RadAjaxLoadingPanel not working

3 posts, 0 answers
  1. Bill
    Bill avatar
    175 posts
    Member since:
    Apr 2010

    Posted 08 Feb 2011 Link to this post

    I have a RadAjaxLoadingPanel at the bottom of my html in a user control and is not being displayed when the page is loading or posting back.

    I have confirmed that the image exists in the proper path. I have a RadScriptManager on my Master page. Here is the full HTML. Scroll all the way down near the bottom in bold to see the control. I also have a RadAjaxManager in place (see bolding). Note that the page works absolutely fine; I just can't get the image to appear... What do I need to do in order for it to appear?


    <%@ Page Language="C#" AutoEventWireup="true" CodeBehind="Demographics.aspx.cs" Inherits="GlobalNET.Patient.Demographics" %>

    <%@ Register Assembly="Telerik.Web.UI" Namespace="Telerik.Web.UI" TagPrefix="telerik" %>
    <!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
    <html xmlns="http://www.w3.org/1999/xhtml">
    <head id="Head1" runat="server">
        <link href="../CommonSecurity/CSS/Stylesheet1.css" rel="stylesheet" type="text/css" />

        <script type="text/javascript" src="../Common/js/bulkscanmatch.js"></script>

        <script type="text/javascript" src="../Common/js/CommonValidations.js"></script>

        <script type="text/javascript" src="../Common/js/sortable.js"></script>

        <script type="text/javascript" src="../Common/js/DemographicsCoding.js"></script>

        <script language="javascript" type="text/javascript" event="OnPostTransfer" for="DynamicWebTwain1">
      <!--
       DynamicWebTwain1_OnPostTransfer();
      //-->
        </script>

        <script language="javascript" type="text/javascript" event="OnMouseClick(index)"
            for="DynamicWebTwain1">
      <!--
       logPage_DynamicWebTwain1_OnMouseClick(index);
      //-->
        </script>

        <telerik:RadCodeBlock ID="RadCodeBlock1" runat="server">

            <script language="javascript" type="text/javascript">

                var td = document.getElementById('tdThumbNails');

                // wyeager - 09/21/2010
                // Tab to next tab depending on last field selected
                // Once all required fields have been entered, enable the Save button    

                function CheckForCompletedReqFlds(currentTab) {

                    var tabStrip = $find("<%= tsPatientDemographics.ClientID %>");

                    if (currentTab == "Patient") {
                        var tab = tabStrip.findTabByText("Guarantor");
                        tab.select();
                        var GuarRelToPat = document.getElementById("GuarRelToPat");
                        GuarRelToPat.focus();
                    }
                    else if (currentTab == "Guarantor") {
                        var tab = tabStrip.findTabByText("Pri Ins");
                        tab.select();
                        var priInsCode = document.getElementById("priInsCode");
                        priInsCode.focus();
                    }
                    else if (currentTab == "Pri Ins") {
                        var tab = tabStrip.findTabByText("Sec Ins");
                        tab.enable();
                        tab.select();
                        var secInsCode = document.getElementById("secInsCode");
                        secInsCode.focus();
                    }
                    else if (currentTab == "Sec Ins") {
                        var tab = tabStrip.findTabByText("Ter Ins");
                        tab.enable();
                        tab.select();
                        var terInsCode = document.getElementById("terInsCode");
                        terInsCode.focus();
                    }
                    else if (currentTab == "Ter Ins") {
                        var tab = tabStrip.findTabByText("Patient");
                        tab.select();
                        var HospAcctno = document.getElementById("HospAcctno");
                        HospAcctno.focus();
                    }

                    if ((document.getElementById("HospAcctno").value != "") && (document.getElementById("MRN").value != "") && (document.getElementById("PatLName").value != "") && (document.getElementById("PatFName").value != "") && (document.getElementById("PatAddress1").value != "") && (document.getElementById("PatCity").value != "") && (document.getElementById("PatState").value != "Select") && (document.getElementById("PatDOB").value != "") && (document.getElementById("PatMaritalStatus").value != "Select") && (document.getElementById("PatSex").value != "Select") && (document.getElementById("GuarRelToPat").value != "Select") && (document.getElementById("GuarLName").value != "") && (document.getElementById("GuarFName").value != "") && (document.getElementById("GuarAddress1").value != "") && (document.getElementById("GuarCity").value != "") && (document.getElementById("GuarState").value != "Select") && (document.getElementById("ddlGuarArrivalMode").value != "Select") && (document.getElementById("radAdmitDate").value != "") && (document.getElementById("radAdmitTime").value != "") && (document.getElementById("GuarSex").value != "Select") && (document.getElementById("radDischargeDate").value != "") && (document.getElementById("radDischargeTime").value != "") && (document.getElementById("ddlGuarMaritalStatus").value != "Select") && (document.getElementById("radGuarDOB").value != "") && (document.getElementById("priInsCode").value != "") && (document.getElementById("priInsName").value != "") && (document.getElementById("priInsAddress1").value != "") && (document.getElementById("priInsCity").value != "") && (document.getElementById("priInsState").value != "") && (document.getElementById("priInsZip").value != "") && (document.getElementById("priInsPolicyNum").value != "") && (document.getElementById("priInsPolicyNumVer").value != "") && (document.getElementById("priInsGrpNum").value != ""))
                        document.getElementById("btnSaveLogEntry").disabled = false;
                    else
                        document.getElementById("btnSaveLogEntry").disabled = true;

                }
            </script>

            <script language="javascript" type="text/javascript">

                // wyeager - 10/06/2010
                // Check if user has secondary or tertiary insurance as a reminder to fill in.
                function CheckForOtherIns() {

                    var tabStrip = $find("<%= tsPatientDemographics.ClientID %>");
                    var selectedTab = tabStrip.get_selectedTab();
                    var hdnOtherIns = document.getElementById("hdnOtherIns");
                    var secInsCode = document.getElementById("secInsCode");
                    var terInsCode = document.getElementById("terInsCode");

                    hdnOtherIns.value = "0";

                    if (selectedTab != null) {
                        var selectedTabValue = selectedTab.get_text();

                        if (selectedTabValue == "Pri Ins") {
                            if (confirm("Is there Secondary or Tertiary Insurance information available?" + '\n' + "Press OK if Yes or CANCEL if No.")) {
                                selectSecTab();
                                hdnOtherIns.value = "1";
                                return false;
                            }
                            else {
                                return true;
                            }
                        }
                        else if ((selectedTabValue == "Sec Ins") && (secInsCode.value == ""))
                            if (confirm("Is there Secondary Insurance information available?" + '\n' + "Press OK if Yes or CANCEL if No.")) {
                            selectSecTab();
                            hdnOtherIns.value = "2";
                            return false;
                        }
                        else {
                            return true;
                        }
                        else if ((selectedTabValue == "Sec Ins") && (secInsCode.value != ""))
                            if (confirm("Is there Tertiary Insurance information available?" + '\n' + "Press OK if Yes or CANCEL if No.")) {
                            selectTerTab();
                            hdnOtherIns.value = "2";
                            return false;
                        }
                        else {
                            return true;
                        }
                        else if ((selectedTabValue == "Ter Ins") && (terInsCode.value == ""))
                            if (confirm("Is there Tertiary Insurance information available?" + '\n' + "Press OK if Yes or CANCEL if No.")) {
                            selectTerTab();
                            hdnOtherIns.value = "3";
                            return false;
                        }
                        else {
                            return true;
                        }
                    }
                }

                // wyeager - 10/13/2010
                function selectSecTab() {
                    var tabStrip = $find("<%= tsPatientDemographics.ClientID %>");
                    var tab = tabStrip.findTabByText("Sec Ins");
                    tab.enable();
                    tab.select();
                }

                // wyeager - 10/13/2010
                function selectTerTab() {
                    var tabStrip = $find("<%= tsPatientDemographics.ClientID %>");
                    var tab = tabStrip.findTabByText("Ter Ins");
                    tab.enable();
                    tab.select();
                }

                // wyeager - 10/13/2010
                // Gets the Relation to Patient for the Guarantor.
                function getGuarSelectedValue() {

                    var index = document.getElementById("GuarRelToPat").selectedIndex;
                    if (document.getElementById("GuarRelToPat").options[index].text == "Self") {

                        var GuarRelToPat = document.getElementById("GuarRelToPat");
                        GuarRelToPat.options[index].text = 'Self';

                        var GuarLName = document.getElementById("GuarLName");
                        var PatLName = document.getElementById("PatLName");
                        GuarLName.value = PatLName.value;

                        var GuarFName = document.getElementById("GuarFName");
                        var PatFName = document.getElementById("PatFName");
                        GuarFName.value = PatFName.value;

                        var GuarInitial = document.getElementById("GuarInitial");
                        var PatInitial = document.getElementById("PatInitial");
                        GuarInitial.value = PatInitial.value;

                        var GuarAddress1 = document.getElementById("GuarAddress1");
                        var PatAddress1 = document.getElementById("PatAddress1");
                        GuarAddress1.value = PatAddress1.value;

                        var GuarAddress2 = document.getElementById("GuarAddress2");
                        var PatAddress2 = document.getElementById("PatAddress2");
                        GuarAddress2.value = PatAddress2.value;

                        var GuarCity = document.getElementById("GuarCity");
                        var PatCity = document.getElementById("PatCity");
                        GuarCity.value = PatCity.value;

                        var GuarState = document.getElementById("GuarState");
                        var PatState = document.getElementById("PatState");
                        GuarState.value = PatState.value;

                        var GuarZip = $find("<%= GuarZip.ClientID %>");
                        var PatZip = $find("<%= PatZip.ClientID %>");
                        GuarZip.set_value(PatZip.get_value());

                        var GuarSex = document.getElementById("GuarSex");
                        var PatSex = document.getElementById("PatSex");
                        GuarSex.value = PatSex.value;

                        var GuarSSN = $find("<%= GuarSSN.ClientID %>");
                        var PatSSN = $find("<%= PatSSN.ClientID %>");
                        GuarSSN.set_value(PatSSN.get_value());

                        var radGuarDOB = $find("<%= radGuarDOB.ClientID %>");
                        var PatDOB = $find("<%= PatDOB.ClientID %>");
                        var PatDOBDate = PatDOB.get_selectedDate();
                        radGuarDOB.set_selectedDate(PatDOBDate);

                        var ddlGuarMaritalStatus = document.getElementById("ddlGuarMaritalStatus");
                        var PatMaritalStatus = document.getElementById("PatMaritalStatus");
                        ddlGuarMaritalStatus.value = PatMaritalStatus.value;

                        var GuarHomePhone = $find("<%= GuarHomePhone.ClientID %>");
                        var PatHomePhone = $find("<%= PatHomePhone.ClientID %>");
                        GuarHomePhone.set_value(PatHomePhone.get_value());

                        var GuarWorkPhone = $find("<%= GuarWorkPhone.ClientID %>");
                        var PatWorkPhone = $find("<%= PatWorkPhone.ClientID %>");
                        GuarWorkPhone.set_value(PatWorkPhone.get_value());

                        var GuarCellPhone = $find("<%= GuarCellPhone.ClientID %>");
                        var PatCellPhone = $find("<%= PatCellPhone.ClientID %>");
                        GuarCellPhone.set_value(PatCellPhone.get_value());
                    }
                }

                // wyeager - 10/13/2010
                // Gets the Relation to Patient for the Primary Insurance.
                function getPriSelectedValue() {

                    var index = document.getElementById("priSubRelToPat").selectedIndex;
                    if (document.getElementById("priSubRelToPat").options[index].text == "Self") {

                        var priSubRelToPat = document.getElementById("priSubRelToPat");
                        priSubRelToPat.options[index].text = 'Self';

                        var priSubLName = document.getElementById("priSubLName");
                        var PatLName = document.getElementById("PatLName");
                        priSubLName.value = PatLName.value;

                        var priSubFName = document.getElementById("priSubFName");
                        var PatFName = document.getElementById("PatFName");
                        priSubFName.value = PatFName.value;

                        var priSubInitial = document.getElementById("priSubInitial");
                        var PatInitial = document.getElementById("PatInitial");
                        priSubInitial.value = PatInitial.value;

                        var priSubAddress1 = document.getElementById("priSubAddress1");
                        var PatAddress1 = document.getElementById("PatAddress1");
                        priSubAddress1.value = PatAddress1.value;

                        var priSubAddress2 = document.getElementById("priSubAddress2");
                        var PatAddress2 = document.getElementById("PatAddress2");
                        priSubAddress2.value = PatAddress2.value;

                        var priSubCity = document.getElementById("priSubCity");
                        var PatCity = document.getElementById("PatCity");
                        priSubCity.value = PatCity.value;

                        var priSubState = document.getElementById("priSubState");
                        var PatState = document.getElementById("PatState");
                        priSubState.value = PatState.value;

                        var priSubZip = $find("<%= priSubZip.ClientID %>");
                        var PatZip = $find("<%= PatZip.ClientID %>");
                        priSubZip.set_value(PatZip.get_value());

                        var priSubSex = document.getElementById("priSubSex");
                        var PatSex = document.getElementById("PatSex");
                        priSubSex.value = PatSex.value;

                        var priSubSSN = $find("<%= priSubSSN.ClientID %>");
                        var PatSSN = $find("<%= PatSSN.ClientID %>");
                        priSubSSN.set_value(PatSSN.get_value());

                        var priSubDOB = $find("<%= priSubDOB.ClientID %>");
                        var PatDOB = $find("<%= PatDOB.ClientID %>");
                        var PatDOBDate = PatDOB.get_selectedDate();
                        priSubDOB.set_selectedDate(PatDOBDate);
                    }
                }

                // wyeager - 10/13/2010
                // Gets the Relation to Patient for the Secondary Insurance.
                function getSecSelectedValue() {

                    var index = document.getElementById("secSubRelToPat").selectedIndex;
                    if (document.getElementById("secSubRelToPat").options[index].text == "Self") {

                        var secSubRelToPat = document.getElementById("secSubRelToPat");
                        secSubRelToPat.options[index].text = 'Self';

                        var secSubLName = document.getElementById("secSubLName");
                        var PatLName = document.getElementById("PatLName");
                        secSubLName.value = PatLName.value;

                        var secSubFName = document.getElementById("secSubFName");
                        var PatFName = document.getElementById("PatFName");
                        secSubFName.value = PatFName.value;

                        var secSubInitial = document.getElementById("secSubInitial");
                        var PatInitial = document.getElementById("PatInitial");
                        secSubInitial.value = PatInitial.value;

                        var secSubAddress1 = document.getElementById("secSubAddress1");
                        var PatAddress1 = document.getElementById("PatAddress1");
                        secSubAddress1.value = PatAddress1.value;

                        var secSubAddress2 = document.getElementById("secSubAddress2");
                        var PatAddress2 = document.getElementById("PatAddress2");
                        secSubAddress2.value = PatAddress2.value;

                        var secSubCity = document.getElementById("secSubCity");
                        var PatCity = document.getElementById("PatCity");
                        secSubCity.value = PatCity.value;

                        var secSubState = document.getElementById("secSubState");
                        var PatState = document.getElementById("PatState");
                        secSubState.value = PatState.value;

                        var secSubZip = $find("<%= secSubZip.ClientID %>");
                        var PatZip = $find("<%= PatZip.ClientID %>");
                        secSubZip.set_value(PatZip.get_value());

                        var secSubSex = document.getElementById("secSubSex");
                        var PatSex = document.getElementById("PatSex");
                        secSubSex.value = PatSex.value;

                        var secSubSSN = $find("<%= secSubSSN.ClientID %>");
                        var PatSSN = $find("<%= PatSSN.ClientID %>");
                        secSubSSN.set_value(PatSSN.get_value());

                        var secSubDOB = $find("<%= secSubDOB.ClientID %>");
                        var PatDOB = $find("<%= PatDOB.ClientID %>");
                        var PatDOBDate = PatDOB.get_selectedDate();
                        secSubDOB.set_selectedDate(PatDOBDate);
                    }
                }

                // wyeager - 10/13/2010
                // Gets the Relation to Patient for the Tertiary Insurance.
                function getTerSelectedValue() {

                    var index = document.getElementById("terSubRelToPat").selectedIndex;
                    if (document.getElementById("terSubRelToPat").options[index].text == "Self") {

                        var terSubRelToPat = document.getElementById("terSubRelToPat");
                        terSubRelToPat.options[index].text = 'Self';

                        var terSubLName = document.getElementById("terSubLName");
                        var PatLName = document.getElementById("PatLName");
                        terSubLName.value = PatLName.value;

                        var terSubFName = document.getElementById("terSubFName");
                        var PatFName = document.getElementById("PatFName");
                        terSubFName.value = PatFName.value;

                        var terSubInitial = document.getElementById("terSubInitial");
                        var PatInitial = document.getElementById("PatInitial");
                        terSubInitial.value = PatInitial.value;

                        var terSubAddress1 = document.getElementById("terSubAddress1");
                        var PatAddress1 = document.getElementById("PatAddress1");
                        terSubAddress1.value = PatAddress1.value;

                        var terSubAddress2 = document.getElementById("terSubAddress2");
                        var PatAddress2 = document.getElementById("PatAddress2");
                        terSubAddress2.value = PatAddress2.value;

                        var terSubCity = document.getElementById("terSubCity");
                        var PatCity = document.getElementById("PatCity");
                        terSubCity.value = PatCity.value;

                        var terSubState = document.getElementById("terSubState");
                        var PatState = document.getElementById("PatState");
                        terSubState.value = PatState.value;

                        var terSubZip = $find("<%= terSubZip.ClientID %>");
                        var PatZip = $find("<%= PatZip.ClientID %>");
                        terSubZip.set_value(PatZip.get_value());

                        var terSubSex = document.getElementById("terSubSex");
                        var PatSex = document.getElementById("PatSex");
                        terSubSex.value = PatSex.value;

                        var terSubSSN = $find("<%= terSubSSN.ClientID %>");
                        var PatSSN = $find("<%= PatSSN.ClientID %>");
                        terSubSSN.set_value(PatSSN.get_value());

                        var terSubDOB = $find("<%= terSubDOB.ClientID %>");
                        var PatDOB = $find("<%= PatDOB.ClientID %>");
                        var PatDOBDate = PatDOB.get_selectedDate();
                        terSubDOB.set_selectedDate(PatDOBDate);
                    }
                }
            </script>

        </telerik:RadCodeBlock>
    </head>
    <body onkeydown="checkImage_onclick(event);" text="#000000" link="#165492" bgcolor="#ffffff"
        leftmargin="0" topmargin="0" marginheight="0" marginwidth="0">
        <form id="frmPatientDemo" runat="server">
        <telerik:RadScriptManager ID="RadScriptManager1" runat="server">
        </telerik:RadScriptManager>
        <telerik:RadWindowManager ID="RadWindowManager1" ShowContentDuringLoad="false" VisibleStatusbar="false"
            ReloadOnShow="true" runat="server">
            <Windows>
                <telerik:RadWindow ID="RadWindow1" Behaviors="Close" Title="Primary Institution Search"
                    Modal="true" runat="server" OnClientClose="OnPriClientClose">
                </telerik:RadWindow>
                <telerik:RadWindow ID="RadWindow2" Behaviors="Close" Title="Secondary Institution Search"
                    Modal="true" runat="server" OnClientClose="OnSecClientClose">
                </telerik:RadWindow>
                <telerik:RadWindow ID="RadWindow3" Behaviors="Close" Title="Tertiary Institution Search"
                    Modal="true" runat="server" OnClientClose="OnTerClientClose">
                </telerik:RadWindow>
            </Windows>
        </telerik:RadWindowManager>
        <div>
            <input type="hidden" id="hdnImageURL" name="hdnImageURL" value="" runat="server" />
            <input type="hidden" id="hdnImageName" name="hdnImageName" value="" runat="server" />
            <input type="hidden" id="hdnPendFlag" name="hdnPendFlag" value="" runat="server" />
            <input type="hidden" id="hdnVoidFlag" name="hdnVoidFlag" value="" runat="server" />
            <input type="hidden" id="hdnDefFlag" name="hdnDefFlag" value="" runat="server" />
            <input type="hidden" id="hdnbfiPriCount" name="hdnbfiPriCount" value="" runat="server" />
            <input type="hidden" id="hdnbfiSecCount" name="hdnbfiSecCount" value="" runat="server" />
            <input type="hidden" id="hdnbfiTerCount" name="hdnbfiTerCount" value="" runat="server" />
            <input type="hidden" id="hdnpriInsID" name="hdnpriInsID" value="" runat="server" />
            <input type="hidden" id="hdnsecInsID" name="hdnsecInsID" value="" runat="server" />
            <input type="hidden" id="hdnterInsID" name="hdnterInsID" value="" runat="server" />
            <input type="hidden" id="hdnPageName" name="hdnPageName" value="Demographics" runat="server" />
            <input type="hidden" id="hdnOtherIns" name="hdnOtherIns" value="0" runat="server" />
            <telerik:RadAjaxManager ID="RadAjaxManager1" runat="server">
                <AjaxSettings>
                    <telerik:AjaxSetting AjaxControlID="btnPriSearch">
                        <UpdatedControls>
                            <telerik:AjaxUpdatedControl ControlID="priInsCode" />
                            <telerik:AjaxUpdatedControl ControlID="priInsName" />
                            <telerik:AjaxUpdatedControl ControlID="priInsAddress1" />
                            <telerik:AjaxUpdatedControl ControlID="priInsAddress2" />
                            <telerik:AjaxUpdatedControl ControlID="priInsCity" />
                            <telerik:AjaxUpdatedControl ControlID="priInsState" />
                            <telerik:AjaxUpdatedControl ControlID="priInsZip" />
                        </UpdatedControls>
                    </telerik:AjaxSetting>
                    <telerik:AjaxSetting AjaxControlID="btnSecSearch">
                        <UpdatedControls>
                            <telerik:AjaxUpdatedControl ControlID="secInsCode" />
                            <telerik:AjaxUpdatedControl ControlID="secInsName" />
                            <telerik:AjaxUpdatedControl ControlID="secInsAddress1" />
                            <telerik:AjaxUpdatedControl ControlID="secInsAddress2" />
                            <telerik:AjaxUpdatedControl ControlID="secInsCity" />
                            <telerik:AjaxUpdatedControl ControlID="secInsState" />
                            <telerik:AjaxUpdatedControl ControlID="secInsZip" />
                        </UpdatedControls>
                    </telerik:AjaxSetting>
                    <telerik:AjaxSetting AjaxControlID="btnTerSearch">
                        <UpdatedControls>
                            <telerik:AjaxUpdatedControl ControlID="terInsCode" />
                            <telerik:AjaxUpdatedControl ControlID="terInsName" />
                            <telerik:AjaxUpdatedControl ControlID="terInsAddress1" />
                            <telerik:AjaxUpdatedControl ControlID="terInsAddress2" />
                            <telerik:AjaxUpdatedControl ControlID="terInsCity" />
                            <telerik:AjaxUpdatedControl ControlID="terInsState" />
                            <telerik:AjaxUpdatedControl ControlID="terInsZip" />
                        </UpdatedControls>
                    </telerik:AjaxSetting>
                    <telerik:AjaxSetting AjaxControlID="btnSaveLogEntry">
                        <UpdatedControls>
                            <telerik:AjaxUpdatedControl ControlID="tsPatientDemographics" />
                            <telerik:AjaxUpdatedControl ControlID="RadMultiPage1" />
                            <telerik:AjaxUpdatedControl ControlID="hdnImageName" />
                            <telerik:AjaxUpdatedControl ControlID="hdnImageURL" />
                        </UpdatedControls>
                    </telerik:AjaxSetting>
                    <telerik:AjaxSetting AjaxControlID="btnVoid">
                        <UpdatedControls>
                            <telerik:AjaxUpdatedControl ControlID="tsPatientDemographics" />
                            <telerik:AjaxUpdatedControl ControlID="RadMultiPage1" />
                            <telerik:AjaxUpdatedControl ControlID="hdnVoidFlag" />
                            <telerik:AjaxUpdatedControl ControlID="hdnImageName" />
                            <telerik:AjaxUpdatedControl ControlID="hdnImageURL" />
                        </UpdatedControls>
                    </telerik:AjaxSetting>
                    <telerik:AjaxSetting AjaxControlID="btnPend">
                        <UpdatedControls>
                            <telerik:AjaxUpdatedControl ControlID="tsPatientDemographics" />
                            <telerik:AjaxUpdatedControl ControlID="RadMultiPage1" />
                            <telerik:AjaxUpdatedControl ControlID="hdnPendFlag" />
                            <telerik:AjaxUpdatedControl ControlID="hdnImageName" />
                            <telerik:AjaxUpdatedControl ControlID="hdnImageURL" />
                        </UpdatedControls>
                    </telerik:AjaxSetting>
                    <telerik:AjaxSetting AjaxControlID="btnDEF">
                        <UpdatedControls>
                            <telerik:AjaxUpdatedControl ControlID="tsPatientDemographics" />
                            <telerik:AjaxUpdatedControl ControlID="RadMultiPage1" />
                            <telerik:AjaxUpdatedControl ControlID="hdnDefFlag" />
                            <telerik:AjaxUpdatedControl ControlID="hdnImageName" />
                            <telerik:AjaxUpdatedControl ControlID="hdnImageURL" />
                        </UpdatedControls>
                    </telerik:AjaxSetting>
                    <telerik:AjaxSetting AjaxControlID="priInsCode">
                        <UpdatedControls>
                            <telerik:AjaxUpdatedControl ControlID="priInsName" />
                            <telerik:AjaxUpdatedControl ControlID="priInsAddress1" />
                            <telerik:AjaxUpdatedControl ControlID="priInsAddress2" />
                            <telerik:AjaxUpdatedControl ControlID="priInsCity" />
                            <telerik:AjaxUpdatedControl ControlID="priInsState" />
                            <telerik:AjaxUpdatedControl ControlID="priInsZip" />
                            <telerik:AjaxUpdatedControl ControlID="hdnpriInsID" />
                        </UpdatedControls>
                    </telerik:AjaxSetting>
                    <telerik:AjaxSetting AjaxControlID="secInsCode">
                        <UpdatedControls>
                            <telerik:AjaxUpdatedControl ControlID="secInsName" />
                            <telerik:AjaxUpdatedControl ControlID="secInsAddress1" />
                            <telerik:AjaxUpdatedControl ControlID="secInsAddress2" />
                            <telerik:AjaxUpdatedControl ControlID="secInsCity" />
                            <telerik:AjaxUpdatedControl ControlID="secInsState" />
                            <telerik:AjaxUpdatedControl ControlID="secInsZip" />
                            <telerik:AjaxUpdatedControl ControlID="hdnsecInsID" />
                        </UpdatedControls>
                    </telerik:AjaxSetting>
                    <telerik:AjaxSetting AjaxControlID="terInsCode">
                        <UpdatedControls>
                            <telerik:AjaxUpdatedControl ControlID="terInsName" />
                            <telerik:AjaxUpdatedControl ControlID="terInsAddress1" />
                            <telerik:AjaxUpdatedControl ControlID="terInsAddress2" />
                            <telerik:AjaxUpdatedControl ControlID="terInsCity" />
                            <telerik:AjaxUpdatedControl ControlID="terInsState" />
                            <telerik:AjaxUpdatedControl ControlID="terInsZip" />
                            <telerik:AjaxUpdatedControl ControlID="hdnterInsID" />
                        </UpdatedControls>
                    </telerik:AjaxSetting>
                </AjaxSettings>
            </telerik:RadAjaxManager>
        </div>
        <table cellpadding="0" cellspacing="0" border="1" style="border: thin solid #004990;
            width: 100%; height: 100%" frame="box">
            <tr valign="top" style="height: 100%">
                <td width="100%">
                    <fieldset>
                        <legend><font color="blue" size="1"><b>Patient Demographics ==> Data Entry</b></font></legend>
                        <table cellpadding="0" cellspacing="0" border="0" width="100%">
                            <tr valign="top">
                                <td width="100%">
                                    <input onclick="rd_onclick();" type="hidden" value=".bmp" name="ImageType">
                                    <object classid="clsid:5220cb21-c88d-11cf-b347-00aa00a28331">
                                        <param name="LPKPath" value="../DynamicWebTwain.lpk" />
                                    </object>
                                    <table cellspacing="1" cellpadding="1" width="100%" border="0">
                                        <tbody>
                                            <tr height="300">
                                                <td valign="top" width="10%" height="280" align="center" bgcolor="f0f0f0" id="tdThumbNails">
                                                    <table cellpadding="1" cellspacing="1" width="100%">
                                                        <tr>
                                                            <td height="300">
                                                                <div align="left">
                                                                    <font color="darkblue"><b>&nbsp;&nbsp;Thumbnails<br>
                                                                        &nbsp;</b></font>
                                                                </div>
                                                                <object classid="clsid:E7DA7F8D-27AB-4EE9-8FC0-3FEC9ECFE758" id="DynamicWebTwain1"
                                                                    height="70%" width="90%" codebase="../DynamicWebTWAIN.cab#version=5,2">
                                                                    <param name="_cx" value="847" />
                                                                    <param name="_cy" value="847" />
                                                                    <param name="JpgQuality" value="80" />
                                                                    <param name="Manufacturer" value="Dynamsoft Corporation" />
                                                                    <param name="ProductFamily" value="Dynamic Web TWAIN" />
                                                                    <param name="ProductName" value="Dynamic Web TWAIN" />
                                                                    <param name="VersionInfo" value="Dynamic Web TWAIN 5.2" />
                                                                    <param name="TransferMode" value="0" />
                                                                    <param name="BorderStyle" value="0" />
                                                                    <param name="FTPUserName" value="" />
                                                                    <param name="FTPPassword" value="" />
                                                                    <param name="FTPPort" value="21" />
                                                                    <param name="HTTPUserName" value="" />
                                                                    <param name="HTTPPassword" value="" />
                                                                    <param name="HTTPPort" value="80" />
                                                                    <param name="ProxyServer" value="" />
                                                                    <param name="IfDisableSourceAfterAcquire" value="0" />
                                                                    <param name="IfShowUI" value="1" />
                                                                    <param name="IfModalUI" value="1" />
                                                                    <param name="IfTiffMultiPage" value="0" />
                                                                    <param name="IfThrowException" value="0" />
                                                                    <param name="MaxImagesInBuffer" value="1" />
                                                                    <param name="TIFFCompressionType" value="0" />
                                                                </object>
                                                            </td>
                                                        </tr>
                                                        <tr>
                                                            <td>
                                                                <table cellpadding="1" cellspacing="1" width="100%">
                                                                    <tr>
                                                                        <td colspan="2" bgcolor="#f0f0f0" align="left">
                                                                            <font color="darkblue"><b>Edit Image</b></font>
                                                                        </td>
                                                                    </tr>
                                                                    <tr>
                                                                        <td bgcolor="#f0f0f0" colspan="2" align="left">
                                                                            <input id="btnRotateRight" onclick="return btnRotateRight_onclick()" style="font-size: xx-small;
                                                                                font-weight: bold; width: 90px;" type="button" value="Rotate Right">
                                                                            <input id="btnRotateLeft" onclick="return btnRotateLeft_onclick()" type="button"
                                                                                style="font-size: xx-small; font-weight: bold; width: 80px;" value="Rotate Left">
                                                                        </td>
                                                                    </tr>
                                                                    <tr>
                                                                        <td bgcolor="#f0f0f0" colspan="2" align="left">
                                                                            <input id="btnFirstImage" onclick="return btnFirstImage_onclick()" type="button"
                                                                                style="font-size: xx-small; font-weight: bold; width: 25px;" value="|<">
                                                                            <input id="btnPreImage" onclick="return btnPreImage_onclick()" style="font-size: xx-small;
                                                                                font-weight: bold; width: 25px;" type="button" value="<">
                                                                            <input id="CurrentImage" readonly size="2" name="CurrentImage" style="font-size: xx-small;
                                                                                font-weight: bold; width: 25px;">/
                                                                            <input id="TotalImage" readonly size="2" value="0" name="TotalImage" style="font-size: xx-small;
                                                                                font-weight: bold; width: 25px;">
                                                                            <input id="btnNextImage" onclick="return btnNextImage_onclick()" style="font-size: xx-small;
                                                                                font-weight: bold; width: 25px;" type="button" value=">">
                                                                            <input id="btnLastImage" onclick="return btnLastImage_onclick()" style="font-size: xx-small;
                                                                                font-weight: bold; width: 25px;" type="button" value=">|">
                                                                        </td>
                                                                    </tr>
                                                                    <tr>
                                                                        <td bgcolor="#f0f0f0" colspan="2" align="left">
                                                                            <input id="btnFit" onclick="return btnFit_onclick()" type="button" value="Fit Window"
                                                                                style="font-size: xx-small; font-weight: bold; width: 80px;" />
                                                                            <input id="btnFact" onclick="return btnFact_onclick()" type="button" value="1:1"
                                                                                style="font-size: xx-small; font-weight: bold; width: 25px;" />&nbsp;
                                                                            <input id="btnZoomIn" onclick="return btnZoomIn_onclick()" type="button" value="+"
                                                                                style="font-size: xx-small; font-weight: bold; width: 25px;">&nbsp;
                                                                            <input id="btnZoomOut" onclick="return btnZoomOut_onclick()" type="button" value="-"
                                                                                style="font-size: xx-small; font-weight: bold; width: 25px;">
                                                                        </td>
                                                                    </tr>
                                                                    <tr>
                                                                        <td bgcolor="#f0f0f0" colspan="2" align="left">
                                                                            <input id="btnPointer" onclick="return btnPointer_onclick()" type="button" value="Pointer"
                                                                                style="font-size: xx-small; font-weight: bold; width: 90px;" />
                                                                            <input id="btnHand" onclick="return btnHand_onclick()" type="button" value="Hand"
                                                                                style="font-size: xx-small; font-weight: bold; width: 90px;" />
                                                                            <br />
                                                                            <br />
                                                                            <div align="left">
                                                                                &nbsp;&nbsp; Message:<br />
                                                                            </div>
                                                                            <center>
                                                                                <textarea name="emessage" rows="4" readonly cols="10"></textarea></center>
                                                                        </td>
                                                                    </tr>
                                                                </table>
                                                            </td>
                                                        </tr>
                                                    </table>
                                                </td>
                                                <td valign="top" width="65%">
                                                    <object classid="clsid:E7DA7F8D-27AB-4EE9-8FC0-3FEC9ECFE758" id="DynamicWebTwain2"
                                                        width="100%" height="900px" codebase="../DynamicWebTWAIN.cab#version=5,1" style="z-index: -10000">
                                                        <param name="_cx" value="847" />
                                                        <param name="_cy" value="847" />
                                                        <param name="JpgQuality" value="80" />
                                                        <param name="Manufacturer" value="Dynamsoft Corporation" />
                                                        <param name="ProductFamily" value="Dynamic Web TWAIN" />
                                                        <param name="ProductName" value="Dynamic Web TWAIN" />
                                                        <param name="VersionInfo" value="Dynamic Web TWAIN 5.1" />
                                                        <param name="TransferMode" value="0" />
                                                        <param name="BorderStyle" value="0" />
                                                        <param name="FTPUserName" value="" />
                                                        <param name="FTPPassword" value="" />
                                                        <param name="FTPPort" value="21" />
                                                        <param name="HTTPUserName" value="" />
                                                        <param name="HTTPPassword" value="" />
                                                        <param name="HTTPPort" value="80" />
                                                        <param name="ProxyServer" value="" />
                                                        <param name="IfDisableSourceAfterAcquire" value="0" />
                                                        <param name="IfShowUI" value="1" />
                                                        <param name="IfModalUI" value="1" />
                                                        <param name="IfTiffMultiPage" value="0" />
                                                        <param name="IfThrowException" value="0" />
                                                        <param name="MaxImagesInBuffer" value="1" />
                                                        <param name="TIFFCompressionType" value="0" />
                                                    </object>
                                                </td>
                                                <td valign="top" width="25%">
                                                    <table cellspacing="0" cellpadding="0" width="100%" border="0">
                                                        <tbody style="font-size: 8pt;">
                                                            <tr>
                                                                <td colspan="3">
                                                                    <table cellpadding="0" cellspacing="0" width="100%">
                                                                        <tr>
                                                                            <td class="td_AEVNoBold">
                                                                                <b>FACILITY: </b>
                                                                                <asp:Label ID="lblFacility" runat="server" Font-Bold="true" ForeColor="Blue"></asp:Label>
                                                                                &nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>DOS: </b>
                                                                                <asp:Label ID="lblDOS" runat="server" Font-Bold="true" ForeColor="Blue"></asp:Label>
                                                                            </td>
                                                                        </tr>
                                                                        <tr>
                                                                            <td>
                                                                                <div>
                                                                                    <telerik:RadTabStrip ID="tsPatientDemographics" runat="server" AutoPostBack="false"
                                                                                        ScrollButtonsPosition="Right" MultiPageID="RadMultiPage1" BackColor="Gray" CausesValidation="False"
                                                                                        Align="Left" Width="100%">
                                                                                        <Tabs>
                                                                                            <telerik:RadTab Text="P<u>a</u>tient" AccessKey="A" Width="60px">
                                                                                            </telerik:RadTab>
                                                                                            <telerik:RadTab Text="G<u>u</u>arantor" AccessKey="U" Width="80px">
                                                                                            </telerik:RadTab>
                                                                                            <telerik:RadTab Text="<u>P</u>ri Ins" AccessKey="P" Width="60px">
                                                                                            </telerik:RadTab>
                                                                                            <telerik:RadTab Text="<u>S</u>ec Ins" AccessKey="S" Value="Sec Ins" Width="60px"
                                                                                                Enabled="false">
                                                                                            </telerik:RadTab>
                                                                                            <telerik:RadTab Text="<u>T</u>er Ins" AccessKey="T" Value="Ter Ins" Width="70px"
                                                                                                Enabled="false">
                                                                                            </telerik:RadTab>
                                                                                        </Tabs>
                                                                                    </telerik:RadTabStrip>
                                                                                    <telerik:RadMultiPage ID="RadMultiPage1" runat="server" SelectedIndex="0" ScrollBars="None">
                                                                                        <telerik:RadPageView ID="RadPatientInfoView" runat="server" Width="100%" BackColor="LightGray">
                                                                                            <table width="100%" bgcolor="#F6F6F6" cellpadding="0" cellspacing="0">
                                                                                                <tr>
                                                                                                    <td>
                                                                                                        <fieldset>
                                                                                                            <legend><b><font style="font-size: x-small;">Patient Info</font></b></legend>
                                                                                                            <table width="100%" bordercolor="white" border="1" cellpadding="0" cellspacing="0">
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV" width="35%">
                                                                                                                        Hosp Acct# *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="HospAcctno" runat="server" onblur="CheckForCompletedReqFlds();"
                                                                                                                            MaxLength="25"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator1" ControlToValidate="HospAcctno"
                                                                                                                            Display="Dynamic" ErrorMessage="Patient Info: Hosp Acct#" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        MRN # *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="MRN" runat="server" onblur="CheckForCompletedReqFlds();" MaxLength="25"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator2" ControlToValidate="MRN"
                                                                                                                            Display="Dynamic" ErrorMessage="Patient Info: MRN #" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Admit Date *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadDatePicker ID="radAdmitDate" runat="server" onblur="CheckForCompletedReqFlds();"
                                                                                                                            Font-Size="8pt">
                                                                                                                            <Calendar UseColumnHeadersAsSelectors="False" UseRowHeadersAsSelectors="False" ViewSelectorText="x">
                                                                                                                            </Calendar>
                                                                                                                            <DatePopupButton HoverImageUrl="" ImageUrl="" />
                                                                                                                            <DateInput ID="DateInput4" DateFormat="M/d/yyyy" DisplayDateFormat="M/d/yyyy" runat="server">
                                                                                                                            </DateInput>
                                                                                                                        </telerik:RadDatePicker>
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator17" ControlToValidate="radAdmitDate"
                                                                                                                            Display="Dynamic" ErrorMessage="Patient Info: Admit Date" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Admit Time *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadTimePicker ID="radAdmitTime" runat="server" onblur="CheckForCompletedReqFlds();"
                                                                                                                            Font-Size="8pt">
                                                                                                                            <Calendar UseColumnHeadersAsSelectors="False" UseRowHeadersAsSelectors="False" ViewSelectorText="x">
                                                                                                                            </Calendar>
                                                                                                                            <TimeView CellSpacing="-1">
                                                                                                                            </TimeView>
                                                                                                                            <TimePopupButton CssClass="" HoverImageUrl="" ImageUrl="" />
                                                                                                                            <DatePopupButton CssClass="" HoverImageUrl="" ImageUrl="" Visible="False" />
                                                                                                                            <DateInput ID="DateInput5" DateFormat="h:mm tt" DisplayDateFormat="h:mm tt" runat="server">
                                                                                                                            </DateInput>
                                                                                                                        </telerik:RadTimePicker>
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator18" ControlToValidate="radAdmitTime"
                                                                                                                            Display="Dynamic" ErrorMessage="Patient Info: Admit Time" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Discharge Date *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadDatePicker ID="radDischargeDate" runat="server" onblur="CheckForCompletedReqFlds();"
                                                                                                                            Font-Size="8pt">
                                                                                                                            <Calendar UseColumnHeadersAsSelectors="False" UseRowHeadersAsSelectors="False" ViewSelectorText="x">
                                                                                                                            </Calendar>
                                                                                                                            <DatePopupButton HoverImageUrl="" ImageUrl="" />
                                                                                                                            <DateInput ID="DateInput6" DateFormat="M/d/yyyy" DisplayDateFormat="M/d/yyyy" runat="server">
                                                                                                                            </DateInput>
                                                                                                                        </telerik:RadDatePicker>
                                                                                                                        <asp:CompareValidator ID="cvAdmitDischargeDates" runat="server" ErrorMessage="Patient Info: Discharge Date cannot be less than Admit Date!"
                                                                                                                            Display="Dynamic" Text="*" ControlToValidate="radAdmitDate" ControlToCompare="radDischargeDate"
                                                                                                                            Operator="LessThanEqual" Type="Date"></asp:CompareValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Discharge Time *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadTimePicker ID="radDischargeTime" runat="server" onblur="CheckForCompletedReqFlds();"
                                                                                                                            Font-Size="8pt">
                                                                                                                            <Calendar UseColumnHeadersAsSelectors="False" UseRowHeadersAsSelectors="False" ViewSelectorText="x">
                                                                                                                            </Calendar>
                                                                                                                            <TimeView CellSpacing="-1">
                                                                                                                            </TimeView>
                                                                                                                            <TimePopupButton CssClass="" HoverImageUrl="" ImageUrl="" />
                                                                                                                            <DatePopupButton CssClass="" HoverImageUrl="" ImageUrl="" Visible="False" />
                                                                                                                            <DateInput ID="DateInput7" DateFormat="h:mm tt" DisplayDateFormat="h:mm tt" runat="server">
                                                                                                                            </DateInput>
                                                                                                                        </telerik:RadTimePicker>
                                                                                                                        <asp:CustomValidator ID="cvDischargeDateTime" runat="server" ErrorMessage="Patient Info: Discharge Date & Time cannot be less than Admit Date & Time!"
                                                                                                                            Display="Dynamic" EnableClientScript="true" Text="Patient Info: Discharge Date & Time cannot be less than Admit Date & Time!"
                                                                                                                            ControlToValidate="radDischargeTime" OnServerValidate="cvAdmitDischargeDateTime_OnServerValidate"></asp:CustomValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Last Name *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="PatLName" runat="server" onblur="CheckForCompletedReqFlds();" MaxLength="50"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator3" ControlToValidate="PatLName"
                                                                                                                            Display="Dynamic" ErrorMessage="Patient Info: Last Name" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        First Name *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="PatFName" runat="server" onblur="CheckForCompletedReqFlds();" MaxLength="50"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator4" ControlToValidate="PatFName"
                                                                                                                            Display="Dynamic" ErrorMessage="Patient Info: First Name" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Initial:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="PatInitial" runat="server" MaxLength="25"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Address1 *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="PatAddress1" runat="server" onblur="CheckForCompletedReqFlds();"
                                                                                                                            MaxLength="50"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator5" ControlToValidate="PatAddress1"
                                                                                                                            Display="Dynamic" ErrorMessage="Patient Info: Address1" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Address2:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="PatAddress2" runat="server" MaxLength="50"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        City *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="PatCity" runat="server" onblur="CheckForCompletedReqFlds();" MaxLength="50"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator6" ControlToValidate="PatCity"
                                                                                                                            Display="Dynamic" ErrorMessage="Patient Info: City" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        State *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:DropDownList ID="PatState" runat="server" Font-Size="8pt" />
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator7" ControlToValidate="PatState"
                                                                                                                            Display="Dynamic" ErrorMessage="Patient Info: State" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Zip:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadMaskedTextBox ID="PatZip" runat="server" Mask="#####-####" Width="70px"
                                                                                                                            Font-Size="8pt">
                                                                                                                        </telerik:RadMaskedTextBox>
                                                                                                                        <asp:RegularExpressionValidator ID="RegularExpressionValidator5" runat="server" ErrorMessage="Patient Info: Zip Invalid!"
                                                                                                                            Display="Dynamic" ValidationExpression="^((\d{5}-_{0,4})|(|(\d{5}-\d{4})))$"
                                                                                                                            ControlToValidate="PatZip"></asp:RegularExpressionValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        SSN:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadMaskedTextBox ID="PatSSN" runat="server" Mask="###-##-####" Width="92px"
                                                                                                                            Font-Size="8pt">
                                                                                                                        </telerik:RadMaskedTextBox>
                                                                                                                        <asp:RegularExpressionValidator ID="RegularExpressionValidator6" runat="server" ErrorMessage="Patient Info: SSN Invalid!"
                                                                                                                            Display="Dynamic" ValidationExpression="^\d{3}-\d{2}-\d{4}$" ControlToValidate="PatSSN"></asp:RegularExpressionValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        DOB *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadDatePicker ID="PatDOB" runat="server" onblur="CheckForCompletedReqFlds();"
                                                                                                                            Font-Size="8pt">
                                                                                                                            <Calendar UseColumnHeadersAsSelectors="False" UseRowHeadersAsSelectors="False" ViewSelectorText="x">
                                                                                                                            </Calendar>
                                                                                                                            <DatePopupButton HoverImageUrl="" ImageUrl="" />
                                                                                                                            <DateInput ID="DateInput0" DateFormat="M/d/yyyy" DisplayDateFormat="M/d/yyyy" runat="server">
                                                                                                                            </DateInput>
                                                                                                                        </telerik:RadDatePicker>
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator8" ControlToValidate="PatDOB"
                                                                                                                            Display="Dynamic" ErrorMessage="Patient Info: DOB" Text="*" runat="server" />
                                                                                                                        <asp:CompareValidator ID="cvPatDOB" runat="server" ErrorMessage="Admit Date cannot be less than Patient DOB!"
                                                                                                                            ControlToValidate="PatDOB" ControlToCompare="radAdmitDate" Operator="LessThanEqual"
                                                                                                                            Display="Dynamic" Type="Date"></asp:CompareValidator>
                                                                                                                        <asp:CompareValidator ID="cvDOB2" runat="server" ErrorMessage="Discharge Date cannot be less than Patient DOB!"
                                                                                                                            Display="Dynamic" ControlToValidate="PatDOB" ControlToCompare="radDischargeDate"
                                                                                                                            Operator="LessThanEqual" Type="Date"></asp:CompareValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Home Phone:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadMaskedTextBox ID="PatHomePhone" runat="server" Mask="(###) ###-####"
                                                                                                                            Width="80px" Font-Size="8pt">
                                                                                                                        </telerik:RadMaskedTextBox>
                                                                                                                        <asp:RegularExpressionValidator ID="RegularExpressionValidator8" runat="server" ErrorMessage="Patient Info: Home Phone Invalid!"
                                                                                                                            Display="Dynamic" ControlToValidate="PatHomePhone" ValidationExpression="^([\(]{1}[0-9]{3}[\)]{1}[ ]{1}[0-9]{3}[\-]{1}[0-9]{4})$"></asp:RegularExpressionValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Work Phone:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadMaskedTextBox ID="PatWorkPhone" runat="server" Mask="(###) ###-####"
                                                                                                                            Width="80px" Font-Size="8pt">
                                                                                                                        </telerik:RadMaskedTextBox>
                                                                                                                        <asp:RegularExpressionValidator ID="RegularExpressionValidator9" runat="server" ErrorMessage="Patient Info: Work Phone Invalid!"
                                                                                                                            Display="Dynamic" ControlToValidate="PatWorkPhone" ValidationExpression="^([\(]{1}[0-9]{3}[\)]{1}[ ]{1}[0-9]{3}[\-]{1}[0-9]{4})$"></asp:RegularExpressionValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Cell Phone:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadMaskedTextBox ID="PatCellPhone" runat="server" Mask="(###) ###-####"
                                                                                                                            Width="80px" Font-Size="8pt">
                                                                                                                        </telerik:RadMaskedTextBox>
                                                                                                                        <asp:RegularExpressionValidator ID="RegularExpressionValidator10" runat="server"
                                                                                                                            Display="Dynamic" ErrorMessage="Patient Info: Cell Phone Invalid!" ControlToValidate="PatCellPhone"
                                                                                                                            ValidationExpression="^([\(]{1}[0-9]{3}[\)]{1}[ ]{1}[0-9]{3}[\-]{1}[0-9]{4})$"></asp:RegularExpressionValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Marital status *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:DropDownList ID="PatMaritalStatus" runat="server" onblur="CheckForCompletedReqFlds();"
                                                                                                                            Font-Size="8pt" />
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator9" ControlToValidate="PatMaritalStatus"
                                                                                                                            Display="Dynamic" ErrorMessage="Patient Info: Marital status" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Sex *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:DropDownList ID="PatSex" runat="server" onblur="CheckForCompletedReqFlds('Patient');"
                                                                                                                            Font-Size="8pt">
                                                                                                                            <asp:ListItem Selected="True" Text="Select" Value=""></asp:ListItem>
                                                                                                                            <asp:ListItem Text="Male" Value="M"></asp:ListItem>
                                                                                                                            <asp:ListItem Text="Female" Value="F"></asp:ListItem>
                                                                                                                        </asp:DropDownList>
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator10" ControlToValidate="PatSex"
                                                                                                                            Display="Dynamic" ErrorMessage="Patient Info: Sex" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                            </table>
                                                                                                        </fieldset>
                                                                                                    </td>
                                                                                                </tr>
                                                                                            </table>
                                                                                        </telerik:RadPageView>
                                                                                        <telerik:RadPageView ID="RadGuarView" runat="server" Width="100%">
                                                                                            <table width="100%" bgcolor="#F6F6F6" cellpadding="0" cellspacing="0">
                                                                                                <tr>
                                                                                                    <td>
                                                                                                        <fieldset>
                                                                                                            <legend><b><font style="font-size: x-small;">Guarantor Info</font></b></legend>
                                                                                                            <table width="100%" bordercolor="white" border="1" cellpadding="0" cellspacing="0">
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Rel to Patient *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:DropDownList ID="GuarRelToPat" runat="server" onblur="CheckForCompletedReqFlds();"
                                                                                                                            onchange="getGuarSelectedValue();" Font-Size="8pt" />
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator11" ControlToValidate="GuarRelToPat"
                                                                                                                            Display="Dynamic" ErrorMessage="Guarantor Info: Rel to Patient" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Last Name *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="GuarLName" runat="server" onblur="CheckForCompletedReqFlds();" MaxLength="50"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator12" ControlToValidate="GuarLName"
                                                                                                                            Display="Dynamic" ErrorMessage="Guarantor Info: Last Name" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        First Name *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="GuarFName" runat="server" onblur="CheckForCompletedReqFlds();" MaxLength="50"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator13" ControlToValidate="GuarFName"
                                                                                                                            Display="Dynamic" ErrorMessage="Guarantor Info: First Name" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Initial:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="GuarInitial" runat="server" MaxLength="25"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Address1 *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="GuarAddress1" runat="server" onblur="CheckForCompletedReqFlds();"
                                                                                                                            MaxLength="50"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator14" ControlToValidate="GuarAddress1"
                                                                                                                            Display="Dynamic" ErrorMessage="Guarantor Info: Address1" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Address2:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="GuarAddress2" runat="server" MaxLength="50"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        City *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="GuarCity" runat="server" onblur="CheckForCompletedReqFlds();" MaxLength="50"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator15" ControlToValidate="GuarCity"
                                                                                                                            Display="Dynamic" ErrorMessage="Guarantor Info: City" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        State *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:DropDownList ID="GuarState" runat="server" Font-Size="8pt" />
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator16" ControlToValidate="GuarState"
                                                                                                                            Display="Dynamic" ErrorMessage="Guarantor Info: State" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Zip:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadMaskedTextBox ID="GuarZip" runat="server" Mask="#####-####" Width="70px">
                                                                                                                        </telerik:RadMaskedTextBox>
                                                                                                                        <asp:RegularExpressionValidator ID="RegularExpressionValidator11" runat="server"
                                                                                                                            ErrorMessage="Guarantor Info: Home Phone Invalid!" ControlToValidate="GuarZip"
                                                                                                                            Display="Dynamic" ValidationExpression="^((\d{5}-_{0,4})|(|(\d{5}-\d{4})))$"></asp:RegularExpressionValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Home Phone:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadMaskedTextBox ID="GuarHomePhone" runat="server" Mask="(###) ###-####"
                                                                                                                            Width="80px" Font-Size="8pt">
                                                                                                                        </telerik:RadMaskedTextBox>
                                                                                                                        <asp:RegularExpressionValidator ID="RegularExpressionValidator12" runat="server"
                                                                                                                            ErrorMessage="Guarantor Info: Home Phone Invalid!" ControlToValidate="GuarHomePhone"
                                                                                                                            Display="Dynamic" ValidationExpression="^([\(]{1}[0-9]{3}[\)]{1}[ ]{1}[0-9]{3}[\-]{1}[0-9]{4})$"></asp:RegularExpressionValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Work Phone:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadMaskedTextBox ID="GuarWorkPhone" runat="server" Mask="(###) ###-####"
                                                                                                                            Width="80px" Font-Size="8pt">
                                                                                                                        </telerik:RadMaskedTextBox>
                                                                                                                        <asp:RegularExpressionValidator ID="RegularExpressionValidator13" runat="server"
                                                                                                                            ErrorMessage="Guarantor Info: Work Phone Invalid!" ControlToValidate="GuarWorkPhone"
                                                                                                                            Display="Dynamic" ValidationExpression="^([\(]{1}[0-9]{3}[\)]{1}[ ]{1}[0-9]{3}[\-]{1}[0-9]{4})$"></asp:RegularExpressionValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Cell Phone:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadMaskedTextBox ID="GuarCellPhone" runat="server" Mask="(###) ###-####"
                                                                                                                            Width="80px" Font-Size="8pt">
                                                                                                                        </telerik:RadMaskedTextBox>
                                                                                                                        <asp:RegularExpressionValidator ID="RegularExpressionValidator14" runat="server"
                                                                                                                            ErrorMessage="Guarantor Info: Cell Phone Invalid!" ControlToValidate="GuarCellPhone"
                                                                                                                            Display="Dynamic" ValidationExpression="^([\(]{1}[0-9]{3}[\)]{1}[ ]{1}[0-9]{3}[\-]{1}[0-9]{4})$"></asp:RegularExpressionValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        SSN:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadMaskedTextBox ID="GuarSSN" runat="server" Mask="###-##-####" Width="92px"
                                                                                                                            Font-Size="8pt">
                                                                                                                        </telerik:RadMaskedTextBox>
                                                                                                                        <asp:RegularExpressionValidator ID="RegularExpressionValidator15" runat="server"
                                                                                                                            ErrorMessage="Guarantor Info: SSN Invalid!" ValidationExpression="^\d{3}-\d{2}-\d{4}$"
                                                                                                                            Display="Dynamic" ControlToValidate="GuarSSN"></asp:RegularExpressionValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Sex *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:DropDownList ID="GuarSex" runat="server" onblur="CheckForCompletedReqFlds();"
                                                                                                                            Font-Size="8pt">
                                                                                                                            <asp:ListItem Selected="True" Text="Select" Value=""></asp:ListItem>
                                                                                                                            <asp:ListItem Text="Male" Value="M"></asp:ListItem>
                                                                                                                            <asp:ListItem Text="Female" Value="F"></asp:ListItem>
                                                                                                                        </asp:DropDownList>
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator22" ControlToValidate="GuarSex"
                                                                                                                            Display="Dynamic" ErrorMessage="Guarantor Info: Sex" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Marital status *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:DropDownList ID="ddlGuarMaritalStatus" runat="server" onblur="CheckForCompletedReqFlds();"
                                                                                                                            Font-Size="8pt" />
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator21" ControlToValidate="ddlGuarMaritalStatus"
                                                                                                                            Display="Dynamic" ErrorMessage="Guarantor Info: Marital status" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV" valign="top">
                                                                                                                        DOB *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadDatePicker ID="radGuarDOB" runat="server" onblur="CheckForCompletedReqFlds();"
                                                                                                                            Font-Size="8pt">
                                                                                                                            <Calendar UseColumnHeadersAsSelectors="False" UseRowHeadersAsSelectors="False" ViewSelectorText="x">
                                                                                                                            </Calendar>
                                                                                                                            <DatePopupButton HoverImageUrl="" ImageUrl="" />
                                                                                                                            <DateInput ID="DateInput8" DateFormat="M/d/yyyy" DisplayDateFormat="M/d/yyyy" runat="server">
                                                                                                                            </DateInput>
                                                                                                                        </telerik:RadDatePicker>
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator23" ControlToValidate="radGuarDOB"
                                                                                                                            Display="Dynamic" ErrorMessage="Guarantor Info: DOB" Text="*" runat="server" />
                                                                                                                        <asp:CompareValidator ID="CompareValidator1" runat="server" ErrorMessage="Admit Date cannot be less than Guarantor DOB!"
                                                                                                                            ControlToValidate="radGuarDOB" ControlToCompare="radAdmitDate" Operator="LessThanEqual"
                                                                                                                            Display="Dynamic" Type="Date"></asp:CompareValidator>
                                                                                                                        <asp:CompareValidator ID="CompareValidator2" runat="server" ErrorMessage="Discharge Date cannot be less than Guarantor DOB!"
                                                                                                                            ControlToValidate="radGuarDOB" ControlToCompare="radDischargeDate" Operator="LessThanEqual"
                                                                                                                            Display="Dynamic" Type="Date"></asp:CompareValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Arrival Mode *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:DropDownList ID="ddlGuarArrivalMode" runat="server" onblur="CheckForCompletedReqFlds();"
                                                                                                                            Font-Size="8pt" />
                                                                                                                        <asp:RequiredFieldValidator ID="RequiredFieldValidator25" ControlToValidate="ddlGuarArrivalMode"
                                                                                                                            Display="Dynamic" ErrorMessage="Guarantor Info: Arrival Mode" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                            </table>
                                                                                                        </fieldset>
                                                                                                    </td>
                                                                                                </tr>
                                                                                                <tr>
                                                                                                    <td>
                                                                                                        <fieldset>
                                                                                                            <legend><b><font style="font-size: x-small;">Employer Info</font></b></legend>
                                                                                                            <table width="100%" bordercolor="white" border="1" cellpadding="0" cellspacing="0">
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV" width="35%">
                                                                                                                        Employer:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="GuarEmployer" runat="server" MaxLength="100"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Address1:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="GuarEmpAddress1" runat="server" MaxLength="50"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Address2:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="GuarEmpAddress2" runat="server" MaxLength="50"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        City:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="GuarEmpCity" runat="server" MaxLength="50"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        State:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:DropDownList ID="GuarEmpState" runat="server" Font-Size="8pt" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Zip:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadMaskedTextBox ID="GuarEmpZip" runat="server" Mask="#####-####" Width="70px"
                                                                                                                            Font-Size="8pt">
                                                                                                                        </telerik:RadMaskedTextBox>
                                                                                                                        <asp:RegularExpressionValidator ID="RegularExpressionValidator17" runat="server"
                                                                                                                            ErrorMessage="Guarantor Employer Info: Zip Invalid!" ControlToValidate="GuarEmpZip"
                                                                                                                            Display="Dynamic" ValidationExpression="^((\d{5}-_{0,4})|(|(\d{5}-\d{4})))$"></asp:RegularExpressionValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Phone:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadMaskedTextBox ID="GuarEmpPhone" runat="server" Mask="(###) ###-####"
                                                                                                                            Width="80px" onblur="CheckForCompletedReqFlds('Guarantor');" Font-Size="8pt">
                                                                                                                        </telerik:RadMaskedTextBox>
                                                                                                                        <asp:RegularExpressionValidator ID="RegularExpressionValidator18" runat="server"
                                                                                                                            ErrorMessage="Guarantor Employer Info: Phone Invalid!" ControlToValidate="GuarEmpPhone"
                                                                                                                            Display="Dynamic" ValidationExpression="^([\(]{1}[0-9]{3}[\)]{1}[ ]{1}[0-9]{3}[\-]{1}[0-9]{4})$"></asp:RegularExpressionValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                            </table>
                                                                                                        </fieldset>
                                                                                                    </td>
                                                                                                </tr>
                                                                                            </table>
                                                                                        </telerik:RadPageView>
                                                                                        <telerik:RadPageView ID="RadPriView" runat="server" Width="100%">
                                                                                            <table width="100%" bgcolor="#F6F6F6" cellpadding="0" cellspacing="0">
                                                                                                <tr>
                                                                                                    <td>
                                                                                                        <fieldset>
                                                                                                            <legend><b><font style="font-size: x-small;">Primary Insurance</font></b></legend>
                                                                                                            <table width="100%" bordercolor="white" border="1" cellpadding="0" cellspacing="0">
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV" width="30%">
                                                                                                                        Ins Code *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="priInsCode" runat="server" AutoPostBack="true" OnTextChanged="priInsCode_OnTextChanged"
                                                                                                                            MaxLength="10"></asp:TextBox>
                                                                                                                        <asp:Button ID="btnPriSearch" runat="server" Text="Search" CausesValidation="false"
                                                                                                                            AccessKey="1" />
                                                                                                                        <asp:RequiredFieldValidator ID="rfvpriInsCode" ControlToValidate="priInsCode" ErrorMessage="Primary Insurance: Pri Ins Code"
                                                                                                                            Display="Dynamic" Text="*" runat="server" Enabled="false" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Ins Name *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="priInsName" runat="server" ReadOnly="true" Width="225px"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Ins Address1 *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="priInsAddress1" runat="server" ReadOnly="true"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Ins Address2:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="priInsAddress2" runat="server" ReadOnly="true"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        City *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="priInsCity" runat="server" ReadOnly="true"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        State *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="priInsState" runat="server" onblur="CheckForCompletedReqFlds();"
                                                                                                                            ReadOnly="true"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Zip *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="priInsZip" runat="server" ReadOnly="true" Width="70px">
                                                                                                                        </asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td>
                                                                                                                        &nbsp;
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Policy # *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="priInsPolicyNum" runat="server" MaxLength="50" onblur="CheckForCompletedReqFlds();"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="rfvpriInsPolicyNum" ControlToValidate="priInsPolicyNum"
                                                                                                                            Display="Dynamic" ErrorMessage="Primary Insurance: Policy #" Text="*" runat="server"
                                                                                                                            Enabled="false" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV" valign="top">
                                                                                                                        Retype Policy #:
                                                                                                                    </td>
                                                                                                                    <td>
                                                                                                                        <asp:TextBox ID="priInsPolicyNumVer" runat="server" MaxLength="50" onblur="CheckForCompletedReqFlds();"></asp:TextBox>
                                                                                                                        <asp:CompareValidator ID="CompareValidator9" runat="server" ErrorMessage="Primary Insurance: Confirmation Primary Policy Numbers NOT equal!"
                                                                                                                            ControlToValidate="priInsPolicyNumVer" ControlToCompare="priInsPolicyNum" Operator="Equal"
                                                                                                                            Display="Dynamic" Type="String"></asp:CompareValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Group # *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="priInsGrpNum" runat="server" MaxLength="25" onblur="CheckForCompletedReqFlds();"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="rfvpriInsGrpNum" ControlToValidate="priInsGrpNum"
                                                                                                                            Display="Dynamic" ErrorMessage="Primary Insurance: Group #" Text="*" runat="server"
                                                                                                                            Enabled="false" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                            </table>
                                                                                                        </fieldset>
                                                                                                    </td>
                                                                                                </tr>
                                                                                                <tr>
                                                                                                    <td>
                                                                                                        <fieldset>
                                                                                                            <legend><b><font style="font-size: x-small;">Primary Subscriber Info</font></b></legend>
                                                                                                            <table width="100%" bordercolor="white" border="1" cellpadding="0" cellspacing="0">
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV" width="30%">
                                                                                                                        Rel to Patient *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:DropDownList ID="priSubRelToPat" runat="server" onchange="getPriSelectedValue();"
                                                                                                                            Font-Size="8pt" />
                                                                                                                        <asp:RequiredFieldValidator ID="rfvpriSubRelToPat" ControlToValidate="priSubRelToPat"
                                                                                                                            Enabled="false" Display="Dynamic" ErrorMessage="Primary Subscriber Info: Rel to Patient"
                                                                                                                            Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Last Name *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="priSubLName" runat="server" MaxLength="100"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="rfvpriSubLName" ControlToValidate="priSubLName" Enabled="false"
                                                                                                                            Display="Dynamic" ErrorMessage="Primary Subscriber Info: Last Name" Text="*"
                                                                                                                            runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        First Name *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="priSubFName" runat="server" MaxLength="100"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="rfvpriSubFName" ControlToValidate="priSubFName" Enabled="false"
                                                                                                                            Display="Dynamic" ErrorMessage="Primary Subscriber Info: First Name" Text="*"
                                                                                                                            runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Initial:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="priSubInitial" runat="server" MaxLength="50"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Address1 *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="priSubAddress1" runat="server" MaxLength="100"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="rfvpriSubAddress1" ControlToValidate="priSubAddress1"
                                                                                                                            Enabled="false" Display="Dynamic" ErrorMessage="Primary Subscriber Info: Address1"
                                                                                                                            Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Address2:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="priSubAddress2" runat="server" MaxLength="100"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        City *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="priSubCity" runat="server" MaxLength="100"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="rfvpriSubCity" ControlToValidate="priSubCity" Enabled="false"
                                                                                                                            Display="Dynamic" ErrorMessage="Primary Subscriber Info: City" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        State *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:DropDownList ID="priSubState" runat="server" Font-Size="8pt" />
                                                                                                                        <asp:RequiredFieldValidator ID="rfvpriSubState" ControlToValidate="priSubState" Enabled="false"
                                                                                                                            Display="Dynamic" ErrorMessage="Primary Subscriber Info: State" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Zip:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadMaskedTextBox ID="priSubZip" runat="server" Mask="#####-####" Width="70px"
                                                                                                                            Font-Size="8pt">
                                                                                                                        </telerik:RadMaskedTextBox>
                                                                                                                        <asp:RegularExpressionValidator ID="RegularExpressionValidator19" runat="server"
                                                                                                                            ErrorMessage="Primary Insurance: Zip Invalid!" ControlToValidate="priSubZip"
                                                                                                                            Display="Dynamic" ValidationExpression="^((\d{5}-_{0,4})|(|(\d{5}-\d{4})))$"></asp:RegularExpressionValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        SSN:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadMaskedTextBox ID="priSubSSN" runat="server" Mask="###-##-####" Width="92px"
                                                                                                                            Font-Size="8pt">
                                                                                                                        </telerik:RadMaskedTextBox>
                                                                                                                        <asp:RegularExpressionValidator ID="RegularExpressionValidator20" runat="server"
                                                                                                                            ErrorMessage="Primary Insurance: SSN Invalid!" ValidationExpression="^\d{3}-\d{2}-\d{4}$"
                                                                                                                            Display="Dynamic" ControlToValidate="priSubSSN"></asp:RegularExpressionValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV" valign="top">
                                                                                                                        DOB:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadDatePicker ID="priSubDOB" runat="server" Font-Size="8pt">
                                                                                                                            <Calendar UseColumnHeadersAsSelectors="False" UseRowHeadersAsSelectors="False" ViewSelectorText="x">
                                                                                                                            </Calendar>
                                                                                                                            <DatePopupButton HoverImageUrl="" ImageUrl="" />
                                                                                                                            <DateInput ID="DateInput1" DateFormat="M/d/yyyy" DisplayDateFormat="M/d/yyyy" runat="server">
                                                                                                                            </DateInput>
                                                                                                                        </telerik:RadDatePicker>
                                                                                                                        <asp:CompareValidator ID="CompareValidator3" runat="server" ErrorMessage="Admit Date cannot be less than Primary Subscriber DOB!"
                                                                                                                            ControlToValidate="priSubDOB" ControlToCompare="radAdmitDate" Operator="LessThanEqual"
                                                                                                                            Display="Dynamic" Type="Date"></asp:CompareValidator>
                                                                                                                        <asp:CompareValidator ID="CompareValidator4" runat="server" ErrorMessage="Discharge Date cannot be less than Primary Subscriber DOB!"
                                                                                                                            ControlToValidate="priSubDOB" ControlToCompare="radDischargeDate" Operator="LessThanEqual"
                                                                                                                            Display="Dynamic" Type="Date"></asp:CompareValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Sex:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:DropDownList ID="priSubSex" runat="server" Font-Size="8pt">
                                                                                                                            <asp:ListItem Selected="True" Text="Select" Value=""></asp:ListItem>
                                                                                                                            <asp:ListItem Text="Male" Value="M"></asp:ListItem>
                                                                                                                            <asp:ListItem Text="Female" Value="F"></asp:ListItem>
                                                                                                                        </asp:DropDownList>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Authorization:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="priAuthorization" runat="server" MaxLength="50" onblur="CheckForCompletedReqFlds('Pri Ins');"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                            </table>
                                                                                                        </fieldset>
                                                                                                    </td>
                                                                                                </tr>
                                                                                            </table>
                                                                                        </telerik:RadPageView>
                                                                                        <telerik:RadPageView ID="RadSecView" runat="server" Width="100%">
                                                                                            <table width="100%" bgcolor="#F6F6F6" cellpadding="0" cellspacing="0">
                                                                                                <tr>
                                                                                                    <td>
                                                                                                        <fieldset>
                                                                                                            <legend><b><font style="font-size: x-small;">Secondary Insurance</font></b></legend>
                                                                                                            <table width="100%" bordercolor="white" border="1" cellpadding="0" cellspacing="0">
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV" width="35%">
                                                                                                                        Ins Code *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="secInsCode" runat="server" AutoPostBack="true" OnTextChanged="secInsCode_OnTextChanged"
                                                                                                                            MaxLength="10"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="rfvsecInsCode" ControlToValidate="secInsCode" ErrorMessage="Secondary Insurance: Sec Ins Code"
                                                                                                                            Display="Dynamic" Text="*" runat="server" Enabled="false" />
                                                                                                                        <asp:Button ID="btnSecSearch" runat="server" Text="Search" CausesValidation="false"
                                                                                                                            AccessKey="2" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Ins Name *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="secInsName" runat="server" ReadOnly="true" Width="225px"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Ins Address1 *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="secInsAddress1" runat="server" ReadOnly="true"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Ins Address2:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="secInsAddress2" runat="server" ReadOnly="true" MaxLength="100"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        City *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="secInsCity" runat="server" ReadOnly="true"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        State *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="secInsState" runat="server" ReadOnly="true"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Zip *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="secInsZip" runat="server" Height="21px" ReadOnly="true" Width="70px">
                                                                                                                        </asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td>
                                                                                                                        &nbsp;
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Policy # *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="secInsPolicyNum" runat="server" MaxLength="50"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="rfvsecInsPolicyNum" ControlToValidate="secInsPolicyNum"
                                                                                                                            Display="Dynamic" ErrorMessage="Secondary Insurance: Policy #" Text="*" runat="server"
                                                                                                                            Enabled="false" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV" valign="top">
                                                                                                                        Retype Policy #:
                                                                                                                    </td>
                                                                                                                    <td>
                                                                                                                        <asp:TextBox ID="secInsPolicyNumVer" runat="server" MaxLength="50"></asp:TextBox>
                                                                                                                        <asp:CompareValidator ID="CompareValidator10" runat="server" ErrorMessage="Secondary Insurance: Confirmation Secondary Policy Numbers NOT equal!"
                                                                                                                            Display="Dynamic" ControlToValidate="secInsPolicyNumVer" ControlToCompare="secInsPolicyNum"
                                                                                                                            Operator="Equal" Type="String"></asp:CompareValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Group # *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="secInsGrpNum" runat="server" MaxLength="25"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="rfvsecInsGrpNum" ControlToValidate="secInsGrpNum"
                                                                                                                            Display="Dynamic" ErrorMessage="Secondary Insurance: Group #" Text="*" runat="server"
                                                                                                                            Enabled="false" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                            </table>
                                                                                                        </fieldset>
                                                                                                    </td>
                                                                                                </tr>
                                                                                                <tr>
                                                                                                    <td>
                                                                                                        <fieldset>
                                                                                                            <legend><b><font style="font-size: x-small;">Secondary Subscriber Info</font></b></legend>
                                                                                                            <table width="100%" bordercolor="white" border="1" cellpadding="0" cellspacing="0">
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV" width="35%">
                                                                                                                        Rel to Patient *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:DropDownList ID="secSubRelToPat" runat="server" onchange="getSecSelectedValue();"
                                                                                                                            Font-Size="8pt" />
                                                                                                                        <asp:RequiredFieldValidator ID="rfvsecSubRelToPat" ControlToValidate="secSubRelToPat"
                                                                                                                            Enabled="false" Display="Dynamic" ErrorMessage="Secondary Subscriber Info: Rel to Patient"
                                                                                                                            Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Last Name *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="secSubLName" runat="server" MaxLength="100"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="rfvsecSubLName" ControlToValidate="secSubLName" Enabled="false"
                                                                                                                            Display="Dynamic" ErrorMessage="Secondary Subscriber Info: Last Name" Text="*"
                                                                                                                            runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        First Name *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="secSubFName" runat="server" MaxLength="100"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="rfvsecSubFName" ControlToValidate="secSubFName" Enabled="false"
                                                                                                                            Display="Dynamic" ErrorMessage="Secondary Subscriber Info: First Name" Text="*"
                                                                                                                            runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Initial:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="secSubInitial" runat="server" MaxLength="50"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Address1 *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="secSubAddress1" runat="server" MaxLength="100"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="rfvsecSubAddress1" ControlToValidate="secSubAddress1"
                                                                                                                            Enabled="false" Display="Dynamic" ErrorMessage="Secondary Subscriber Info: Address1"
                                                                                                                            Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Address2:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="secSubAddress2" runat="server" MaxLength="100"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        City *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="secSubCity" runat="server" MaxLength="100"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="rfvsecSubCity" ControlToValidate="secSubCity" Enabled="false"
                                                                                                                            Display="Dynamic" ErrorMessage="Secondary Subscriber Info: City" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        State *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:DropDownList ID="secSubState" runat="server" />
                                                                                                                        <asp:RequiredFieldValidator ID="rfvsecSubState" ControlToValidate="secSubState" Enabled="false"
                                                                                                                            Display="Dynamic" ErrorMessage="Secondary Subscriber Info: State" Text="*" runat="server" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Zip:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadMaskedTextBox ID="secSubZip" runat="server" Height="21px" Mask="#####-####"
                                                                                                                            Width="70px">
                                                                                                                        </telerik:RadMaskedTextBox>
                                                                                                                        <asp:RegularExpressionValidator ID="RegularExpressionValidator22" runat="server"
                                                                                                                            ErrorMessage="Secondary Insurance: Zip Invalid!" ControlToValidate="secSubZip"
                                                                                                                            Display="Dynamic" ValidationExpression="^((\d{5}-_{0,4})|(|(\d{5}-\d{4})))$"></asp:RegularExpressionValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        SSN:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadMaskedTextBox ID="secSubSSN" runat="server" Height="20px" Mask="###-##-####"
                                                                                                                            Width="92px">
                                                                                                                        </telerik:RadMaskedTextBox>
                                                                                                                        <asp:RegularExpressionValidator ID="RegularExpressionValidator23" runat="server"
                                                                                                                            Display="Dynamic" ErrorMessage="Secondary Insurance: SSN Invalid!" ValidationExpression="^\d{3}-\d{2}-\d{4}$"
                                                                                                                            ControlToValidate="secSubSSN"></asp:RegularExpressionValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV" valign="top">
                                                                                                                        DOB:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <telerik:RadDatePicker ID="secSubDOB" runat="server">
                                                                                                                            <DateInput ID="DateInput2" DateFormat="M/d/yyyy" DisplayDateFormat="M/d/yyyy" runat="server">
                                                                                                                            </DateInput>
                                                                                                                        </telerik:RadDatePicker>
                                                                                                                        <asp:CompareValidator ID="CompareValidator5" runat="server" ErrorMessage="Admit Date cannot be less than Secondary Subscriber DOB!"
                                                                                                                            ControlToValidate="secSubDOB" ControlToCompare="radAdmitDate" Operator="LessThanEqual"
                                                                                                                            Display="Dynamic" Type="Date"></asp:CompareValidator>
                                                                                                                        <asp:CompareValidator ID="CompareValidator6" runat="server" ErrorMessage="Discharge Date cannot be less than Secondary Subscriber DOB!"
                                                                                                                            ControlToValidate="secSubDOB" ControlToCompare="radDischargeDate" Operator="LessThanEqual"
                                                                                                                            Display="Dynamic" Type="Date"></asp:CompareValidator>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Sex:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:DropDownList ID="secSubSex" runat="server">
                                                                                                                            <asp:ListItem Selected="True" Text="Select" Value=""></asp:ListItem>
                                                                                                                            <asp:ListItem Text="Male" Value="M"></asp:ListItem>
                                                                                                                            <asp:ListItem Text="Female" Value="F"></asp:ListItem>
                                                                                                                        </asp:DropDownList>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Authorization:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="secAuthorization" runat="server" MaxLength="50" onblur="CheckForCompletedReqFlds('Sec Ins');"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                            </table>
                                                                                                        </fieldset>
                                                                                                    </td>
                                                                                                </tr>
                                                                                            </table>
                                                                                        </telerik:RadPageView>
                                                                                        <telerik:RadPageView ID="RadTerView" runat="server" Width="100%">
                                                                                            <table width="100%" bgcolor="#F6F6F6" cellpadding="0" cellspacing="0">
                                                                                                <tr>
                                                                                                    <td>
                                                                                                        <fieldset>
                                                                                                            <legend><b><font style="font-size: x-small;">Tertiary Insurance</font></b></legend>
                                                                                                            <table width="100%" bordercolor="white" border="1" cellpadding="0" cellspacing="0">
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV" width="35%">
                                                                                                                        Ins Code *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="terInsCode" runat="server" AutoPostBack="true" OnTextChanged="terInsCode_OnTextChanged"
                                                                                                                            MaxLength="10"></asp:TextBox>
                                                                                                                        <asp:RequiredFieldValidator ID="rfvterInsCode" ControlToValidate="terInsCode" ErrorMessage="Tertiary Insurance: Ter Ins Code"
                                                                                                                            Display="Dynamic" Text="*" runat="server" Enabled="false" />
                                                                                                                        <asp:Button ID="btnTerSearch" runat="server" Text="Search" CausesValidation="false"
                                                                                                                            AccessKey="3" />
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Ins Name *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="terInsName" runat="server" ReadOnly="true" Width="225px"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Ins Address1 *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="terInsAddress1" runat="server" ReadOnly="true"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Ins Address2:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="terInsAddress2" runat="server" ReadOnly="true"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        City *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="terInsCity" runat="server" ReadOnly="true"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        State *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="terInsState" runat="server" ReadOnly="true"></asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                                                                                                                        Zip *:
                                                                                                                    </td>
                                                                                                                    <td class="td_AEVNoBold">
                                                                                                                        <asp:TextBox ID="terInsZip" runat="server" Height="21px" ReadOnly="true" Width="70px">
                                                                                                                        </asp:TextBox>
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td>
                                                                                                                        &nbsp;
                                                                                                                    </td>
                                                                                                                </tr>
                                                                                                                <tr>
                                                                                                                    <td class="td_AEV">
                        &n