129 lines
6.0 KiB
YAML
129 lines
6.0 KiB
YAML
- generic [ref=e1]:
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- main [ref=e2]:
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- generic [ref=e3]:
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- link "🇬🇧 English" [ref=e4] [cursor=pointer]:
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- /url: /core/set-language/?language=en
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- generic [ref=e5]: 🇬🇧
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- generic [ref=e6]: English
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- link "🇸🇦 Arabic" [ref=e7] [cursor=pointer]:
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- /url: /core/set-language/?language=ar
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- generic [ref=e8]: 🇸🇦
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- generic [ref=e9]: Arabic
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- generic [ref=e10]:
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- generic [ref=e72]:
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- button "Back to Selection" [ref=e74] [cursor=pointer]:
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- img [ref=e75]
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- text: Back to Selection
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- generic [ref=e77]:
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- generic [ref=e78]:
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- heading "About This Form" [level=4] [ref=e79]:
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- img [ref=e80]
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- text: About This Form
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- 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.
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- generic [ref=e83]:
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- generic [ref=e84]:
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- heading "Complainant Information" [level=3] [ref=e85]:
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- img [ref=e86]
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- text: Complainant Information
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- generic [ref=e89]:
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- generic [ref=e90]: Complainant Name *
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- textbox "Complainant Name *" [ref=e91]:
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- /placeholder: Your full name
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- text: Test Complainant
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- generic [ref=e92]: Please provide your full name.
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- generic [ref=e93]:
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- generic [ref=e94]: Relation to Patient *
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- combobox "Relation to Patient *" [ref=e95]:
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- option "Select Relation"
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- option "Patient"
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- option "Relative" [selected]
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- option "Friend"
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- option "Other"
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- generic [ref=e96]:
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- generic [ref=e97]:
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- generic [ref=e98]: Email Address
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- textbox "Email Address" [ref=e99]:
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- /placeholder: your@email.com
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- text: test@example.com
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- generic [ref=e100]:
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- generic [ref=e101]: Mobile Number *
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- textbox "Mobile Number *" [ref=e102]:
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- /placeholder: 05xxxxxxxx
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- text: "+966501234567"
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- generic [ref=e103]:
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- heading "Patient Information" [level=3] [ref=e104]: Patient Information
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- generic [ref=e106]:
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- generic [ref=e107]: Patient Name *
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- textbox "Patient Name *" [ref=e108]:
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- /placeholder: Name of patient involved
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- text: Test Patient
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- generic [ref=e109]:
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- generic [ref=e110]: National ID / Iqama No. *
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- textbox "National ID / Iqama No. *" [ref=e111]:
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- /placeholder: 10-digit National ID or Iqama number
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- text: "1234567890"
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- generic [ref=e112]:
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- generic [ref=e113]: Incident Date *
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- textbox "Incident Date *" [ref=e114]: 2026-01-15
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- generic [ref=e115]:
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- heading "Complaint Details" [level=3] [ref=e116]:
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- img [ref=e117]
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- text: Complaint Details
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- generic [ref=e120]:
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- generic [ref=e121]: Hospital *
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- combobox "Hospital *" [ref=e122]:
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- option "Select Hospital"
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- option "NUZHA" [selected]
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- option "SUWAIDI"
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- generic [ref=e123]:
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- strong [ref=e124]:
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- img [ref=e125]
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- text: Location Selection
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- paragraph [ref=e128]: Select the location where the incident occurred. Start with the general area, then section and subsection if applicable.
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- generic [ref=e129]:
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- generic [ref=e130]: Location *
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- combobox "Location *" [ref=e131]:
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- option "Select Location"
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- option "Inpatient"
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- option "Outpatient Clinics"
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- option "Emergency" [selected]
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- option "Others"
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- generic [ref=e154]:
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- generic [ref=e155]: Main Section *
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- combobox "Main Section *" [ref=e156]:
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- option "Select Main Section" [selected]
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- option "Administrative"
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- option "Medical"
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- option "Nursing"
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- option "Support Services"
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- generic [ref=e132]:
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- generic [ref=e133]: Complaint Description *
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- textbox "Please describe your complaint in detail..." [active] [ref=e134]: This is a test complaint for E2E testing purposes.
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- generic [ref=e135]:
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- generic [ref=e136]: Attachments
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- generic [ref=e137] [cursor=pointer]:
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- img [ref=e138]
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- paragraph [ref=e141]: Click to upload files
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- paragraph [ref=e142]: Images, PDF, Word (max 10MB each)
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- button "Submit Complaint" [ref=e144] [cursor=pointer]:
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- img [ref=e145]
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- text: Submit Complaint
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- generic [ref=e55]:
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- paragraph [ref=e56]: Already submitted something?
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- generic [ref=e57]:
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- link "Track Complaint" [ref=e58] [cursor=pointer]:
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- /url: /complaints/public/track/
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- img [ref=e148]
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- text: Track Complaint
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- link "Track Observation" [ref=e62] [cursor=pointer]:
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- /url: /observations/track/
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- img [ref=e151]
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- text: Track Observation
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- contentinfo [ref=e66]:
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- generic [ref=e67]:
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- paragraph [ref=e68]: © 2026 Al Hammadi Hospital - PX360. All rights reserved.
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- paragraph [ref=e69]: Your feedback helps us improve our services
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- paragraph [ref=e70]:
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- text: Powered by
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- link "tenhal.sa" [ref=e71] [cursor=pointer]:
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- /url: https://tenhal.sa |