1<form name="bpmeasurement" id="bpmeasurement" __FORM__>
2  <p align="center">
3  <table border="0" cellpadding="2" cellspacing="2" style="margin-left:20px;">
4  <tr>
5    <td class="bpmeasurement_who">Vos nom et prénoms :</td>
6    <td class="cell2"><input name="names" type="text" id="names" style="width:20em;text-align:left;" tabindex="1" value="" /></td>
7  </tr>
8  <tr>
9  <td class="bpmeasurement_who">Date de la première mesure (dd/MM/yyyy) :</td>
10    <td class="cell2"><input name="date" type="text" id="date" style="width:10em;text-align:left;" tabindex="1" value="" /></td>
11  </tr>
12  </table>
13  </p>
14
15  <p align="center">
16  <table border="0" cellpadding="2" cellspacing="2" style="margin-left:20px;">
17    <tr>
18      <td width="60">&nbsp;</td>
19      <td width="80">&nbsp;</td>
20      <td colspan="2" class="bpmeasurement_day">Jour 1 </td>
21      <td colspan="2" class="bpmeasurement_day">Jour 2 </td>
22      <td colspan="2" class="bpmeasurement_day">Jour 3 </td>
23      <td width="140">&nbsp;</td>
24    </tr>
25    <tr>
26      <td>&nbsp;</td>
27      <td>&nbsp;</td>
28      <td class="bpmeasurement_type">SYS</td>
29      <td class="bpmeasurement_type">DIA</td>
30      <td class="bpmeasurement_type">SYS</td>
31      <td class="bpmeasurement_type">DIA</td>
32      <td class="bpmeasurement_type">SYS</td>
33      <td class="bpmeasurement_type">DIA</td>
34      <td>&nbsp;</td>
35    </tr>
36    <tr>
37      <td rowspan="3" class="bpmeasurement_horizheader_main">MATIN</td>
38      <td class="bpmeasurement_horizheader">mesure 1 </td>
39      <td class="cell2"><input name="s1" type="text" id="s1" style="width:40px;text-align:center;" tabindex="1" value="" /></td>
40      <td class="cell2b"><input name="d1" type="text" id="d1" style="width:40px;text-align:center;" tabindex="2" value="" /></td>
41      <td class="cell2"><input name="s7" type="text" id="s7" style="width:40px;text-align:center;" tabindex="13" value="" /></td>
42      <td class="cell2b"><input name="d7" type="text" id="d7" style="width:40px;text-align:center;" tabindex="14" value="" /></td>
43      <td class="cell2"><input name="s13" type="text" id="s13" style="width:40px;text-align:center;" tabindex="25" value="" /></td>
44      <td class="cell2b"><input name="d13" type="text" id="d13" style="width:40px;text-align:center;" tabindex="26" value="" /></td>
45    </tr>
46    <tr>
47      <td class="bpmeasurement_horizheader">mesure 2 </td>
48      <td class="cell2"><input name="s2" type="text" id="s2" style="width:40px;text-align:center;" tabindex="3" value="" /></td>
49      <td class="cell2b"><input name="d2" type="text" id="d2" style="width:40px;text-align:center;" tabindex="4" value="" /></td>
50      <td class="cell2"><input name="s8" type="text" id="s8" style="width:40px;text-align:center;" tabindex="15" value="" /></td>
51      <td class="cell2b"><input name="d8" type="text" id="d8" style="width:40px;text-align:center;" tabindex="16" value="" /></td>
52      <td class="cell2"><input name="s14" type="text" id="s14" style="width:40px;text-align:center;" tabindex="27" value="" /></td>
53      <td class="cell2b"><input name="d14" type="text" id="d14" style="width:40px;text-align:center;" tabindex="28" value="" /></td>
54    </tr>
55    <tr>
56      <td class="bpmeasurement_horizheader">mesure 3 </td>
57      <td class="cell2"><input name="s3" type="text" id="s3" style="width:40px;text-align:center;" tabindex="5" value="" /></td>
58      <td class="cell2b"><input name="d3" type="text" id="d3" style="width:40px;text-align:center;" tabindex="6" value="" /></td>
59      <td class="cell2"><input name="s9" type="text" id="s9" style="width:40px;text-align:center;" tabindex="17" value="" /></td>
60      <td class="cell2b"><input name="d9" type="text" id="d9" style="width:40px;text-align:center;" tabindex="18" value="" /></td>
61      <td class="cell2"><input name="s15" type="text" id="s15" style="width:40px;text-align:center;" tabindex="29" value="" /></td>
62      <td class="cell2b"><input name="d15" type="text" id="d15" style="width:40px;text-align:center;" tabindex="30" value="" /></td>
63    </tr>
64    <tr>
65      <td class="cell1">&nbsp;</td>
66      <td class="cell1">&nbsp;</td>
67      <td>&nbsp;</td>
68      <td class="cell2b">&nbsp;</td>
69      <td>&nbsp;</td>
70      <td class="cell2b">&nbsp;</td>
71      <td>&nbsp;</td>
72      <td class="cell2b">&nbsp;</td>
73      <td class="cell3">&nbsp;</td>
74    </tr>
75    <tr>
76      <td rowspan="3" class="bpmeasurement_horizheader_main">SOIR</td>
77      <td class="bpmeasurement_horizheader">mesure 1 </td>
78      <td class="cell2"><input name="s4" type="text" id="s4" style="width:40px;text-align:center;" tabindex="7" value="" /></td>
79      <td class="cell2b"><input name="d4" type="text" id="d4" style="width:40px;text-align:center;" tabindex="8" value="" /></td>
80      <td class="cell2"><input name="s10" type="text" id="s10" style="width:40px;text-align:center;" tabindex="19" value="" /></td>
81      <td class="cell2b"><input name="d10" type="text" id="d10" style="width:40px;text-align:center;" tabindex="20" value="" /></td>
82      <td class="cell2"><input name="s16" type="text" id="s16" style="width:40px;text-align:center;" tabindex="31" value="" /></td>
83      <td class="cell2b"><input name="d16" type="text" id="d16" style="width:40px;text-align:center;" tabindex="32" value="" /></td>
84    <tr>
85      <td class="bpmeasurement_horizheader">mesure 2 </td>
86      <td class="cell2"><input name="s5" type="text" id="s5" style="width:40px;text-align:center;" tabindex="9" value="" /></td>
87      <td class="cell2b"><input name="d5" type="text" id="d5" style="width:40px;text-align:center;" tabindex="10" value="" /></td>
88      <td class="cell2"><input name="s11" type="text" id="s11" style="width:40px;text-align:center;" tabindex="21" value="" /></td>
89      <td class="cell2b"><input name="d11" type="text" id="d11" style="width:40px;text-align:center;" tabindex="22" value="" /></td>
90      <td class="cell2"><input name="s17" type="text" id="s17" style="width:40px;text-align:center;" tabindex="33" value="" /></td>
91      <td class="cell2b"><input name="d17" type="text" id="d17" style="width:40px;text-align:center;" tabindex="34" value="" /></td>
92    </tr>
93    <tr>
94      <td class="bpmeasurement_horizheader">mesure 3 </td>
95      <td class="cell2"><input name="s6" type="text" id="s6" style="width:40px;text-align:center;" tabindex="11" value="" /></td>
96      <td class="cell2b"><input name="d6" type="text" id="d6" style="width:40px;text-align:center;" tabindex="12" value="" /></td>
97      <td class="cell2"><input name="s12" type="text" id="s12" style="width:40px;text-align:center;" tabindex="23" value="" /></td>
98      <td class="cell2b"><input name="d12" type="text" id="d12" style="width:40px;text-align:center;" tabindex="24" value="" /></td>
99      <td class="cell2"><input name="s18" type="text" id="s18" style="width:40px;text-align:center;" tabindex="35" value="" /></td>
100      <td class="cell2b"><input name="d18" type="text" id="d18" style="width:40px;text-align:center;" tabindex="36" value="" /></td>
101    </tr>
102  </table>
103  </p>
104
105  <p align="center">
106    <table border="O" cellpadding="2" cellspacing="2" style="margin-left:20px;">
107      <tr>
108        <td>&nbsp;</td>
109        <td class="bpmeasurement_average_verticheader">Systolique</td>
110        <td class="bpmeasurement_average_verticheader">Diastolique</td>
111      </tr>
112      <tr>
113        <td class="bpmeasurement_average_horizheader">Nombre de mesures</td>
114        <td><input name="systNb" type="text" id="systNb" value="" size="7" readonly="readonly" /></td>
115        <td><input name="diastNb" type="text" id="diastNb" value="" size="7" readonly="readonly" /></td>
116      </tr>
117      <tr>
118        <td class="bpmeasurement_average_horizheader">Moyenne</td>
119        <td><input name="systAverage" type="text" id="systAverage" value="" size="7" readonly="readonly" /></td>
120        <td><input name="diastAverage" type="text" id="diastAverage" value="" size="7" readonly="readonly" /></td>
121      </tr>
122    </table>
123
124    <input name="button" type="button" onclick="javascript:selfmeasurement_computeAverages();" value="Calculer" />
125    <input name="button" type="button" onclick="javascript:selfmeasurement_clear();" value="Effacer">
126    <input name="__SUBMIT_NAME__" type="submit" value="Envoyer">
127    <!--<input name="button" type="Submit" value="Envoyer" />-->
128  </p>
129</form>
130