From bfd488b90d050423d145ca772bcb7884f353dffe Mon Sep 17 00:00:00 2001
From: zeeshan <zeeshan@stratawiz.com>
Date: Fri, 6 Nov 2026 14:47:30 +0530
Subject: [PATCH] GlenmarkCV (Clinic Input Survey)

---
 ...58cb-76ad-4e4e-b395-5ff6ff6203e9.blade.php | 24 +++++++++----------
 1 file changed, 12 insertions(+), 12 deletions(-)

diff --git a/resources/views/form/rapport-glenmarkcv/1793873536-4dbb58cb-76ad-4e4e-b395-5ff6ff6203e9.blade.php b/resources/views/form/rapport-glenmarkcv/1793873536-4dbb58cb-76ad-4e4e-b395-5ff6ff6203e9.blade.php
index f00e2203..7b14ab35 100644
--- a/resources/views/form/rapport-glenmarkcv/1793873536-4dbb58cb-76ad-4e4e-b395-5ff6ff6203e9.blade.php
+++ b/resources/views/form/rapport-glenmarkcv/1793873536-4dbb58cb-76ad-4e4e-b395-5ff6ff6203e9.blade.php
@@ -328,65 +328,65 @@
 
         $('#field-eptus_extended_sep').on('change',function(){
             
-            $('#report-form').append('<input type="hidden"  name="eptus_extended_sep" value="1">');
+            $('#report-form').append('<input type="hidden"  name="eptus_extended_sep_count" value="1">');
         })
 
         $('#field-eptus_extended_oct').on('change',function(){
             
-            $('#report-form').append('<input type="hidden"  name="eptus_extended_oct" value="1">');
+            $('#report-form').append('<input type="hidden"  name="eptus_extended_oct_count" value="1">');
         })
 
         $('#field-eptus_extended_nov').on('change',function(){
              
-            $('#report-form').append('<input type="hidden"  name="eptus_extended_nov" value="1">');
+            $('#report-form').append('<input type="hidden"  name="eptus_extended_nov_count" value="1">');
         })
 
 
         $('#field-sitazit_dm_sept').on('change',function(){
              
-            $('#report-form').append('<input type="hidden"  name="sitazit_dm_sept" value="1">');
+            $('#report-form').append('<input type="hidden"  name="sitazit_dm_sept_count" value="1">');
         })
 
         $('#field-sitazit_d_dm_oct').on('change',function(){
             
-            $('#report-form').append('<input type="hidden"  name="sitazit_d_dm_oct" value="1">');
+            $('#report-form').append('<input type="hidden"  name="sitazit_d_dm_oct_count" value="1">');
         })
 
         $('#field-sitazit_d_dm_gimmick_nov').on('change',function(){
             
-            $('#report-form').append('<input type="hidden"  name="sitazit_d_dm_gimmick_nov" value="1">');
+            $('#report-form').append('<input type="hidden"  name="sitazit_d_dm_gimmick_nov_count" value="1">');
         })
         
 
         $('#field-lobg_trial_sep').on('change',function(){
              
-            $('#report-form').append('<input type="hidden"  name="lobg_trial_sep" value="1">');
+            $('#report-form').append('<input type="hidden"  name="lobg_trial_sep_count" value="1">');
         })
 
         $('#field-lobg_isp_oct').on('change',function(){
              
-            $('#report-form').append('<input type="hidden"  name="lobg_isp_oct" value="1">');
+            $('#report-form').append('<input type="hidden"  name="lobg_isp_oct_count" value="1">');
         })
 
         $('#field-lobg_nov26').on('change',function(){
              
-            $('#report-form').append('<input type="hidden"  name="lobg_nov26" value="1">');
+            $('#report-form').append('<input type="hidden"  name="lobg_nov26_count" value="1">');
         })
 
 
         $('#field-ziten_lbl_sept').on('change',function(){
              
-            $('#report-form').append('<input type="hidden"  name="ziten_lbl_sept" value="1">');
+            $('#report-form').append('<input type="hidden"  name="ziten_lbl_sept_count" value="1">');
         })
 
         $('#field-ziten_lbl_oct').on('change',function(){
              
-            $('#report-form').append('<input type="hidden"  name="ziten_lbl_oct" value="1">');
+            $('#report-form').append('<input type="hidden"  name="ziten_lbl_oct_count" value="1">');
         })
 
         $('#field-ziten_lbl_nov').on('change',function(){
             
-            $('#report-form').append('<input type="hidden"  name="ziten_lbl_nov" value="1">');
+            $('#report-form').append('<input type="hidden"  name="ziten_lbl_nov_count" value="1">');
         })
 
         $(document).ready(function() {