+<br>\n+<?php echo xlt('You must EDIT the form after saving and reviewing to finalize.');?>\n+\t\n+\t<table id='ros'>\n+\t\n+\t<TR>\n+\t\t<TD> <?php echo xlt('REVIEW of SYSTEMS:');?></TD>\n+\t</TR>\n+\t<TR class=\"alt\">\n+\t<TD>\n+\t<B><?php echo xlt('GEN:');?></B>\n+\t</TD>\n+\t</TR>\n+\t<TR>\n+\t<TD>\n+  \n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GEN1\" name=\"GEN1\" type=\"checkbox\" value=\"on\">\n+\t\t\t<label for=\"GEN1\" > <?php echo xlt('Fatigue');?></label>\n+\t\t</span>\n+\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GEN2\" name=\"GEN2\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GEN2\"> <?php echo xlt('Fever');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GEN3\" name=\"GEN3\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GEN3\"> <?php echo xlt('Chills');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GEN4\" name=\"GEN4\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GEN4\"> <?php echo xlt('Night Sweats');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GEN5\" name=\"GEN5\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GEN5\"> <?php echo xlt('Recent Weight Gain');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GEN6\" name=\"GEN6\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GEN6\"> <?php echo xlt('Recent Weight Loss');?></label>\n+\t\t</span>\n+\t\t</TD>\n+\t\t</TR>\n+\t\t<TR>\n+\t\t<TD>\n+\t\t<?php echo xlt('Note abnormalities:');?> \n+\t\t\t\t\t<TEXTAREA NAME=\"GEN_notes\" ROWS=3 COLS=25 WRAP=SOFT STYLE=\"width: 2in; height: 0.21in\"></TEXTAREA>\n+\t\t\t\t\t</TD>\n+\t</TR>\t\n+\n+\t\t<TR class=\"alt\">\n+\t<TD>\n+\t<B><?php echo xlt('EYES:');?> </B>\n+\t</TD>\n+\t</TR>\n+\t<TR>\n+\t<TD>\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"EYES1\" name=\"EYES1\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"EYES1\"> <?php echo xlt('Vision Changes');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"EYES2\" name=\"EYES2\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"EYES2\"> <?php echo xlt('Floaters');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"EYES3\" name=\"EYES3\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"EYES3\"> <?php echo xlt('Diplopia');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"EYES4\" name=\"EYES4\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"EYES4\"> <?php echo xlt('Blurry Vision');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"EYES5\" name=\"EYES5\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"EYES5\"> <?php echo xlt('Eye Pain');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"EYES6\" name=\"EYES6\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"EYES6\"> <?php echo xlt('Photophobia');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"EYES7\" name=\"EYES7\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"EYES7\"> <?php echo xlt('Red Eyes');?></label>\n+\t\t</span>\n+\t\t</TD>\n+\t\t</TR>\n+\t\t<TR>\n+\t\t<TD>\n+\t\t<?php echo xlt('Note abnormalities:');?> \n+\t\t\t\t\t<TEXTAREA NAME=\"EYES_notes\" ROWS=3 COLS=25 WRAP=SOFT STYLE=\"width: 2in; height: 0.21in\"></TEXTAREA>\n+\t\t\t\t\t</TD>\n+\t</TR>\t\n+\n+\t\n+\t\n+\t<TR class=\"alt\">\n+\t<TD>\n+\t<B><?php echo xlt('ENT:');?></B>\n+\t</TD>\n+\t</TR>\n+\t<TR>\n+\t<TD>\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"ENT1\" name=\"ENT1\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"ENT1\"> <?php echo xlt('Hearing Loss');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"ENT2\" name=\"ENT2\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"ENT2\"> <?php echo xlt('Ear Ache');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"ENT3\" name=\"ENT3\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"ENT3\"> <?php echo xlt('Otorrhea');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"ENT4\" name=\"ENT4\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"ENT4\"> <?php echo xlt('Tinnitis');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"ENT5\" name=\"ENT5\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"ENT5\"> <?php echo xlt('Epistaxis');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"ENT6\" name=\"ENT6\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"ENT6\"> <?php echo xlt('Sneezing');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"ENT7\" name=\"ENT7\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"ENT7\"> <?php echo xlt('Nasal Drip');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"ENT8\" name=\"ENT8\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"ENT8\"> <?php echo xlt('Sore Throat');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"ENT9\" name=\"ENT9\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"ENT9\"> <?php echo xlt('Mouth Dryness');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"ENT10\" name=\"ENT10\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"ENT10\"> <?php echo xlt('Problem Swallowing');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"ENT11\" name=\"ENT11\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"ENT11\"> <?php echo xlt('Dental Problems');?></label>\n+\t\t</span>\n+\t\t</TD>\t\n+\t\t</TR>\n+\t\t<TR>\n+\t\t<TD>\n+\t\t<?php echo xlt('Note abnormalities:');?> \n+\t\t\t\t\t<TEXTAREA NAME=\"ENT_notes\" ROWS=3 COLS=25 WRAP=SOFT STYLE=\"width: 2in; height: 0.21in\"></TEXTAREA>\n+\t\t\t\t\t</TD>\n+\t</TR>\t\n+\t\n+\t<TR class=\"alt\">\n+\t<TD>\n+\t<B><?php echo xlt('RESP:');?></B>\n+\t</TD>\n+\t</TR>\n+\t<TR>\n+\t<TD>\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"RESP1\" name=\"RESP1\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"RESP1\"> <?php echo xlt('Speech Problem');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"RESP2\" name=\"RESP2\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"RESP2\"> <?php echo xlt('Shortness of Breath');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"RESP3\" name=\"RESP3\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"RESP3\"> <?php echo xlt('Orthopnea');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"RESP4\" name=\"RESP4\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"RESP4\"> <?php echo xlt('Cough');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"RESP5\" name=\"RESP5\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"RESP5\"> <?php echo xlt('Cough w/Sputum');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"RESP6\" name=\"RESP6\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"RESP6\"> <?php echo xlt('Hemoptysis');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"RESP7\" name=\"RESP7\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"RESP7\"> <?php echo xlt('Wheezing');?></label>\n+\t\t</span>\n+\t\t</TD>\n+\t\t</TR>\n+\t\t<TR>\n+\t\t<TD>\n+\t\t<?php echo xlt('Note abnormalities:');?> \n+\t\t\t\t\t<TEXTAREA NAME=\"RESP_notes\" ROWS=3 COLS=25 WRAP=SOFT STYLE=\"width: 2in; height: 0.21in\"></TEXTAREA>\n+\t\t\t\t\t</TD>\n+\t</TR>\n+\n+\t<TR class=\"alt\">\n+\t<TD>\n+\t<B><?php echo xlt('CVS:');?></B>\n+\t</TD>\n+\t</TR>\n+\t<TR>\n+\t<TD>\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"CVS1\" name=\"CVS1\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"CVS1\"> <?php echo xlt('Chest Pain');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"CVS2\" name=\"CVS2\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"CVS2\"> <?php echo xlt('Palpitations');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"CVS3\" name=\"CVS3\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"CVS3\"> <?php echo xlt('Leg Pain w/Exercise');?></label>\n+\t\t</span>\n+\t\t</TD>\n+\t\t</TR>\n+\t\t<TR>\n+\t\t<TD>\n+\t\t<?php echo xlt('Note abnormalities:');?> \n+\t\t\t\t\t<TEXTAREA NAME=\"CVS_notes\" ROWS=3 COLS=25 WRAP=SOFT STYLE=\"width: 2in; height: 0.21in\"></TEXTAREA>\n+\t\t\t\t\t</TD>\n+\t</TR>\t\t\n+\t\t\n+\t<TR class=\"alt\">\n+\t<TD>\n+\t<B><?php echo xlt('GI:');?></B>\n+\t</TD>\n+\t</TR>\n+\t<TR>\n+\t<TD>\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GI1\" name=\"GI1\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GI1\"> <?php echo xlt('Appetite Decrease');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GI2\" name=\"GI2\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GI2\"> <?php echo xlt('Anorexia');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GI3\" name=\"GI3\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GI3\"> <?php echo xlt('Dysphagia');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GI4\" name=\"GI4\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GI4\"> <?php echo xlt('Heartburn');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GI5\" name=\"GI5\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GI5\"> <?php echo xlt('Nausea');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GI6\" name=\"GI6\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GI6\"> <?php echo xlt('Vomiting');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GI7\" name=\"GI7\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GI7\"> <?php echo xlt('Hematemesis');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GI8\" name=\"GI8\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GI8\"> <?php echo xlt('Abdominal Pain');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GI9\" name=\"GI9\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GI9\"> <?php echo xlt('Jaundice');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GI10\" name=\"GI10\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GI10\"> <?php echo xlt('Diarrhea');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GI11\" name=\"GI11\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GI11\"> <?php echo xlt('Constipation');?></label>\n+\t\t</span>\n+\t\t</TD>\t\n+\t\n+\t\t</TR>\n+\t\t<TR>\n+\t\t<TD>\n+\t\t<?php echo xlt('Note abnormalities:');?> \n+\t\t\t\t\t<TEXTAREA NAME=\"GI_notes\" ROWS=3 COLS=25 WRAP=SOFT STYLE=\"width: 2in; height: 0.21in\"></TEXTAREA>\n+\t\t\t\t\t</TD>\n+\t</TR>\t\n+\n+\t<TR class=\"alt\">\n+\t<TD>\n+\t<B><?php echo xlt('GU:');?></B>\n+\t</TD>\n+\t</TR>\n+\t<TR>\n+\t<TD>\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GU1\" name=\"GU1\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GU1\"> <?php echo xlt('Hematura');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GU2\" name=\"GU2\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GU2\"> <?php echo xlt('Change in Frequency of Urination');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GU3\" name=\"GU3\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GU3\"> <?php echo xlt('Urinary Urgency');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GU4\" name=\"GU4\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GU4\"> <?php echo xlt('Incontinence');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GU5\" name=\"GU5\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GU5\"> <?php echo xlt('Slow Urination');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GU6\" name=\"GU6\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GU6\"> <?php echo xlt('Irregular Periods');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GU7\" name=\"GU7\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GU7\"> <?php echo xlt('Hot Flashes');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"GU8\" name=\"GU8\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"GU8\"> <?php echo xlt('Post Menopausal Bleeding');?></label>\n+\t\t</span>\n+\t\t</TD>\n+\t\t</TR>\n+\t\t<TR>\n+\t\t<TD>\n+\t\t<?php echo xlt('Note abnormalities:');?> \n+\t\t\t\t\t<TEXTAREA NAME=\"GU_notes\" ROWS=3 COLS=25 WRAP=SOFT STYLE=\"width: 2in; height: 0.21in\"></TEXTAREA>\n+\t\t\t\t\t</TD>\n+\t</TR>\n+\n+\t<TR class=\"alt\">\n+\t<TD>\n+\t<B><?php echo xlt('MSK:');?></B>\n+\t</TD>\n+\t</TR>\n+\t\n+\t<TR>\n+\t<TD>\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"MSK1\" name=\"MSK1\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"MSK1\"> <?php echo xlt('Back Pain');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"MSK2\" name=\"MSK2\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"MSK2\"> <?php echo xlt('Muscle Aches');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"MSK3\" name=\"MSK3\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"MSK3\"> <?php echo xlt('Arthralgias');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"MSK4\" name=\"MSK4\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"MSK4\"> <?php echo xlt('Muscle Cramps');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"MSK5\" name=\"MSK5\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"MSK5\"> <?php echo xlt('Localized Joint Pain');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"MSK6\" name=\"MSK6\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"MSK6\"> <?php echo xlt('Localized Joint Swelling');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"MSK7\" name=\"MSK7\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"MSK7\"> <?php echo xlt('Localized Joint Stiffness');?></label>\n+\t\t</span>\n+\t\t</TD>\n+\t\t</TR>\n+\t\t<TR>\n+\t\t<TD>\n+\t\t<?php echo xlt('Note abnormalities:');?> \n+\t\t\t\t\t<TEXTAREA NAME=\"MSK_notes\" ROWS=3 COLS=25 WRAP=SOFT STYLE=\"width: 2in; height: 0.21in\"></TEXTAREA>\n+\t\t\t\t\t</TD>\n+\t</TR>\n+\n+\t<TR class=\"alt\">\n+\t<TD>\n+\t<B><?php echo xlt('NEURO:');?></B>\n+\t</TD>\n+\t</TR>\n+\t<TR>\n+\t<TD>\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"NEURO1\" name=\"NEURO1\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"NEURO1\"> <?php echo xlt('Dizziness');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"NEURO2\" name=\"NEURO2\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"NEURO2\"> <?php echo xlt('Vertigo');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"NEURO3\" name=\"NEURO3\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"NEURO3\"> <?php echo xlt('Syncope');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"NEURO4\" name=\"NEURO4\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"NEURO4\"> <?php echo xlt('Confusion');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"NEURO5\" name=\"NEURO5\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"NEURO5\"> <?php echo xlt('Memory Loss');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"NEURO6\" name=\"NEURO6\" type=\"checkbox\" value=\"on\" >\n+\t\t\t<label for=\"NEURO6\"> <?php echo xlt('Speech Disturbance');?></label>\n+\t\t</span>\n+\t\t\n+\t\t<span class=\"checkbox-button\">\n+\t\t\t<input id=\"NEURO7\" 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