- generic [active] [ref=e1]:
  - banner [ref=e2]:
    - generic [ref=e4]:
      - generic [ref=e5]:
        - img "HH Logo" [ref=e7]
        - generic [ref=e8]:
          - heading "PX360" [level=1] [ref=e9]
          - paragraph [ref=e10]: Patient Experience Management
      - generic [ref=e11]:
        - link "🇬🇧 English" [ref=e12] [cursor=pointer]:
          - /url: /core/set-language/?language=en
          - generic [ref=e13]: 🇬🇧
          - generic [ref=e14]: English
        - link "🇸🇦 Arabic" [ref=e15] [cursor=pointer]:
          - /url: /core/set-language/?language=ar
          - generic [ref=e16]: 🇸🇦
          - generic [ref=e17]: Arabic
  - main [ref=e18]:
    - generic [ref=e21]:
      - generic [ref=e22]:
        - img [ref=e24]
        - heading "Report an Observation" [level=1] [ref=e27]
        - paragraph [ref=e28]: Help us improve by reporting issues you notice
      - generic [ref=e30]:
        - img [ref=e31]
        - generic [ref=e34]:
          - strong [ref=e35]: Anonymous Reporting
          - paragraph [ref=e36]: You can submit this report anonymously. Providing your information is optional but may help us follow up if needed.
      - generic [ref=e37]:
        - generic [ref=e38]:
          - generic [ref=e39]:
            - img [ref=e40]
            - text: Hospital
            - generic [ref=e44]: (optional)
          - combobox [ref=e45]:
            - option "Select hospital" [selected]
            - option "Al Nuzha"
            - option "Al Olya"
            - option "Al Suwaidi"
            - option "Al-Hammadi Hospital (KPI Test)"
            - option "E2E Test Hospital"
        - generic [ref=e46]:
          - generic [ref=e47]:
            - img [ref=e48]
            - text: Location Type
            - generic [ref=e51]: "*"
          - combobox [ref=e52]:
            - option "Select Location Type" [selected]
            - option "Outpatient (OP)"
            - option "Inpatient (IP)"
            - option "Emergency (ER)"
            - option "General"
        - generic [ref=e53]:
          - generic [ref=e54]:
            - img [ref=e55]
            - text: Category
            - generic [ref=e58]: (optional)
          - combobox [ref=e59]:
            - option "Select Category" [selected]
            - option "Medical"
            - option "Nursing"
            - option "Administrative"
            - option "Support Services"
        - generic [ref=e60]:
          - generic [ref=e61]:
            - img [ref=e62]
            - text: Description
            - generic [ref=e65]: "*"
          - textbox "Please describe what you observed in detail..." [ref=e66]
          - paragraph [ref=e67]: Please describe what you observed in detail.
        - generic [ref=e68]:
          - generic [ref=e69]:
            - img [ref=e70]
            - text: Location Details
            - generic [ref=e73]: (optional)
          - textbox "e.g., Building A, Floor 2, Room 205" [ref=e74]
        - generic [ref=e75]:
          - generic [ref=e76]:
            - img [ref=e77]
            - text: When did this occur?
          - textbox [ref=e79]: 2026-07-12T23:40:27
        - generic [ref=e80]:
          - generic [ref=e81]:
            - img [ref=e82]
            - text: Attachments
            - generic [ref=e84]: (optional)
          - generic [ref=e85] [cursor=pointer]:
            - img [ref=e86]
            - paragraph [ref=e89]: Click to upload files
            - paragraph [ref=e90]: Images, PDF, Word, Excel (max 10MB each)
        - generic [ref=e91]:
          - generic [ref=e92]:
            - img [ref=e93]
            - text: Your Information
            - generic [ref=e96]: (optional)
          - paragraph [ref=e97]: Providing your information helps us follow up if needed. Leave blank to submit anonymously.
          - generic [ref=e98]:
            - generic [ref=e99]:
              - generic [ref=e100]: Staff ID
              - textbox "Your staff ID (optional)" [ref=e101]
            - generic [ref=e102]:
              - generic [ref=e103]: Name
              - textbox "Your name (optional)" [ref=e104]
            - generic [ref=e105]:
              - generic [ref=e106]: Phone
              - textbox "Your phone number (optional)" [ref=e107]
            - generic [ref=e108]:
              - generic [ref=e109]: Email
              - textbox "Your email (optional)" [ref=e110]
        - button "Submit Observation" [ref=e111] [cursor=pointer]:
          - img [ref=e112]
          - text: Submit Observation
        - link "Track an existing observation" [ref=e116] [cursor=pointer]:
          - /url: /observations/track/
          - img [ref=e117]
          - text: Track an existing observation
  - contentinfo [ref=e120]:
    - generic [ref=e121]:
      - paragraph [ref=e122]: © 2026 Al Hammadi Hospital - PX360. All rights reserved.
      - paragraph [ref=e123]: Your feedback helps us improve our services
      - paragraph [ref=e124]:
        - text: Powered by
        - link "tenhal.sa" [ref=e125] [cursor=pointer]:
          - /url: https://tenhal.sa