<div class="modal fade" tabindex="-1" role="dialog" id="modal-wizard-oto-dialog">
  <div class="modal-dialog modal-lg modal-95" role="document">
    <div class="modal-content">
      <div class="modal-header">
        <h5 class="modal-title"><?php echo _('Wizard Ear'); ?></h5>
        <input type="hidden" id="process-path" value="<?php echo $this->config['settings']['processes']['otoaccess']; ?>">
        <img src="/images/oticonotoaccess.png" class="btn-run-process" width="400" height="68">
        <!--<button type="button" class="close" data-dismiss="modal" aria-label="Close">
          <span aria-hidden="true">&times;</span>
        </button>-->
      </div>
      <div class="modal-body">
	      <div class="row">
		      <div class="col-lg-6">
			      <div class="row">

				      <div class="col-lg-6 text-center">
					      <div data-wrappertype="images-wrapper-oto" data-checkboxclass="oto-desease-check" class="derma-image-wrapper text-center <?php echo isset($this->view->otoImages['oto_myringitis']) ? 'wizard-images-selected' : ''; ?>" data-type="oto_myringitis">
						      <div class="derma-title"><?php echo $this->view->otoPositionLabels['oto_myringitis']; ?></div>
						      <img src="/images/wizards/oto/bullous-myringitis.jpg" alt="">
						      <input type="checkbox" name="data[ear_desease][value][]" class="oto-desease-check" id="derma-position-check-oto_myringitis" class="derma-position-check" data-label="<?php echo $this->view->otoPositionLabels['oto_myringitis']; ?>" value="oto_myringitis" <?php echo isset($this->view->otoImages['oto_myringitis']) ? 'checked' : ''; ?>>
						  </div>
				      </div>
				      <div class="col-lg-6 text-center">
					      <div data-wrappertype="images-wrapper-oto" data-checkboxclass="oto-desease-check" class="derma-image-wrapper text-center <?php echo isset($this->view->otoImages['oto_polip']) ? 'wizard-images-selected' : ''; ?>" data-type="oto_polip">
						      <div class="derma-title"><?php echo $this->view->otoPositionLabels['oto_polip']; ?></div>
						      <img src="/images/wizards/oto/polyp-of-the-eac.jpg" alt="">
						      <input type="checkbox" name="data[ear_desease][value][]" class="oto-desease-check" id="derma-position-check-oto_polip" class="derma-position-check" data-label="<?php echo $this->view->otoPositionLabels['oto_polip']; ?>" value="oto_polip" <?php echo isset($this->view->otoImages['oto_polip']) ? 'checked' : ''; ?>>
						  </div>
				      </div>
			      </div>

			      <div class="row">
				      <div class="col-lg-6 text-center">
					      <div data-wrappertype="images-wrapper-oto" data-checkboxclass="oto-desease-check" class="derma-image-wrapper text-center <?php echo isset($this->view->otoImages['oto_atelectasis']) ? 'wizard-images-selected' : ''; ?>" data-type="oto_atelectasis">
						      <div class="derma-title"><?php echo $this->view->otoPositionLabels['oto_atelectasis']; ?></div>
						      <img src="/images/wizards/oto/tympanic-atelectatis.jpg" alt="">
						      <input type="checkbox" name="data[ear_desease][value][]" class="oto-desease-check" id="derma-position-check-oto_atelectasis" class="derma-position-check" data-label="<?php echo $this->view->otoPositionLabels['oto_atelectasis']; ?>" value="oto_atelectasis" <?php echo isset($this->view->otoImages['oto_atelectasis']) ? 'checked' : ''; ?>>
						  </div>
				      </div>
				      <div class="col-lg-6 text-center">
					      <div data-wrappertype="images-wrapper-oto" data-checkboxclass="oto-desease-check" class="derma-image-wrapper text-center <?php echo isset($this->view->otoImages['oto_perforation']) ? 'wizard-images-selected' : ''; ?>" data-type="oto_perforation">
						      <div class="derma-title"><?php echo $this->view->otoPositionLabels['oto_perforation']; ?></div>
						      <img src="/images/wizards/oto/perforation.jpg" alt="">
						      <input type="checkbox" name="data[ear_desease][value][]" class="oto-desease-check" id="derma-position-check-oto_perforation" class="derma-position-check" data-label="<?php echo $this->view->otoPositionLabels['oto_perforation']; ?>" value="oto_perforation" <?php echo isset($this->view->otoImages['oto_perforation']) ? 'checked' : ''; ?>>
						  </div>
				      </div>
			      </div>
			      <div class="row">
				      <div class="col-lg-6 text-center">
					      <div data-wrappertype="images-wrapper-oto" data-checkboxclass="oto-desease-check" class="derma-image-wrapper text-center <?php echo isset($this->view->otoImages['oto_chole']) ? 'wizard-images-selected' : ''; ?>" data-type="oto_chole">
						      <div class="derma-title"><?php echo $this->view->otoPositionLabels['oto_chole']; ?></div>
						      <img src="/images/wizards/oto/cholesteatomatous-otitis-media.jpg" alt="">
						      <input type="checkbox" name="data[ear_desease][value][]" class="oto-desease-check" id="derma-position-check-oto_chole" class="derma-position-check" data-label="<?php echo $this->view->otoPositionLabels['oto_chole']; ?>" value="oto_chole" <?php echo isset($this->view->otoImages['oto_chole']) ? 'checked' : ''; ?>>
						  </div>
				      </div>
				      <div class="col-lg-6 text-center">
					      <div data-wrappertype="images-wrapper-oto" data-checkboxclass="oto-desease-check" class="derma-image-wrapper text-center <?php echo isset($this->view->otoImages['oto_tympanoscler']) ? 'wizard-images-selected' : ''; ?>" data-type="oto_tympanoscler">
						      <div class="derma-title"><?php echo $this->view->otoPositionLabels['oto_tympanoscler']; ?></div>
						      <img src="/images/wizards/oto/tympanosclerosis.jpg" alt="">
						      <input type="checkbox" name="data[ear_desease][value][]" class="oto-desease-check" id="derma-position-check-oto_tympanoscler" class="derma-position-check" data-label="<?php echo $this->view->otoPositionLabels['oto_tympanoscler']; ?>" value="oto_tympanoscler" <?php echo isset($this->view->otoImages['oto_tympanoscler']) ? 'checked' : ''; ?>>
						  </div>
				      </div>
			      </div>
			      <div class="row">
				      <div class="col-lg-6 text-center">
					      <div data-wrappertype="images-wrapper-oto" data-checkboxclass="oto-desease-check" class="derma-image-wrapper text-center <?php echo isset($this->view->otoImages['oto_tyjugular']) ? 'wizard-images-selected' : ''; ?>" data-type="oto_tyjugular">
						      <div class="derma-title"><?php echo $this->view->otoPositionLabels['oto_tyjugular']; ?></div>
						      <img src="/images/wizards/oto/tympano-jugular.jpg" alt="">
						      <input type="checkbox" name="data[ear_desease][value][]" class="oto-desease-check" id="derma-position-check-oto_tyjugular" class="derma-position-check" data-label="<?php echo $this->view->otoPositionLabels['oto_tyjugular']; ?>" value="oto_tyjugular" <?php echo isset($this->view->otoImages['oto_tyjugular']) ? 'checked' : ''; ?>>
						  </div>
				      </div>
				      <div class="col-lg-6 text-center">
					      <div data-wrappertype="images-wrapper-oto" data-checkboxclass="oto-desease-check" class="derma-image-wrapper text-center <?php echo isset($this->view->otoImages['oto_cholesterol']) ? 'wizard-images-selected' : ''; ?>" data-type="oto_cholesterol">
						     <div class="derma-title"><?php echo $this->view->otoPositionLabels['oto_cholesterol']; ?></div>
						     <img src="/images/wizards/oto/cholesterol-granuloma.jpg" alt="">
						      <input type="checkbox" name="data[ear_desease][value][]" class="oto-desease-check" id="derma-position-check-oto_cholesterol" class="derma-position-check" data-label="<?php echo $this->view->otoPositionLabels['oto_cholesterol']; ?>" value="oto_cholesterol" <?php echo isset($this->view->otoImages['oto_cholesterol']) ? 'checked' : ''; ?>>
						  </div>
				      </div>
			      </div>
		      </div>
		      <div class="col-lg-6">
			      <div class="row">
				      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Ear Symptoms', 'oto'); ?></div>
			      </div>
			      <hr>
			      <div class="row">
				      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Associated symptoms', 'oto'); ?></div>
			      </div>
			      <div class="strike-center"><span><?php echo _('Otological examination'); ?></span></div>
			      <div class="margin-bottom-20"></div>
			      <div class="wiazard-ident-list">
				      <div class="row">
					      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Pinna/pre/retroauricular region', 'oto'); ?></div>
				      </div>
				      <hr>
					  <div class="row">
					      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'External auditory canal (EAC)', 'oto'); ?></div>
				      </div>
				      <hr>
				      <div class="row">
					    <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Tympanic membrane (Eardrum)', 'oto'); ?></div>
				      </div>
				      <hr>
				      <div class="row">
					    <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Middle ear', 'oto'); ?></div>
				      </div>
				      <hr>
				      <div class="row">
					    <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Tuning fork tests', 'oto'); ?></div>
				      </div>
			      </div>
			      <div class="strike-center"><span><?php echo _('Vestibular system'); ?></span></div>
			      <div class="margin-bottom-20"></div>
			      <div class="wiazard-ident-list">
				      <div class="row">
					    <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Eye movements', 'oto'); ?></div>
				      </div>
				      <hr>
				      <div class="row">
					    <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Vestibulo-occular reflex', 'oto'); ?></div>
				      </div>
				      <hr>
				      <div class="row">
					    <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Vestibulo-spinal reflex', 'oto'); ?></div>
				      </div>
			      </div>
			      <hr>
			      <div class="row">
				    <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Cranial nerves examination', 'oto'); ?></div>
			      </div>
		      </div>
	      </div>
      </div>
      <div class="modal-footer">
      	<button type="button" class="btn btn-primary" data-dismiss="modal"><?php echo _('Done'); ?></button>
      </div>
    </div>
  </div>
</div>
