Po bej prova per te rregullluar

[text size="3"]yo [select name="Sex" value="M|F"] with gastrointestinal symptoms:
[comment memo="Initial questions"]
-Sx include: [checkbox name="GI" value="decreased appetite|bloating sensation|pain with defecation|constipation|diarrhea|abdominal pain|nausea/vomiting|other-"][conditional field="GI" condition="(GI).is('other-')"]
[text size="50"][/conditional]

[conditional field="GI" condition="(GI).is('abdominal pain')"][comment memo="Pain specific questions"]
-Location: [text size="50"]
-Radiation: [text size="50"]
-Severity currently: [select value="1|2|3|4|5|6|7|8|9|10"]/10
-Severity at worst: [select value="1|2|3|4|5|6|7|8|9|10"]/10
-Timing: [select value="constant|comes and goes"] Duration of pain if episodic: [text default="n/a" size="50"]
-Described as: [select value="both sharp and dull|sharp/knifelike|dull/pressure|other-"] [text size="50"]
[/conditional][conditional field="GI" condition="(GI).is('nausea/vomiting')"][comment memo="N/V specific questions"]
-[select value="no|YES"] <-- nausea
-[select value="no|YES"] <-- vomiting [text][comment memo="if yes, indicate color"]
[comment memo="Exposures"]
-[select value="no|YES"] <-- Recent intake of questionable/new food
-[select value="no|YES"] <-- Recent antibiotics
-[select value="no|YES"] <-- Recent travel
[/conditional][comment memo="Add'l questions"]
-Other Associated Symptoms:
--[select value="no|YES"] <-- Chest pain or chest/belly pain with breathing
--[select value="no|YES"] <-- Black or bloody stool
--[select value="no|YES"] <-- Fever
--[select value="no|YES"] <-- Dysuria
--[select value="no|YES"] <-- Urinary frequency
--[select value="no|YES"] <-- Urinary urgency
--[select value="no|YES"] <-- Hematuria