- generic [ref=e1]:
  - main [ref=e2]:
    - generic [ref=e3]:
      - link "🇬🇧 English" [ref=e4] [cursor=pointer]:
        - /url: /core/set-language/?language=en
        - generic [ref=e5]: 🇬🇧
        - generic [ref=e6]: English
      - link "🇸🇦 Arabic" [ref=e7] [cursor=pointer]:
        - /url: /core/set-language/?language=ar
        - generic [ref=e8]: 🇸🇦
        - generic [ref=e9]: Arabic
    - generic [ref=e10]:
      - generic [ref=e72]:
        - button "Back to Selection" [ref=e74] [cursor=pointer]:
          - img [ref=e75]
          - text: Back to Selection
        - generic [ref=e77]:
          - generic [ref=e78]:
            - heading "About This Form" [level=4] [ref=e79]:
              - img [ref=e80]
              - text: About This Form
            - paragraph [ref=e82]: Use this form to submit a complaint about your experience at one of our hospitals. We will review your complaint and get back to you as soon as possible.
          - generic [ref=e83]:
            - generic [ref=e84]:
              - heading "Complainant Information" [level=3] [ref=e85]:
                - img [ref=e86]
                - text: Complainant Information
              - generic [ref=e89]:
                - generic [ref=e90]: Complainant Name *
                - textbox "Complainant Name *" [ref=e91]:
                  - /placeholder: Your full name
                  - text: Test Complainant
                - generic [ref=e92]: Please provide your full name.
              - generic [ref=e93]:
                - generic [ref=e94]: Relation to Patient *
                - combobox "Relation to Patient *" [ref=e95]:
                  - option "Select Relation"
                  - option "Patient"
                  - option "Relative" [selected]
                  - option "Friend"
                  - option "Other"
              - generic [ref=e96]:
                - generic [ref=e97]:
                  - generic [ref=e98]: Email Address
                  - textbox "Email Address" [ref=e99]:
                    - /placeholder: your@email.com
                    - text: test@example.com
                - generic [ref=e100]:
                  - generic [ref=e101]: Mobile Number *
                  - textbox "Mobile Number *" [ref=e102]:
                    - /placeholder: 05xxxxxxxx
                    - text: "+966501234567"
            - generic [ref=e103]:
              - heading "Patient Information" [level=3] [ref=e104]: Patient Information
              - generic [ref=e106]:
                - generic [ref=e107]: Patient Name *
                - textbox "Patient Name *" [ref=e108]:
                  - /placeholder: Name of patient involved
                  - text: Test Patient
              - generic [ref=e109]:
                - generic [ref=e110]: National ID / Iqama No. *
                - textbox "National ID / Iqama No. *" [ref=e111]:
                  - /placeholder: 10-digit National ID or Iqama number
                  - text: "1234567890"
              - generic [ref=e112]:
                - generic [ref=e113]: Incident Date *
                - textbox "Incident Date *" [active] [ref=e114]: 2026-01-15
            - generic [ref=e115]:
              - heading "Complaint Details" [level=3] [ref=e116]:
                - img [ref=e117]
                - text: Complaint Details
              - generic [ref=e120]:
                - generic [ref=e121]: Hospital *
                - combobox "Hospital *" [ref=e122]:
                  - option "Select Hospital"
                  - option "NUZHA" [selected]
                  - option "SUWAIDI"
              - generic [ref=e123]:
                - strong [ref=e124]:
                  - img [ref=e125]
                  - text: Location Selection
                - paragraph [ref=e128]: Select the location where the incident occurred. Start with the general area, then section and subsection if applicable.
              - generic [ref=e129]:
                - generic [ref=e130]: Location *
                - combobox "Location *" [ref=e131]:
                  - option "Select Location"
                  - option "Inpatient"
                  - option "Outpatient Clinics"
                  - option "Emergency" [selected]
                  - option "Others"
              - generic [ref=e132]:
                - generic [ref=e133]: Complaint Description *
                - textbox "Please describe your complaint in detail..." [ref=e134]
              - generic [ref=e135]:
                - generic [ref=e136]: Attachments
                - generic [ref=e137] [cursor=pointer]:
                  - img [ref=e138]
                  - paragraph [ref=e141]: Click to upload files
                  - paragraph [ref=e142]: Images, PDF, Word (max 10MB each)
            - button "Submit Complaint" [ref=e144] [cursor=pointer]:
              - img [ref=e145]
              - text: Submit Complaint
      - generic [ref=e55]:
        - paragraph [ref=e56]: Already submitted something?
        - generic [ref=e57]:
          - link "Track Complaint" [ref=e58] [cursor=pointer]:
            - /url: /complaints/public/track/
            - img [ref=e148]
            - text: Track Complaint
          - link "Track Observation" [ref=e62] [cursor=pointer]:
            - /url: /observations/track/
            - img [ref=e151]
            - text: Track Observation
  - contentinfo [ref=e66]:
    - generic [ref=e67]:
      - paragraph [ref=e68]: © 2026 Al Hammadi Hospital - PX360. All rights reserved.
      - paragraph [ref=e69]: Your feedback helps us improve our services
      - paragraph [ref=e70]:
        - text: Powered by
        - link "tenhal.sa" [ref=e71] [cursor=pointer]:
          - /url: https://tenhal.sa