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Current File : /home1/savoy/public_html/savoyglobal.net/cocorico/application/views/student/physicalreport.php

<?php
$student = $this->mastermodel->get_single_field_value('student', 'first_name', 'student_id', $physical->nutrition_student_id);
$teacher = $this->mastermodel->get_single_field_value('employee', 'employee_name', 'employee_id', $physical->nutrition_teacher_id);
$center_info = $this->mastermodel->search_nursery();
foreach ($center_info['results']->result_array() as $row) {
    $nursery_name = $row['nursery_name'];
    $nursery_address = $row['address'];
    $nursery_phone = $row['contact_no'];
    $nursery_email = $row['email'];
    $nursery_website = $row['website'];
    $nursery_logo = $row['logo'];
}
$j = 0;
?>
<html>
    <table  width="100%" height="100%" style="font-size: 12px;">
        <tr>
            <td width="50%">
                <table width="95%" style="height: 100%; border: 1px solid black;border-radius: 10px;font-size: 12px;float: left;">
                    <tr style="height: 20px;">
                        <td style="text-align:center;"><font size="16px"><b>Nutrition Report</b></font></td>
                    </tr>
                    <tr style="height: 120px;">
                        <td>
                            <table width="100%">
                                <tr>
                                    <td width="50%">
                                        <img style="width:60px;height:60px" src="<?= base_url() ?>assets/logo/<?= $nursery_logo; ?>" >
                                    </td>
                                    <td width="50%" style="text-align:right;"> <b><?= $nursery_name ?></b><br/>
                                                            <?= $nursery_address ?><br/><?php if($nursery_phone != ''){?>Tel: <?= $nursery_phone ?><?php } if($nursery_email != ''){?>, <?= $nursery_email ?><?php } if($nursery_website != ''){?>, <?= $nursery_website ?><?php } ?></td>
                                </tr>
                                <tr>
                                    <td colspan="2"><hr></td>
                                </tr>
                                    
                            </table>
                        </td>
                    </tr>
                    <tr><td style="text-align:center;font-size: 16px;">Dear Parent....</td></tr>
                    <tr><td style="height: 15px;"></td></tr>
                    <tr>
                        <td width="100%">
                            <table width="100%">
                                <tr>
                                    <td width="12%">
                                        Your child 
                                    </td>
                                    <td width="28%" style="border-bottom:1px dotted #444;color:#333;">
                                        <span style="color:#000;"><b><?= $student; ?></b></span></td>
                                    <td width="32%" > was looked after by Mr/Miss: </td>
                                    <td width="25%" style="border-bottom:1px dotted #444;color:#333;">
                                        <span style="color:#000;"><b><?= $teacher; ?></b></span></td>
                                </tr>
                            </table>
                        </td>
                    </tr>
                    <?php
                    $nutrition_sleep = $this->mastermodel->get_data('nutrition', $physical->nutrition_id, 'nutrition_id');
                    ?>
                    <tr>
                        <td width="100%">
                            <table width="100%">
                                <tr>
                                    <td style="width: 25%">Arrived: </td>
                                    <td style="border-bottom:1px dotted #444;color:#333;width: 25%;" ><?= substr($physical->nutrition_arrived, 0, 5); ?><span style="color:#000;"></span></td>
                                    <td style="width: 25%">Departed: </td>
                                    <td style="border-bottom:1px dotted #444;color:#333;width: 25%;" ><?= substr($physical->nutrition_departed, 0, 5); ?><span style="color:#000;"></span></td>
                                </tr>
                            </table>
                        </td>
                    </tr>
                    <tr><td style="height: 5px;"></td></tr>
                    <tr>
                        <td><span style="color:#000;font-size:15px"><b>Sleep</b></span></td>
                    </tr>

                    <tr>
                        <td>
                            <table style="width: 100%">
                                <?php
                                $i = 1;
                                $nutrition_sleep = $this->mastermodel->get_data('nutrition_sleep', $physical->nutrition_id, 'nutrition_id');
                                for ($i = 0; $i < count($nutrition_sleep); $i+=2) {
                                    ?>
                                    <tr>

                                        <td>From:</td>
                                        <td style="border-bottom:1px dotted #444;color:#333;" ><?= substr($nutrition_sleep[$i]['nutrition_sleep_from'], 0, 5); ?></td>
                                        <td>To:</td>
                                        <td style="border-bottom:1px dotted #444;color:#333;" ><?= substr($nutrition_sleep[$i]['nutrition_sleep_to'], 0, 5); ?></td>
                                      
                                        <td>From:</td>
                                        <td style="border-bottom:1px dotted #444;color:#333;" >
                                            <?php  if(isset($nutrition_sleep[$i + 1]['nutrition_sleep_from']))
                                        {  
                                           echo substr($nutrition_sleep[$i + 1]['nutrition_sleep_from'], 0, 5); ?>
                                        </td>
                                        <td>To:</td>
                                        <td style="border-bottom:1px dotted #444;color:#333;" >
                                            <?php echo substr($nutrition_sleep[$i + 1]['nutrition_sleep_to'], 0, 5);
                                        } ?>
                                        </td>
                                       
                                    </tr>
                                    <?php
                                    ++$j;
                                }
                                ?>
                            </table>
                        </td>
                    </tr>
                    <tr><td style="height: 5px;"></td></tr>
                    <tr>
                        <td><span style="color:#000;font-size:15px"><b>Food</b></span></td>
                    </tr>
                    <tr>
                        <td>
                            <table style="width: 100%">
                                <?php
                                $i = 1;
                                $nutrition_food = $this->mastermodel->get_data('nutrition_food', $physical->nutrition_id, 'nutrition_id');
                                foreach ($nutrition_food as $list) {
                                    ?>
                                    <tr>
                                        <td>Time: </td>
                                        <td style="border-bottom:1px dotted #444;color:#333;" ><?= substr($list['nutrition_food_time'], 0, 5); ?><span style="color:#000;"></span></td>
                                        <td width="5%"></td>
                                        <td>Consumption: </td>
                                        <td style="border-bottom:1px dotted #444;color:#333;" ><?= $list['nutrition_food_status']; ?></td>


                                    </tr>
                                    <?php
                                    ++$j;
                                }
                                ?> 
                            </table>
                        </td>
                    </tr>
                    <tr>
                        <td>
                            <table style="width: 100%">
                                <tr>
                                    <td width="30%">Any dislikes?</td>
                                    <td width="70%" style="border-bottom:1px dotted #444;color:#333;" ><span style="color:#000;"><?= $physical->nutrition_food_dislike ?></span></td>

                                </tr>
                            </table>
                        </td>
                    </tr>
                    <tr><td style="height: 5px;"></td></tr>
                    <tr>
                        <td style="font-size: 15px"><b>Bottles</b></td>
                    </tr>
                    <tr>
                        <td>
                            <table style="width: 100%">

                                <?php
                                $i = 1;
                                $nutrition_bottle = $this->mastermodel->get_data('nutrition_bottle', $physical->nutrition_id, 'nutrition_id');
                                foreach ($nutrition_bottle as $list) {
                                    ?>
                                    <tr>
                                        <td>Time:</td>
                                        <td style="border-bottom:1px dotted #444;color:#333;" ><?= substr($list['nutrition_bottle_time'], 0, 5); ?><span style="color:#000;"></span></td>
                                        <td width="5%"></td>
                                        <td>Amount:</td>
                                        <td style="border-bottom:1px dotted #444;color:#333;" ><?= $list['nutrition_bottle_amount']; ?></td>

                                    </tr>
                                    <?php
                                    ++$j;
                                }
                                ?>
                            </table>
                        </td>
                    </tr>
                    <tr><td style="height: 5px;"></td></tr>
                    <tr>
                        <td><span style="color:#000;font-size:15px"><b>Nappies</b></span></td>
                    </tr>
                    <tr>
                        <td>
                            <table style="width: 100%">
                                <?php
                                $i = 1;
                                $nutrition_nappies = $this->mastermodel->get_data('nutrition_nappies', $physical->nutrition_id, 'nutrition_id');
                                foreach ($nutrition_nappies as $list) {
                                    ?>
                                    <tr>
                                        <td>Time: </td>
                                        <td style="border-bottom:1px dotted #444;color:#333;" ><?= substr($list['nutrition_nappies_time'], 0, 5); ?></td>
                                        <td width="2%"></td>
                                        <td>Status: </td><td style="border-bottom:1px dotted #444;color:#333;" ><?= $list['nutrition_nappies_status']; ?></td>

                                        <td width="2%"></td>

                                        <td>Cream applied: </td>
                                        <td style="border-bottom:1px dotted #444;color:#333;" >
                                            <?php
                                            echo $list['nutrition_nappies_cream']
                                            ?>
                                        </td>
                                    </tr>
                                    <?php
                                    ++$j;
                                }
                                ?>
                            </table>
                        </td>
                    </tr>
                    <tr><td style="height: 5px;"></td></tr>
                    <tr>
                        <td><span style="color:#000;font-size:15px"><b>Outside Play/Indoor Activities:</b></span></td> 
                    </tr>
                    <tr>
                        <td width="100%" style="border-bottom:1px dotted #444;color:#333;height: 10px" ><?= $physical->nutrition_play ?></td>
                    </tr>
                    <tr>
                        <td width="100%" style="border-bottom:1px dotted #444;color:#333;height: 10px" ></td>
                    </tr>
                    <tr><td style="height: 5px;"></td></tr>
                    <tr>
                        <td><span style="color:#000;font-size:15px"><b>Requirements:</b></span></td> 
                    </tr>
                    <tr>
                        <td width="100%" style="border-bottom:1px dotted #444;color:#333;height: 10px" ><?=  $physical->nutrition_requirement ?></td>
                    </tr>
                    <tr>
                        <td width="100%" style="border-bottom:1px dotted #444;color:#333;height: 10px" ></td>
                    </tr>  
                    
                    <?php
                    if($j <= 3)
                    {
                    ?>
                    <tr><td style="height: 130px;"></td></tr>
                    <?php
                    }
                    else if($j <= 6)
                    {
                    ?>
                    <tr><td style="height: 75px;"></td></tr>
                    <?php
                    }    
                    ?>
                    
                </table>
            </td>
            <td width="50%">
                <table width="95%" style="height: 100%; border: 1px solid black;border-radius: 10px;font-size: 12px;float: left;">
                    <tr style="height: 20px;">
                        <td style="text-align:center;"><font size="16px"><b>Nutrition Report</b></font></td>
                    </tr>
                    <tr style="height: 120px;">
                        <td>
                            <table width="100%">
                                <tr>
                                    <td width="50%">
                                        <img style="width:60px;height:60px" src="<?= base_url() ?>assets/logo/<?= $nursery_logo; ?>" >
                                    </td>
                                    <td width="50%" style="text-align:right;"> <b><?= $nursery_name ?></b><br/>
                                                            <?= $nursery_address ?><br/><?php if($nursery_phone != ''){?>Tel: <?= $nursery_phone ?><?php } if($nursery_email != ''){?>, <?= $nursery_email ?><?php } if($nursery_website != ''){?>, <?= $nursery_website ?><?php } ?></td>
                                </tr>
                                <tr>
                                    <td colspan="2"><hr></td>
                                </tr>
                                    
                            </table>
                        </td>
                    </tr>
                    <tr><td style="text-align:center;font-size: 16px;">Dear Nursery....</td></tr>
                    <tr><td style="height: 15px;"></td></tr>
                    <tr>
                        <td>
                            <table style="width: 100%;font-size: 12px">
                                <tr>
                                    <td style="width:8%;">Day</td>
                                    <td style="width:40%;">Mon/Tue/Wed/Thur/Fri</td>
                                    <td style="width:5%;"><b>Date</b>:</td>
                                    <td style="border-bottom:1px dotted #444;color:#333;width: 15%" ><span style="color:#000;"></span></td>
                                </tr>
                            </table>
                        </td>
                    </tr>
                    <tr><td style="height: 15px;"></td></tr>

                    <tr>
                        <td><span style="color:#000;font-size:15px"><b>Sleep</b></span></td>
                    </tr>
                    <tr>
                        <td>
                            <table style="width: 100%;font-size: 12px">
                                <tr>
                                    <td style="width:15%;">Went to bed at:</td>
                                    <td style="border-bottom:1px dotted #444;color:#333;width: 15%" ><span style="color:#000;"></span></td>
                                    <td style="width:15%;">Wake up at:</td>
                                    <td style="border-bottom:1px dotted #444;color:#333;width: 15%" ><span style="color:#000;"></span></td>
                                </tr>
                            </table>
                        </td>
                    </tr>
                    <tr><td style="height: 15px;"></td></tr>
                    <tr>
                        <td style="font-size:15px"><b>Food</b></td>
                    </tr>
                    <tr>
                        <td>
                            <table style="width: 100%;font-size: 12px">
                                <tr>
                                    <td style="width:30%;">Is your child being weaned?</td>
                                    <td style="border-bottom:1px dotted #444;color:#333;width: 70%" ><span style="color:#000;"></span></td>
                                </tr>
                            </table>
                        </td>
                        
                    </tr>
                    <tr>
                        <td>
                            <table style="width: 100%;font-size: 12px">
                                <tr>
                                    <td style="width:30%;">If yes state food:</td>
                                    <td style="border-bottom:1px dotted #444;color:#333;width: 70%" ><span style="color:#000;"></span></td>
                                </tr>
                            </table>
                        </td>
                    </tr>
                    <tr>
                        <td>
                            <table style="width: 100%;font-size: 12px">
                                <tr>
                                    <td style="width:30%;">Last bottle time:</td>
                                    <td style="border-bottom:1px dotted #444;color:#333;width: 70%" ><span style="color:#000;"></span></td>

                                </tr>
                            </table>
                        </td>
                    </tr>
                    <tr>
                        <td>
                            <table style="width: 100%;font-size: 12px">
                                <tr>
                                    <td style="width:30%;">Amount:</td>
                                    <td style="border-bottom:1px dotted #444;color:#333;width: 70%" ><span style="color:#000;"></span></td>

                                </tr>
                            </table>
                        </td>
                    </tr>
                    <tr>
                        <td>
                            <table style="width: 100%;font-size: 12px">
                                <tr>
                                    <td style="width:30%;">Breakfast:</td>
                                    <td style="border-bottom:1px dotted #444;color:#333;width: 70%" ><span style="color:#000;"></span></td>

                                </tr>
                            </table>

                        </td>
                    </tr>
                    <tr>
                        <td>

                            <table style="width: 100%;font-size: 12px">
                                <tr>
                                    <td style="width:30%;">Time:</td>
                                    <td style="border-bottom:1px dotted #444;color:#333;width: 70%" ><span style="color:#000;"></span></td>

                                </tr>
                            </table>
                        </td>
                    </tr>
                     <tr><td style="height: 205px;"></td></tr>
                    <tr>
                        <td>
                            <table style="width: 100%;">
                                <tr>
                                    <td width="40%">Parent's Name: </td>
                                    <td width="30%">Date: </td>
                                    <td width="30%">Signature: </td>
                                </tr>
                            </table>
                        </td>
                    </tr>

                </table>
            </td>
        </tr>

    </table>

    <div style="page-break-after: always;"></div>
  
    <table width="100%" height="100%">
        <tr>
            <td width="50%">
                <table width="95%" style="height: 100%; border: 1px solid black;border-radius: 10px;font-size: 12px;float: left;">
                    <tr style="height: 20px;">
                        <td style="text-align:center;"><font size="16px"><b>Physical Report</b></font></td>
                    </tr>
                    <tr style="height: 120px;">
                        <td>
                            <table width="100%">
                                <tr>
                                    <td width="50%">
                                        <img style="width:60px;height:60px" src="<?= base_url() ?>assets/logo/<?= $nursery_logo; ?>" >
                                    </td>
                                    <td width="50%" style="text-align:right;"> <b><?= $nursery_name ?></b><br/>
                                                            <?= $nursery_address ?><br/><?php if($nursery_phone != ''){?>Tel: <?= $nursery_phone ?><?php } if($nursery_email != ''){?>, <?= $nursery_email ?><?php } if($nursery_website != ''){?>, <?= $nursery_website ?><?php } ?></td>
                                </tr>
                                <tr>
                                    <td colspan="2"><hr></td>
                                </tr>
                                    
                            </table>
                        </td>
                    </tr>
                    <tr><td style="text-align:center;font-size: 16px;">Dear Parent....</td></tr>
                    <tr><td style="height: 15px;"></td></tr>
                    <tr>

                        <td>
                            <table style="width: 100%;font-size: 12px;">
                                <tr>
                                    <td style="border-bottom:1px dotted #444;color:#333;width: 25%" ><span style="color:#000;"><b><?= $student; ?></b></span></td>
                                    <td style="width:22%;">was looked after by</td>
                                    <td style="border-bottom:1px dotted #444;color:#333;width: 20%" ><span style="color:#000;"><b><?= $teacher; ?></b></span></td>
                                    <td style="width:8%;"><b>Date</b>:</td>
                                    <td style="border-bottom:1px dotted #444;color:#333;width: 15%" ><span style="color:#000;"><?= $this->mastermodel->convertdatenormalformat($physical->nutrition_date) ?></span></td>
                                </tr>
                            </table>
                        </td>
                    </tr>
                    <tr>
                        <td>
                            <table style="width: 100%;font-size: 12px;">
                                <tr>
                                    <td width="35%">Your child has appeared to be:</td>
                                    <td width="65%" style="border-bottom:1px dotted #444;color:#333;" >
                                        <span style="color:#000; float: left"><b><?= $physical->physical_status; ?></b></span>
                                    </td>
                                </tr>
                            </table>
                        </td>
                    </tr>
                    <tr><td style="height: 25px;"></td></tr>
                    <tr>
                        <td><font size="15px"><b>Nappies or Toileting</b></font></td>
                    </tr>
                    <tr>
                        <td>(Any comments/changes)</td>
                    </tr>
                    <tr>
                        <td style="border-bottom:1px dotted #444;color:#333;height: 10px" ><span style="color:#000;"><?= $physical->physical_nappies; ?></span></td>
                        
                    </tr>
                    <tr><td style="height: 25px;"></td></tr>
                    <tr style="height: 20px;">
                        <td><font size="15px"><b>Essentials</b></font></td>
                    </tr>
                    <tr>
                        <td>Could you please send some more: <b><?= $physical->physical_essentials; ?></b></td>
                    </tr>
                    <tr>
                        <td>Other: <b><?= $physical->physical_essentials_other; ?></b></td>
                    </tr>
                    <tr><td style="height: 25px;"></td></tr>
                    <tr>
                        <td><font size="15px"><b>Play and Learning</b></font>   
                    </tr>
                    <tr>
                        <td><b>Outdoor/Indoor Activities enjoyed today</b></td>
                    </tr>
                    <tr>
                        <td style="border-bottom:1px dotted #444;color:#333;height: 10px" ><span style="color:#000;"><?= $physical->physical_learning; ?></span></td>
                        
                    </tr>
                    <tr>
                        <td><b>Any Comments</b></td>
                    </tr>
                    <tr>
                        <td style="border-bottom:1px dotted #444;color:#333;height: 10px" ><span style="color:#000;"><?= $physical->physical_meal_comments; ?></span></td>
                    </tr>
                    <tr><td style="height: 10px;"></td></tr>
                    <tr>
                        <td><font size="15px"><b>Notes from home</b></font></td>
                    </tr>
                    <tr>
                        <td>
                            <table style="width: 100%;">
                                <tr>
                                    <td width="100%" style="border-bottom:1px dotted #444;color:#333;height:10px;" ><span style="color:#000;"></span></td>
                                </tr>
                                <tr>
                                    <td width="100%" style="border-bottom:1px dotted #444;color:#333;height:10px;" ><span style="color:#000;"></span></td>
                                </tr>
                                <tr>
                                    <td width="100%" style="border-bottom:1px dotted #444;color:#333;height:10px;" ><span style="color:#000;"></span></td>
                                </tr>
                                <tr>
                                    <td width="100%" style="border-bottom:1px dotted #444;color:#333;height:10px;" ><span style="color:#000;"></span></td>
                                </tr>
                                <tr>
                                    <td width="100%" style="border-bottom:1px dotted #444;color:#333;height:10px;" ><span style="color:#000;"></span></td>
                                </tr>
                            </table>
                        </td>
                    </tr>
                    <tr><td style="height: 10px;"></td></tr>
                    <tr>
                        <td>
                            <table style="width: 100%;">
                                <tr>
                                    <td width="40%">Parent's Name: </td>
                                    <td width="30%">Date: </td>
                                    <td width="30%">Signature: </td>
                                </tr>
                            </table>
                        </td>
                    </tr>
                </table>
            </td>
            <td width="50%">
                <table width="95%" style="height: 100%; border: 1px solid black;border-radius: 10px;font-size: 12px;float: left;">
                    <tr style="height: 20px;">
                        <td style="text-align:center;"><font size="16px"><b>Medical Report</b></font></td>
                    </tr>
                    <tr style="height: 120px;">
                        <td>
                            <table width="100%">
                                <tr>
                                    <td width="50%">
                                        <img style="width:60px;height:60px" src="<?= base_url() ?>assets/logo/<?= $nursery_logo; ?>" >
                                    </td>
                                    <td width="50%" style="text-align:right;"> <b><?= $nursery_name ?></b><br/>
                                                            <?= $nursery_address ?><br/><?php if($nursery_phone != ''){?>Tel: <?= $nursery_phone ?><?php } if($nursery_email != ''){?>, <?= $nursery_email ?><?php } if($nursery_website != ''){?>, <?= $nursery_website ?><?php } ?></td>
                                </tr>
                                <tr>
                                    <td colspan="2"><hr></td>
                                </tr>
                                    
                            </table>
                        </td>
                    </tr>
                    <tr><td style="text-align:center;font-size: 16px;">Dear Parent ....</td></tr>
                    <tr><td style="height: 15px;"></td></tr>
                    <tr>

                        <td>
                            <table style="width: 100%;font-size: 12px;">
                                <tr>
                                    <td style="width:22%;">Child Name</td>
                                    <td style="border-bottom:1px dotted #444;color:#333;width: 25%" ><span style="color:#000;"><b><?= $student; ?></b></span></td>
                                    <td></td>
                                    <td style="width:12%;"><b>Date</b>:</td>
                                    <td style="border-bottom:1px dotted #444;color:#333;width: 15%" ><span style="color:#000;"><?= $this->mastermodel->convertdatenormalformat($physical->nutrition_date) ?></span></td>
                                </tr>
                            </table>
                        </td>
                    </tr>
                    <tr><td style="height: 25px;"></td></tr>
                    <tr>
                        <td><b><font size="15px">Health status /if there is any illness</font></b></td>
                    </tr>
                    <tr>
                        <td>
                            <table style="width: 100%;font-size: 12px">
                                <tr>
                                    <td style="border-bottom:1px dotted #444;color:#333;height: 10px" ><span style="color:#000;"><?= $medical->medical_health_status; ?></span></td>
                                </tr>
                               
                            </table>
                        </td>
                    </tr>
                    <tr><td style="height: 25px;"></td></tr>
                    <tr>
                        <td><b><font size="15px">Medication</font></b></td>
                    </tr>
                    <tr>
                        <td>
                            <table style="width: 100%;font-size: 12px">
                                <tr>
                                    <td style="border-bottom:1px dotted #444;color:#333;height: 10px" ><span style="color:#000;"><?= $medical->medical_medication; ?></span></td>
                                </tr>
                            </table>
                        </td>
                    </tr>

                    
                    
                    
                    <tr><td style="height: 25px;"></td></tr>
                    <tr>
                        <td><b><font size="15px">Other special requirements</font></b></td>
                    </tr>
                    <tr>
                        <td>
                            <table style="width: 100%;font-size: 12px">
                                 <tr>
                                    <td style="border-bottom:1px dotted #444;color:#333;height: 10px" ><span style="color:#000;"><?= $medical->medical_special_requirements; ?></span></td>
                                </tr>
                            </table>
                        </td>
                    </tr>
                    <tr><td style="height: 25px;"></td></tr>
                    <tr>
                        <td><b><font size="15px">Notes</font></b></td>
                    </tr>
                    <tr>
                        <td>
                            <table style="width: 100%;">
                                 <tr>
                                    <td style="border-bottom:1px dotted #444;color:#333;height: 10px" ><span style="color:#000;"><?= $medical->medical_notes; ?></span></td>
                                </tr>
                            </table>
                        </td>
                    </tr>
                    <tr><td style="height: 30px;"></td></tr>
                    <tr>
                        <td><font size="15px"><b>Notes from home</b></font></td>
                    </tr>
                    <tr>
                        <td>
                            <table style="width: 100%;">
                                <tr>
                                    <td width="100%" style="border-bottom:1px dotted #444;color:#333;height:10px;" ><span style="color:#000;"></span></td>
                                </tr>
                                <tr>
                                    <td width="100%" style="border-bottom:1px dotted #444;color:#333;height:10px;" ><span style="color:#000;"></span></td>
                                </tr>
                                <tr>
                                    <td width="100%" style="border-bottom:1px dotted #444;color:#333;height:10px;" ><span style="color:#000;"></span></td>
                                </tr>
                                <tr>
                                    <td width="100%" style="border-bottom:1px dotted #444;color:#333;height:10px;" ><span style="color:#000;"></span></td>
                                </tr>
                                <tr>
                                    <td width="100%" style="border-bottom:1px dotted #444;color:#333;height:10px;" ><span style="color:#000;"></span></td>
                                </tr>
                            </table>
                        </td>
                    </tr>
                    <tr><td style="height: 10px;"></td></tr>
                    <tr>
                        <td>
                            <table style="width: 100%;">
                                <tr>
                                    <td width="40%">Parent's Name: </td>
                                    <td width="30%">Date: </td>
                                    <td width="30%">Signature: </td>
                                </tr>
                            </table>
                        </td>
                    </tr>
                </table>
            </td>
        </tr>
    </table>
    

</html>

bypass 1.0, Devloped By El Moujahidin (the source has been moved and devloped)
Email: contact@elmoujehidin.net