<div id="claim_response">
<?php
$query_claim="select * from claims_details where process_claim_no='$process_claim_no' and item_service='Drugs' order by id desc;";
$rsclaim=mysql_query($query_claim, $courier) or die(mysql_error());
$row_rsclaim = mysql_fetch_assoc($rsclaim);
$totalRows_rsclaim = mysql_num_rows($rsclaim); ?>                                              
             
<div class="task-content task-list">
                                        <div class="row">
                        <div class="col-md-12">
                                <div class="portlet-body flip-scroll">
                                    <table class="table table-striped table-hover flip-content">
                                        <thead class="flip-content">
                                            <tr>
                                                <th style="width:60%" > Item </th>
                                                <th style="width:35%"> Dose&nbsp;| Unit </th>
                                                <th style="width:8%"> Freq. </th>
                                                <th style="width:6%"> Days </th>
                                                <th> Action </th>
                                            </tr>
                                        </thead>
                                    <tbody> 
                                                <?php if ($totalRows_rsclaim> 0) { ?>   
                                                    <?php
                                                    do {
                                                        $i = $i + 1;
                                                        ?>
                                                        <tr>
                                                          <td><?php echo strtoupper($row_rsclaim['item']); ?></td>
                    <td>
                      <select name="itemdose<?php echo $row_rsclaim['id']; ?>" id="itemdose<?php echo $row_rsclaim['id']; ?>" style="" onChange="searchItemsName('updatedose_claim_details','#claimsno_drugs_prescriptions',<?php echo $row_rsclaim['id']; ?>,'no_field',this.value);">
                        <option value="" selected></option>
                      <?php for ($i = 1; $i <= 10; $i++) {?>
                      <option value="<?php echo $i;?>" <?php if($row_rsclaim['dose']==$i){echo "selected";}?>><?php echo $i;?></option>
                      <?php }?>
                      </select>
                      <select name="itemdoseform<?php echo $row_rsclaim['id']; ?>" id="itemdoseform<?php echo $row_rsclaim['id']; ?>" style="" onChange="searchItemsName('updatedoseform_claim_details_drugs','#claimsno_drugs_prescriptions',<?php echo $row_rsclaim['id']; ?>,'no_field',this.value);">
                        <option value="" selected></option>
                        <?php 
                      $query_claim_dosage_form="select * from dosage_form order by dosage_form;";
$rsclaim_dosage_form=mysql_query($query_claim_dosage_form, $courier) or die(mysql_error());
$row_rsclaim_dosage_form = mysql_fetch_assoc($rsclaim_dosage_form);  
                        do {  
?>
                              <option value="<?php echo $row_rsclaim_dosage_form['dosage_form'];?>" <?php if($row_rsclaim['dosage_form']==$row_rsclaim_dosage_form['dosage_form']){echo "selected";}?>><?php echo $row_rsclaim_dosage_form['dosage_form'];?></option>
                              <?php
} while ($row_rsclaim_dosage_form = mysql_fetch_assoc($rsclaim_dosage_form));
  $rows = mysql_num_rows($rsclaim_dosage_form);
  if($rows > 0) {
      mysql_data_seek($rsclaim_dosage_form, 0);
	  $row_rsclaim_dosage_form = mysql_fetch_assoc($rsclaim_dosage_form);
  }
         ?>               
                        
                      </select></td>
                    <td>
                    <select name="itemfrequency<?php echo $row_rsclaim['id']; ?>" id="itemfrequency<?php echo $row_rsclaim['id']; ?>" style="" onChange="searchItemsName('updatefrequency_claim_details_drugs','#claimsno_drugs_prescriptions',<?php echo $row_rsclaim['id']; ?>,'no_field',this.value);">
                        <option value="" selected></option>
                      
					  
                      <?php 
                      $query_claim_dosage_form="select * from dosage_frequency order by ranking;";
$rsclaim_dosage_form=mysql_query($query_claim_dosage_form, $courier) or die(mysql_error());
$row_rsclaim_dosage_form = mysql_fetch_assoc($rsclaim_dosage_form);  
                        do {  
?>
                              <option value="<?php echo $row_rsclaim_dosage_form['frequency'];?>" <?php if($row_rsclaim['frequency']==$row_rsclaim_dosage_form['frequency']){echo "selected";}?>><?php echo $row_rsclaim_dosage_form['frequency'];?></option>
                              <?php
} while ($row_rsclaim_dosage_form = mysql_fetch_assoc($rsclaim_dosage_form));
  $rows = mysql_num_rows($rsclaim_dosage_form);
  if($rows > 0) {
      mysql_data_seek($rsclaim_dosage_form, 0);
	  $row_rsclaim_dosage_form = mysql_fetch_assoc($rsclaim_dosage_form);
  }
         ?>           
                      
                      
                      </select>
                    
                    </td>
                    <td>
                    <select name="itemnoofdays<?php echo $row_rsclaim['id']; ?>" id="itemnoofdays<?php echo $row_rsclaim['id']; ?>" style="" onChange="searchItemsName('updatenoofdays_claim_details_drugs','#claimsno_drugs_prescriptions',<?php echo $row_rsclaim['id']; ?>,'no_field',this.value);">
                        <option value="" selected></option>
                      <?php for ($i = 1; $i <= 60; $i++) {?>
                      <option value="<?php echo $i;?>" <?php if($row_rsclaim['no_of_days']==$i){echo "selected";}?>><?php echo $i;?></option>
                      <?php }?>
                      </select>
                    </td>
                      <td><span onclick="delInformtion('del_claim_drug_prescriptions','#claimsno_drugs_prescriptions','<?php echo $row_rsclaim['id']; ?>','<?php echo strtoupper($row_rsclaim['item']); ?> ?', 'You are about to Delete <?php echo strtoupper($row_rsclaim['item']); ?> from this Patient.', '<?php echo strtoupper($row_rsclaim['item']); ?> Deleted Successfully !');" style="font-weight:bold;color:red;cursor: pointer;"> <i class="icon-trash"></i></span></td>
                    </tr>
                  <?php }  while ($row_rsclaim = mysql_fetch_assoc($rsclaim)); ?>
                  <?php }else{echo '<tr><td colspan="9" style="background: linen"><div class="none">No Drugs Found.</div></td></tr>';}?>
                  </tbody>
                </table> 
</div>                                
</div>
</div>
</div>
</div>