Hi Daniel,
pastebin, i have some account activation issue and have to wait for somemore time for the activation. Here i have paste the htmlform code.
<!-- Autogenerated example form (template from 01-Nov-2010 -->
<macros>
paperFormId = (Fill this in)
headerColor =#009d8e
fontOnHeaderColor = white
</macros>
<style>
.section {
border: 1px solid $headerColor;
padding: 2px;
text-align: left;
margin-bottom: 1em;
}
.sectionHeader {
background-color: $headerColor;
color: $fontOnHeaderColor;
display: block;
padding: 2px;
font-weight: bold;
}
table.baseline-aligned td {
vertical-align: baseline;
}
</style>
table, tr, td
{
background-color:#E6E6E6;
border:1px solid black;
border-collapse: collapse;
padding: 0.1cm;
margin-left: 0.8cm;
}
body {
font-family: "Arial";
font-size: 12px;
}
body[Attributes Style] {
margin-right: 0px;
margin-left: 0px;
margin-bottom: 0px;
margin-top: 0px;
}
body {
display: block;
}
article, aside, footer, header, hgroup, main, nav, section {
display: block;
}
p {
padding-left: 0.8cm;
margin-top: 0.0cm;
margin-bottom: 0.0cm;
}
p {
display: block;
-webkit-margin-before: 1em;
-webkit-margin-after: 1em;
-webkit-margin-start: 0px;
-webkit-margin-end: 0px;
}
label {
cursor: default;
}
input[type="number"] {
width: 6em;
}
textarea {
width: 55em;
height: 3em;
display: block;
}
textarea {
-webkit-appearance: textarea;
background-color: white;
border-image-source: initial;
border-image-slice: initial;
border-image-width: initial;
border-image-outset: initial;
border-image-repeat: initial;
-webkit-rtl-ordering: logical;
-webkit-user-select: text;
flex-direction: column;
resize: auto;
cursor: auto;
white-space: pre-wrap;
word-wrap: break-word;
border-width: 1px;
border-style: solid;
border-color: initial;
padding: 2px;
}
header.level1 {
font-family: "Arial";
font-size: medium;
font-weight: bold;
margin-top: 0.3cm;
margin-bottom: 0.0cm;
background-color: white;
color: black;
}
input[type="text"] {
width: 20em;
}
header.level2 {
text-align: left;
font-family: "Arial";
font-size: small;
font-weight: bold;
margin-top: 0.3cm;
margin-bottom: 0.0cm;
background-color: white;
color: black;
}
form input, form select, form textarea, form ul.select, .form input, .form select, .form textarea, .form ul.select {
min-width: 30%;
color: #363463;
display: block;
padding: 5px 10px;
margin: 0;
margin-top: 5px;
background-color: #FFF;
border: 1px solid #dddddd;
}
#label_text{
float:left;
/* padding-right: 10px; */
padding-right: 1%;
}
#label_placeholder{
float:right;
margin-top: -18px;
/* padding-right: 540px;
padding-right: 52%; */
}
header {
position: relative;
/* background-color: #00463f; */
color: #CCC;
line-height: 1em;
-moz-border-radius: 5px;
-webkit-border-radius: 5px;
-o-border-radius: 5px;
-ms-border-radius: 5px;
-khtml-border-radius: 5px;
border-radius: 5px;
}
<span style="float:right">Paper Form ID: $paperFormId</span>
<h2>Cardiac MRI Adenosine Stress Protocol</h2>
<section headerLabel="1. Encounter Details">
<table class="baseline-aligned">
<tr>
<td>Date:</td>
<td><encounterDate default="today"/></td>
</tr>
<tr>
<td>Location:</td>
<td><encounterLocation/></td>
</tr>
<tr>
<td>Provider:</td>
<td><encounterProvider/></td>
</tr>
</table>
</section>
Cardiac MRI: Adenosine Stress Protocol
Field strength:
T
Adenosine stress protocol:
Clinical information
Comparison
Findings
Stress perfusion imaging:
Rest perfusion imaging:
Cine images:
Left ventricle
End-diastole volume:
mL
End-systolic volume:
mL
Stroke volume:
mL
Ejection fraction:
%
Mass:
g
Antero-septal wall (end-diastole):
cm
Infero-lateral wall (end-diastole):
cm
Left ventricular diameter measured at the base (end-diastole):
cm
Left ventricular diameter measured at the base (end-systole):
cm
Delayed enhancement:
Reference
Reference values from: Maceira et al., Normalized left ventricular systolic and diastolic function by steady state free precession cardiovascular magnetic resonance. J Cardiovascular Magn Reson 2006; 8:417-426.
Impression
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