<div class="modal fade" tabindex="-1" role="dialog" id="modal-wizard-cardio-dialog">
  <div class="modal-dialog modal-lg" role="document">
    <div class="modal-content">
      <div class="modal-header">
        <h5 class="modal-title"><?php echo _('Wizard Cardio'); ?></h5>
        <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"><?php echo $this->helper->getRequestExam($this->view->exams, 'Gastritis / Ulcers', 'cardio'); ?></div>
	      </div>
	      <div class="row">
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Diabetes', 'cardio'); ?></div>
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Insulin', 'cardio'); ?></div>
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Oral antidiabetics', 'cardio'); ?></div>
	      </div>
	      <div class="row">
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Hypertension', 'cardio'); ?></div>
	      </div>
	      <div class="row">
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Unspecified renal insufficiency', 'cardio'); ?></div>
	      </div>
	      <div class="row">
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Thyroid diseases', 'cardio'); ?></div>
	      </div>
	      <div class="strike-center"><span><?php echo _('Physical examination'); ?></span></div>
	      <div class="margin-bottom-20"></div>
	      <div class="row">
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Cyanosis', 'cardio'); ?></div>
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Cardiac activity', 'cardio'); ?></div>
	      </div>
		  <div class="row">
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Visible jugular', 'cardio'); ?></div>
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Hepatomegaly', 'cardio'); ?></div>
	      </div>
	      <div class="strike-center"><span><?php echo _('Physical examination - chest'); ?></span></div>
	      <div class="margin-bottom-20"></div>
	      <div class="row">
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Wheezes at the bases', 'cardio'); ?></div>
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Cough', 'cardio'); ?></div>
	      </div>
	      <div class="row">
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Dyspnea (Objective exam)', 'cardio'); ?></div>
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Nail clubbing', 'cardio'); ?></div>
	      </div>
	      <div class="strike-center"><span><?php echo _('Physical examination - edema'); ?></span></div>
	      <div class="margin-bottom-20"></div>
	      <div class="row">
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Ankles', 'cardio'); ?></div>
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Legs', 'cardio'); ?></div>
	      </div>
	      <div class="row">
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Presacral', 'cardio'); ?></div>
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Anasarca', 'cardio'); ?></div>
	      </div>
	      <div class="strike-center"><span><?php echo _('Chest pain - position'); ?></span></div>
	      <div class="margin-bottom-20"></div>
	      <div class="row">
			  <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Retrosternal', 'cardio'); ?></div>
			  <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Precordial', 'cardio'); ?></div>
	      </div>
	      <div class="row">
			  <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Epigastric', 'cardio'); ?></div>
			  <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Neck, jaw', 'cardio'); ?></div>
	      </div>
	      <div class="row">
			  <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Back', 'cardio'); ?></div>
	      </div>
	      <div class="row">
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Shoulder, left arm', 'cardio'); ?></div>
			  <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Right arm', 'cardio'); ?></div>
	      </div>
	      <div class="strike-center"><span><?php echo _('Chest pain - symptoms'); ?></span></div>
	      <div class="margin-bottom-20"></div>
	      <div class="row">
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Sweating', 'cardio'); ?></div>
			  <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Lipotimia', 'cardio'); ?></div>
	      </div>
	      <div class="row">
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Syncope', 'cardio'); ?></div>
			  <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Nausea and vomit', 'cardio'); ?></div>
	      </div>
	      <div class="row">
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Dyspnea (symptom)', 'cardio'); ?></div>
	      </div>
	      <div class="strike-center"><span><?php echo _('Chest pain - duration and time'); ?></span></div>
	      <div class="margin-bottom-20"></div>
	      <div class="row">
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Chest pain duration', 'cardio'); ?></div>
			  <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Chest pain time', 'cardio'); ?></div>
	      </div>
	      <div class="strike-center"><span><?php echo _('Arrhythmias'); ?></span></div>
	      <div class="margin-bottom-20"></div>
	      <div class="row">
		      <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Arrhythmias', 'cardio'); ?></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>
