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Form:CalcBenzo

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{{{for template|CalculateBenzo}}}
{{{for template|CalculateBenzo}}}
{| class="formtable"
{| class="formtable"
 +
| colspan="4" | <center>Choose one or more benzodiazepines and dosage expressed as mg/day</center>
|-
|-
!
!
-
! Benzodiazepines
+
! drug
-
! mg/day
+
! dosage
 +
!
|-
|-
| Benzodiazepine 1
| Benzodiazepine 1
| {{{field|benzo1|mandatory|values from category=Benzodiazepine}}}  
| {{{field|benzo1|mandatory|values from category=Benzodiazepine}}}  
-
| {{{field|dose1|mandatory|type=Number}}}  
+
| {{{field|dose1|mandatory|input type=Number}}}
 +
| mg/day
|-
|-
| Benzodiazepine 2
| Benzodiazepine 2
| {{{field|benzo2|values from category=Benzodiazepine}}}  
| {{{field|benzo2|values from category=Benzodiazepine}}}  
-
| {{{field|dose2|type=Number}}}  
+
| {{{field|dose2|input type=Number}}}  
 +
| mg/day
|-
|-
| Benzodiazepine 3
| Benzodiazepine 3
| {{{field|benzo3|values from category=Benzodiazepine}}}  
| {{{field|benzo3|values from category=Benzodiazepine}}}  
-
| {{{field|dose3|type=Number}}}  
+
| {{{field|dose3|input type=Number}}}  
 +
| mg/day
|-
|-
| Benzodiazepine 4
| Benzodiazepine 4
| {{{field|benzo4|values from category=Benzodiazepine}}}  
| {{{field|benzo4|values from category=Benzodiazepine}}}  
-
| {{{field|dose4|type=Number}}}  
+
| {{{field|dose4|input type=Number}}}  
 +
| mg/day
|-
|-
| Benzodiazepine 5
| Benzodiazepine 5
| {{{field|benzo5|values from category=Benzodiazepine}}}  
| {{{field|benzo5|values from category=Benzodiazepine}}}  
-
| {{{field|dose5|type=Number}}}  
+
| {{{field|dose5|input type=Number}}}  
 +
| mg/day
|}
|}
 +
{{{end template}}}
{{{end template}}}
</includeonly>
</includeonly>

Revision as of 18:40, 8 June 2010

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