diff --git a/resources/views/srvey/common.blade.php b/resources/views/srvey/common.blade.php
index 851c7532..1b988959 100644
--- a/resources/views/srvey/common.blade.php
+++ b/resources/views/srvey/common.blade.php
@@ -216,17 +216,6 @@
             $('#report-form').on('submit', function(event) {
                 event.preventDefault();
                 $("#pageloader").fadeIn();
-                $.ajax({
-                    type: "POST",
-                    url: '/srvey/ciplatodoctor',
-                    data: new FormData($('#report-form')[0]),
-                    processData: false,
-                    contentType: false,
-                    success: function(data) {
-                        console.log(data);  
-                    },
-                });
-
                 $.ajax({
                     type: "POST",
                     url: '/srvey/ajaxsubmit',
@@ -250,7 +239,7 @@
                             })
                         }
                     },
-                });                
+                });
             });
         });
     </script>
diff --git a/resources/views/srvey/rapport-rapport/1674212914-9f377f34-4762-4b40-a466-8b282d183332.blade.php b/resources/views/srvey/rapport-rapport/1674212914-9f377f34-4762-4b40-a466-8b282d183332.blade.php
new file mode 100644
index 00000000..851c7532
--- /dev/null
+++ b/resources/views/srvey/rapport-rapport/1674212914-9f377f34-4762-4b40-a466-8b282d183332.blade.php
@@ -0,0 +1,259 @@
+<!DOCTYPE html>
+<html lang="en">
+
+<head>
+    @include('layouts.shared/title-meta', ['title' => 'Form'])
+    @include('layouts.shared/head-css', ['mode' => $mode ?? '', 'demo' => $demo ?? ''])
+    <link href="{{ asset('assets/libs/sweetalert2/sweetalert2.min.css') }}" rel="stylesheet" type="text/css" />
+</head>
+<div id="pageloader">
+    <img src="http://cdnjs.cloudflare.com/ajax/libs/semantic-ui/0.16.1/images/loader-large.gif" alt="processing..." />
+</div>
+
+<body class="loading">
+    <div class="account-pages">
+        <div class="container">
+            <div class="row justify-content-center">
+                <div class="col-md-8 col-lg-6 col-xl-5 p-0">
+                    <div class="card bg-pattern">
+                        <div class="card-body p-3 row">
+
+                            @if (Session::has('error'))
+                                <div class="alert alert-danger">{{ Session::get('error') }}</div>
+                                <br>
+                            @endif
+                            @if (session('success'))
+                                <div class=" alert alert-success">{{ session('success') }}
+                                </div>
+                                <br>
+                            @endif
+                            <div class="col-12">
+                                <h4 class="page-title">{{ $form->title }}</h4>
+                            </div>
+
+                            <form method="POST" action="/form/submit" id="report-form" enctype="multipart/form-data">
+                                <input type="hidden" name="form_id" value="{{ $form_id }}">
+                                @csrf
+                                @if ($id)
+                                    <input type="hidden" name="id" value="{{ $id }}">
+                                @endif
+                                @if (isset($form->manager_can_submit) && $form->manager_can_submit == true)
+                                    <div class="col-md-12 mb-2">
+                                        <label for="field-user_id" class="form-label"> Select User / Territory <span
+                                                class="text-danger">*</span> </label>
+                                        <select class="form-control" id="field-user_id" name="user_id" required>
+                                            <option value=""> -- Select -- </option>
+                                            @foreach ($form->users as $option)
+                                                <option value="{{ $option->value }}"
+                                                    hierarchy="{{ $option->hierarchy_id }}"
+                                                    {{ isset($question->value) && $question->value == $option->value ? 'selected' : '' }}>
+                                                    {{ $option->display }}</option>
+                                            @endforeach
+                                        </select>
+                                    </div>
+                                @endif
+
+                                @foreach ($questions as $question)
+                                    <div class="col-md-12 mb-2">
+                                        <label for="field-{{ $question->code }}"
+                                            class="form-label">{{ $question->question }} {!! $question->required == 'yes' ? '<span class="text-danger">*</span>' : '' !!}
+                                        </label>
+                                        @switch($question->type)
+                                            @case('hidden')
+                                                <input type="{{ $question->type }}" id="field-{{ $question->code }}"
+                                                    name="{{ $question->code }}"
+                                                    value="{{ isset($question->value) ? $question->value : '' }}">
+                                            @break
+
+                                            @case('text')
+                                            @case('email')
+
+                                            @case('tel')
+                                            @case('date')
+                                                <input type="{{ $question->type }}" id="field-{{ $question->code }}"
+                                                    name="{{ $question->code }}" class="form-control"
+                                                    {{ $question->required == 'yes' ? 'required' : '' }}
+                                                    value="{{ isset($question->value) ? $question->value : '' }}">
+                                            @break
+
+                                            @case('number')
+                                                <input type="{{ $question->type }}" min="0" max="9999999999"
+                                                    step="1" id="field-{{ $question->code }}"
+                                                    name="{{ $question->code }}" class="form-control"
+                                                    {{ $question->required == 'yes' ? 'required' : '' }}
+                                                    value="{{ isset($question->value) ? $question->value : 0 }}">
+                                            @break
+
+                                            @case('textarea')
+                                                <textarea id="field-{{ $question->code }}" name="{{ $question->code }}" class="form-control"
+                                                    {{ $question->required == 'yes' ? 'required' : '' }}>{{ isset($question->value) ? $question->value : '' }}</textarea>
+                                            @break
+
+                                            @case('dropdown')
+                                                <select class="form-control" id="field-{{ $question->code }}"
+                                                    name="{{ $question->code }}"
+                                                    {{ $question->required == 'yes' ? 'required' : '' }}>
+                                                    <option value=""> -- Select -- </option>
+                                                    @foreach ($question->options as $option)
+                                                        <option value="{{ $option->value }}"
+                                                            {{ isset($question->value) && $question->value == $option->value ? 'selected' : '' }}>
+                                                            {{ $option->display }}</option>
+                                                    @endforeach
+                                                </select>
+                                            @break
+
+                                            @case('checkbox')
+                                                @foreach ($question->options as $option)
+                                                    <div class="form-check mb-2 form-check-primary">
+                                                        <input class="form-check-input" type="checkbox"
+                                                            id="field-{{ $question->code }}-{{ $option->value }}"
+                                                            name="{{ $question->code }}[]" value="{{ $option->value }}"
+                                                            {{ isset($question->value) && $question->value != '' && in_array($option->value, $question->value) ? 'checked' : '' }}>
+                                                        <label class="form-check-label"
+                                                            for="field-{{ $question->code }}-{{ $option->value }}">{{ $option->display }}</label>
+                                                    </div>
+                                                @endforeach
+                                            @break
+
+                                            @case('radio')
+                                                @foreach ($question->options as $option)
+                                                    <div class="form-check">
+                                                        <input type="radio"
+                                                            id="field-{{ $question->code }}-{{ $option->value }}"
+                                                            name="{{ $question->code }}" class="form-check-input" value="{{$option->value}}"
+                                                            {{ isset($question->value) && $question->value != $question->value ? 'checked' : '' }}>
+                                                        <label class="form-check-label"
+                                                            for="field-{{ $question->code }}-{{ $option->value }}">{{ $option->display }}</label>
+                                                    </div>
+                                                @endforeach
+                                            @break
+
+                                            @case('file')
+                                                <input type="file" id="field-{{ $question->code }}"
+                                                    name="{{ $question->code }}" class="form-control" value=""
+                                                    accept="image/jpg, image/jpeg, image/png" required>
+                                            @break
+
+                                            @case('multitextbox')
+                                                <div class="row">
+                                                    @foreach ($question->options as $option)
+                                                        <div class="col-6">{{ $option->display }}</div>
+                                                        <div class="col-6 mb-1">
+                                                            <input type="number" id="field-{{ $option->value }}"
+                                                                name="{{ $option->value }}" class="form-control" required
+                                                                value="{{ isset($option->val) ? $option->val : 0 }}">
+                                                        </div>
+                                                    @endforeach
+                                                </div>
+                                            @break
+
+                                            @case('radiometrix')
+                                                @foreach ($question->options as $option)
+                                                    <div class="row">
+                                                        <div class="col-5">{{ $option->display }}</div>
+                                                        <div class="col-7 mb-1">
+                                                            @php
+                                                               $nn = json_decode($option->value);
+                                                            @endphp
+                                                            @foreach ($nn as $value)
+                                                                <input type="radio"
+                                                                    id="field-{{ $option->display }}-{{ $value }}"
+                                                                    name="{{ $question->code }}[{{$option->display}}]" value="{{$value}}" class="form-check-input"
+                                                                    {{ isset($question->display) && $option->display != $option->display ? 'checked' : '' }}>
+                                                                {{ $value }}
+                                                            @endforeach
+                                                        </div>
+
+                                                    </div>
+                                                @endforeach
+                                            @break
+                                        @endswitch
+                                    </div>
+                                @endforeach
+                                @if (!isset($form->is_approval) || (isset($form->is_approval) && $form->is_approval != 'yes'))
+                                    <div class="text-center d-grid mt-3">
+                                        <button class="btn btn-primary" type="submit" id="submit-btn"> Submit
+                                        </button>
+                                    </div>
+                                @endif
+                            </form>
+
+                        </div> <!-- end card-body -->
+                    </div>
+                    <!-- end card -->
+
+                    <!-- end row -->
+
+                </div> <!-- end col -->
+            </div>
+            <!-- end row -->
+        </div>
+        <!-- end container -->
+    </div>
+    <!-- end page -->
+    <style type="text/css">
+        #pageloader {
+            background: rgba(255, 255, 255, 0.8);
+            display: none;
+            height: 100%;
+            position: fixed;
+            width: 100%;
+            z-index: 9999;
+        }
+
+        #pageloader img {
+            left: 50%;
+            margin-left: -32px;
+            margin-top: -32px;
+            position: absolute;
+            top: 50%;
+        }
+    </style>
+    @include('layouts.shared/footer-script')
+    <script src="{{ asset('assets/libs/sweetalert2/sweetalert2.min.js') }}"></script>
+    <script type="text/javascript">
+        jQuery(document).ready(function($) {
+            $('#report-form').on('submit', function(event) {
+                event.preventDefault();
+                $("#pageloader").fadeIn();
+                $.ajax({
+                    type: "POST",
+                    url: '/srvey/ciplatodoctor',
+                    data: new FormData($('#report-form')[0]),
+                    processData: false,
+                    contentType: false,
+                    success: function(data) {
+                        console.log(data);  
+                    },
+                });
+
+                $.ajax({
+                    type: "POST",
+                    url: '/srvey/ajaxsubmit',
+                    data: new FormData($('#report-form')[0]),
+                    processData: false,
+                    contentType: false,
+                    success: function(data) {
+                        $("#pageloader").fadeOut();
+                        if (data.status == 'success') {
+                            Swal.fire({
+                                title: 'Great!',
+                                text: 'Your data is successfully submitted!',
+                                icon: 'success'
+                            })
+                            $('#report-form').trigger("reset");
+                        } else {
+                            Swal.fire({
+                                icon: 'error',
+                                title: 'Data not submitted',
+                                text: 'Something went wrong, please try again after some time!'
+                            })
+                        }
+                    },
+                });                
+            });
+        });
+    </script>
+</body>
+
+</html>