<div class="page-content-wrapper">
    <div class="page-content">
        <div class="row">
            <div class="col-md-12">
                <!-- BEGIN EXAMPLE TABLE PORTLET-->
                <div class="portlet box blue">
                    <div class="portlet-title">
                        <div class="caption">
                            <i class="fa fa-users"></i>Combined Report
                        </div>
                    </div>
                    <div class="portlet-body all">
                        <input type="hidden" id="reportPage" value="1"/>
                        <input type="hidden" id="controllName" value="combinedreport"/>

                        <div class="row">
                            <div class="row clinick posre">
                                <div class="col-md-1">
                                    <div class="form-group form-md-line-input form-md-floating-label has-info">
                                        <input type="number" class="form-control txtc comSearch" id="fromage" value=""/>
                                        <label for="form_control_1">Age From </label>
                                    </div>
                                </div>
                                <div class="col-md-1"></div>
                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label class="control-label ls2">Termination</label>

                                        <select class="form-control searchFin comSearch" id="termination">
                                            <option value="">choose</option>
                                            {foreach  $allTermination as $data}
                                            <option value="{$data->id}" >{$data->name}</option>
                                            {/foreach}
                                        </select>

                                    </div>
                                </div>
                                <div class="col-md-1"></div>
                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label class="control-label ls2">Operation</label>

                                        <select class="form-control searchFin comSearch" id="operation">
                                            <option value="">choose</option>
                                            {foreach  $allOperation as $data}
                                            <option value="{$data->id}" >{$data->name}</option>
                                            {/foreach}
                                        </select>

                                    </div>
                                </div>

                            </div>

                            <div class="row clinick posre">

                                <div class="col-md-1">
                                    <div class="form-group form-md-line-input form-md-floating-label has-info">
                                        <input type="number" class="form-control txtc comSearch" id="toage" value=""/>
                                        <label for="form_control_1">Age To </label>
                                    </div>
                                </div>
                                <div class="col-md-1"></div>
                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label class="control-label ls2">Diagnosis</label>

                                        <select multiple size="1" class="form-control searchFin comSearch" id="diagnosis">
                                            <option value="0">choose</option>
                                            {foreach  $allDiagnosis as $data}
                                            <option value="{$data->id}" >{$data->name}</option>
                                            {/foreach}
                                        </select>

                                    </div>
                                </div>
                                <div class="col-md-1"></div>
                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label class="control-label ls2">Diagnosis antenal</label>

                                        <select multiple size="1" class="form-control searchFin comSearch" id="diagnosisant">
                                            <option value="0">choose</option>
                                            {foreach  $allDiagnosisant as $data}
                                            <option value="ant{$data->id}" >{$data->name}</option>
                                            {/foreach}
                                        </select>

                                    </div>
                                </div>


                            </div>

                            <div class="clearfix"></div>

                            <div class="portlet box white">
                                <div class="portlet-title">
                                    <div class="actions">
                                        <a class="btn btn-default btn-sm" id="printCom" data-id="">
                                            <i class="fa fa-print"></i> Print </a>

                                    </div>
                                </div>

                                <div class="portlet-body form" id="combinedDiv">
                                    <table class="table table-hover portlet light bg-inverse " id="controllpropr">
                                        <thead>
                                            <tr>
                                                <th>#</th>
                                                <th>
                                                    Patient Name
                                                </th>
                                                <th>Patient Number</th>
                                                <th>Husband Name</th>
                                                <th>
                                                    Age
                                                </th>

                                            </tr>
                                        </thead>
                                        <tbody>

                                        </tbody>
                                    </table>
                                </div>
                            </div>
                        </div>

                    </div>

                    <div class="clearfix"></div>

                </div>
            </div>
        </div>
    </div>
</div>

<div class="clearfix"></div>
<div id="comPrint"></div>