<!-- Form Start -->
<div class="block">
    <div class="title lightTextShadow"><?php echo $this->lang->line('medicaleq_edit'); ?></div>
    <br />   


    <a href="<?= base_url() ?>checkup/admin_medicaleq/overview" class="button sub inlineBlock rnd3 lightTextShadow">
        <span><?php echo $this->lang->line('button_medicaleq'); ?></span>
    </a>
    <div class="content">
        <?php echo form_open_multipart('checkup/admin_medicaleq/edit/' . $medicaleq->medicaleq_id, array('id' => 'medicaleq_edit')) ?>
        <fieldset class="form boxStyle">                                
            <?php echo $this->template->flash_msg(); ?>                          

            <label for="medicaleq_name" class="label"><?php echo $this->lang->line('medicaleq_title'); ?></label>
            <input id="medicaleq_name" class="textBox med rnd5" name="medicaleq_name" value="<?= set_value('medicaleq_name', $medicaleq->medicaleq_name) ?>"  />
            <?php echo form_error('medicaleq_name'); ?>
            <br />
            <label for="medicaleq_notice" class="label"><?php echo $this->lang->line('medicaleq_notice'); ?></label>
            <textarea id="new_desc" rows="6" cols="0" class="textArea lrg rnd5" name="medicaleq_notice" ><?= set_value('medicaleq_notice', $medicaleq->medicaleq_notice) ?></textarea>
            <?php echo form_error('medicaleq_notice'); ?>
            <br />

            <div class="center">
                <input id="submit" type="submit" value="أدخل" class="button sml inlineBlock rnd5 drkTextShadow" />
            </div>
        </fieldset>
        <?php echo form_close(); ?>
    </div>
</div>