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Key objectives
Key objectives
Give patients a digital care plan to track their bladder function at home.
Outcome measures
Outcome measures
Equip every patient with the tools to monitor and record their in and outputs daily to help the physio team diagnose and treat patients quicker.
Current Baselines
Current Baselines
Patients currently adding their in and output on pieces of paper and sending them to the team, no easy way to share with the team. Reliant on patients bringing records with them to clinic appointments, sometimes meaning follow-ups aren’t being efficiently or effectively managed.
Workflow
Workflow
PKB care plan is given to patients to record their daily input and output for the team to review in a timely manner and start treatment started faster.
Bladder Diary care plan template
Bladder Diary care plan template
Example care plan template code for Bladder Diary Care Plan HTML
Example care plan template code for Bladder Diary Care Plan HTML
<div class="form-inline">
<style media="screen">
a {word-wrap: break-word;}
.form-group {width: 100%; !important}
ul {list-style:inherit; margin-left: 15px;}
.cp_whiteBox {background-color:#ffffff; padding:15px; margin-bottom:10px; margin-top:10px; -moz-border-radius: 10px; -webkit-border-radius: 10px; -khtml-border-radius: 10px; border-radius: 10px;}
</style>
<div class="cp_whiteBox">
<h2>Bladder Diary</h2>
<p>This chart is designed to help assess how your bladder functions at home, work or any place you happen to be over the period of time you are recording.</p>
<p>By filling in this chart correctly you will help us diagnose and treat your condition.</p>
<p>Please <b>complete 3 days</b> of this chart. They do not have to be consecutive days.</p>
<ul>
<li style="list-style:inherit; margin-left: 15px;"><b>Drinks</b>: Please measure (mls) and record what you drink if it was Tea, Coffee, Water, Juice, Fizzy drink, or Other.</li>
<li style="list-style:inherit; margin-left: 15px;"><b>Urine</b>: Please measure (mls) and record the amount of urine you pass.</li>
<li style="list-style:inherit; margin-left: 15px;"><b>Leak</b>: Please indicate when you leaked if it was Damp, Wet, or Very wet.</li>
</ul>
<p>Please add the totals of drink and urine volume at the end of each day.</p>
</div>
<div class="row">
<div class="col-sm-3" style="margin-top: 30px; margin-bottom: 30px;">
<a href="#Day1" class="btn arrow btn-primary" title="Day1" alt="Click here to go to Day 1">Day 1</a>
</div>
<div class="col-sm-3" style="margin-top: 30px; margin-bottom: 30px;">
<a href="#Day2" class="btn arrow btn-primary" title="Day2" alt="Click here to go to Day 2">Day 2</a>
</div>
<div class="col-sm-3" style="margin-top: 30px; margin-bottom: 30px;">
<a href="#Day3" class="btn arrow btn-primary" title="Day3" alt="Click here to go to Day 3">Day 3</a>
</div>
<div class="col-sm-3" style="margin-top: 30px; margin-bottom: 30px;">
<a href="#end" class="btn arrow btn-primary" title="Bottom" alt="Click here to go to go to bottom to save">Jump to Save</a>
</div>
</div>
<div class="cp_whiteBox">
<h2 id="Day1">Day 1</h2>
<div class="row hidden-xs" style="margin-top: 15px;">
<div class="col-sm-2">
<h4>Time</h4>
</div>
<div class="col-sm-2">
<h4>Drink (ml)</h4>
</div>
<div class="col-sm-3">
<h4>Drink Type</h4>
</div>
<div class="col-sm-2">
<h4>Urine (ml)</h4>
</div>
<div class="col-sm-3">
<h4>Leak</h4>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>06:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H0600Drinks" id="cp_D1H0600Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0600DrinkType" id="cp_D1H0600DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H0600Urine" id="cp_D1H0600Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0600Leak" id="cp_D1H0600Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>06:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H0630Drinks" id="cp_D1H0630Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0630DrinkType" id="cp_D1H0630DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H0630Urine" id="cp_D1H0630Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0630Leak" id="cp_D1H0630Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>07:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H0700Drinks" id="cp_D1H0700Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0700DrinkType" id="cp_D1H0700DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H0700Urine" id="cp_D1H0700Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0700Leak" id="cp_D1H0700Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>07:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H0730Drinks" id="cp_D1H0730Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0730DrinkType" id="cp_D1H0730DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H0730Urine" id="cp_D1H0730Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0730Leak" id="cp_D1H0730Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>08:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H0800Drinks" id="cp_D1H0800Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0800DrinkType" id="cp_D1H0800DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H0800Urine" id="cp_D1H0800Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0800Leak" id="cp_D1H0800Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>08:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H0830Drinks" id="cp_D1H0830Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0830DrinkType" id="cp_D1H0830DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H0830Urine" id="cp_D1H0830Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0830Leak" id="cp_D1H0830Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>09:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H0900Drinks" id="cp_D1H0900Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0900DrinkType" id="cp_D1H0900DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H0900Urine" id="cp_D1H0900Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0900Leak" id="cp_D1H0900Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>09:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H0930Drinks" id="cp_D1H0930Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0930DrinkType" id="cp_D1H0930DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H0930Urine" id="cp_D1H0930Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0930Leak" id="cp_D1H0930Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>10:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H1000Drinks" id="cp_D1H1000Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1000DrinkType" id="cp_D1H1000DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H1000Urine" id="cp_D1H1000Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1000Leak" id="cp_D1H1000Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>10:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H1030Drinks" id="cp_D1H1030Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1030DrinkType" id="cp_D1H1030DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H1030Urine" id="cp_D1H1030Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1030Leak" id="cp_D1H1030Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>11:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H1100Drinks" id="cp_D1H1100Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1100DrinkType" id="cp_D1H1100DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H1100Urine" id="cp_D1H1100Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1100Leak" id="cp_D1H1100Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>11:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H1130Drinks" id="cp_D1H1130Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1130DrinkType" id="cp_D1H1130DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H1130Urine" id="cp_D1H1130Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1130Leak" id="cp_D1H1130Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>12:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H1200Drinks" id="cp_D1H1200Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1200DrinkType" id="cp_D1H1200DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H1200Urine" id="cp_D1H1200Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1200Leak" id="cp_D1H1200Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>12:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H1230Drinks" id="cp_D1H1230Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1230DrinkType" id="cp_D1H1230DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H1230Urine" id="cp_D1H1230Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1230Leak" id="cp_D1H1230Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>13:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H1300Drinks" id="cp_D1H1300Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1300DrinkType" id="cp_D1H1300DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H1300Urine" id="cp_D1H1300Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1300Leak" id="cp_D1H1300Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>13:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H1330Drinks" id="cp_D1H1330Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1330DrinkType" id="cp_D1H1330DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H1330Urine" id="cp_D1H1330Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1330Leak" id="cp_D1H1330Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>14:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H1400Drinks" id="cp_D1H1400Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1400DrinkType" id="cp_D1H1400DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H1400Urine" id="cp_D1H1400Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1400Leak" id="cp_D1H1400Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>14:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H1430Drinks" id="cp_D1H1430Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1430DrinkType" id="cp_D1H1430DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H1430Urine" id="cp_D1H1430Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1430Leak" id="cp_D1H1430Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>15:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H1500Drinks" id="cp_D1H1500Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1500DrinkType" id="cp_D1H1500DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H1500Urine" id="cp_D1H1500Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1500Leak" id="cp_D1H1500Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>15:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H1530Drinks" id="cp_D1H1530Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1530DrinkType" id="cp_D1H1530DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H1530Urine" id="cp_D1H1530Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1530Leak" id="cp_D1H1530Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>16:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H1600Drinks" id="cp_D1H1600Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1600DrinkType" id="cp_D1H1600DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H1600Urine" id="cp_D1H1600Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1600Leak" id="cp_D1H1600Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>16:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H1630Drinks" id="cp_D1H1630Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1630DrinkType" id="cp_D1H1630DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H1630Urine" id="cp_D1H1630Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1630Leak" id="cp_D1H1630Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>17:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H1700Drinks" id="cp_D1H1700Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1700DrinkType" id="cp_D1H1700DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H1700Urine" id="cp_D1H1700Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1700Leak" id="cp_D1H1700Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>17:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H1730Drinks" id="cp_D1H1730Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1730DrinkType" id="cp_D1H1730DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H1730Urine" id="cp_D1H1730Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1730Leak" id="cp_D1H1730Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>18:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H1800Drinks" id="cp_D1H1800Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1800DrinkType" id="cp_D1H1800DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H1800Urine" id="cp_D1H1800Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1800Leak" id="cp_D1H1800Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>18:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H1830Drinks" id="cp_D1H1830Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1830DrinkType" id="cp_D1H1830DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H1830Urine" id="cp_D1H1830Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1830Leak" id="cp_D1H1830Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>19:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H1900Drinks" id="cp_D1H1900Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1900DrinkType" id="cp_D1H1900DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H1900Urine" id="cp_D1H1900Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1900Leak" id="cp_D1H1900Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>19:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H1930Drinks" id="cp_D1H1930Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1930DrinkType" id="cp_D1H1930DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H1930Urine" id="cp_D1H1930Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H1930Leak" id="cp_D1H1930Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>20:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H2000Drinks" id="cp_D1H2000Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H2000DrinkType" id="cp_D1H2000DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H2000Urine" id="cp_D1H2000Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H2000Leak" id="cp_D1H2000Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>20:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H2030Drinks" id="cp_D1H2030Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H2030DrinkType" id="cp_D1H2030DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H2030Urine" id="cp_D1H2030Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H2030Leak" id="cp_D1H2030Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>21:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H2100Drinks" id="cp_D1H2100Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H2100DrinkType" id="cp_D1H2100DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H2100Urine" id="cp_D1H2100Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H2100Leak" id="cp_D1H2100Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>21:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H2130Drinks" id="cp_D1H2130Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H2130DrinkType" id="cp_D1H2130DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H2130Urine" id="cp_D1H2130Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H2130Leak" id="cp_D1H2130Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>22:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H2200Drinks" id="cp_D1H2200Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H2200DrinkType" id="cp_D1H2200DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H2200Urine" id="cp_D1H2200Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H2200Leak" id="cp_D1H2200Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>22:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H2230Drinks" id="cp_D1H2230Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H2230DrinkType" id="cp_D1H2230DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H2230Urine" id="cp_D1H2230Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H2230Leak" id="cp_D1H2230Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>23:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H2300Drinks" id="cp_D1H2300Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H2300DrinkType" id="cp_D1H2300DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H2300Urine" id="cp_D1H2300Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H2300Leak" id="cp_D1H2300Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>23:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H2330Drinks" id="cp_D1H2330Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H2330DrinkType" id="cp_D1H2330DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H2330Urine" id="cp_D1H2330Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H2330Leak" id="cp_D1H2330Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>00:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H0000Drinks" id="cp_D1H0000Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0000DrinkType" id="cp_D1H0000DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H0000Urine" id="cp_D1H0000Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0000Leak" id="cp_D1H0000Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>00:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H0030Drinks" id="cp_D1H0030Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0030DrinkType" id="cp_D1H0030DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H0030Urine" id="cp_D1H0030Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0030Leak" id="cp_D1H0030Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>01:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H0100Drinks" id="cp_D1H0100Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0100DrinkType" id="cp_D1H0100DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H0100Urine" id="cp_D1H0100Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0100Leak" id="cp_D1H0100Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>01:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H0130Drinks" id="cp_D1H0130Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0130DrinkType" id="cp_D1H0130DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H0130Urine" id="cp_D1H0130Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0130Leak" id="cp_D1H0130Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>02:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H0200Drinks" id="cp_D1H0200Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0200DrinkType" id="cp_D1H0200DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H0200Urine" id="cp_D1H0200Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0200Leak" id="cp_D1H0200Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>02:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H0230Drinks" id="cp_D1H0230Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0230DrinkType" id="cp_D1H0230DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H0230Urine" id="cp_D1H0230Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0230Leak" id="cp_D1H0230Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>03:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H0300Drinks" id="cp_D1H0300Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0300DrinkType" id="cp_D1H0300DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H0300Urine" id="cp_D1H0300Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0300Leak" id="cp_D1H0300Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>03:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H0330Drinks" id="cp_D1H0330Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0330DrinkType" id="cp_D1H0330DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H0330Urine" id="cp_D1H0330Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0330Leak" id="cp_D1H0330Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>04:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H0400Drinks" id="cp_D1H0400Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0400DrinkType" id="cp_D1H0400DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H0400Urine" id="cp_D1H0400Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0400Leak" id="cp_D1H0400Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>04:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H0430Drinks" id="cp_D1H0430Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0430DrinkType" id="cp_D1H0430DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H0430Urine" id="cp_D1H0430Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0430Leak" id="cp_D1H0430Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>05:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H0500Drinks" id="cp_D1H0500Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0500DrinkType" id="cp_D1H0500DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H0500Urine" id="cp_D1H0500Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0500Leak" id="cp_D1H0500Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>05:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D1H0530Drinks" id="cp_D1H0530Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0530DrinkType" id="cp_D1H0530DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D1H0530Urine" id="cp_D1H0530Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D1H0530Leak" id="cp_D1H0530Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p><b>Total</b></p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Total Drink (ml)</p>
<input type="text" name="cp_D1TotalDrinks" id="cp_D1TotalDrinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm"> </p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Total Urine (ml)</p>
<input type="text" name="cp_D1TotalUrine" id="cp_D1TotalUrine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm"> </p>
</div>
</div>
</div>
<div class="row">
<div class="col-sm-3" style="margin-top: 30px; margin-bottom: 30px;">
<a href="#Day1" class="btn arrow btn-primary" title="Day1" alt="Click here to go to Day 1">Day 1</a>
</div>
<div class="col-sm-3" style="margin-top: 30px; margin-bottom: 30px;">
<a href="#Day2" class="btn arrow btn-primary" title="Day2" alt="Click here to go to Day 2">Day 2</a>
</div>
<div class="col-sm-3" style="margin-top: 30px; margin-bottom: 30px;">
<a href="#Day3" class="btn arrow btn-primary" title="Day3" alt="Click here to go to Day 3">Day 3</a>
</div>
<div class="col-sm-3" style="margin-top: 30px; margin-bottom: 30px;">
<a href="#end" class="btn arrow btn-primary" title="Bottom" alt="Click here to go to go to bottom to save">Jump to Save</a>
</div>
</div>
<div class="cp_whiteBox">
<h2 id="Day2">Day 2</h2>
<div class="row hidden-xs" style="margin-top: 15px;">
<div class="col-sm-2">
<h4>Time</h4>
</div>
<div class="col-sm-2">
<h4>Drink (ml)</h4>
</div>
<div class="col-sm-3">
<h4>Drink Type</h4>
</div>
<div class="col-sm-2">
<h4>Urine (ml)</h4>
</div>
<div class="col-sm-3">
<h4>Leak</h4>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>06:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H0600Drinks" id="cp_D2H0600Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0600DrinkType" id="cp_D2H0600DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H0600Urine" id="cp_D2H0600Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0600Leak" id="cp_D2H0600Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>06:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H0630Drinks" id="cp_D2H0630Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0630DrinkType" id="cp_D2H0630DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H0630Urine" id="cp_D2H0630Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0630Leak" id="cp_D2H0630Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>07:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H0700Drinks" id="cp_D2H0700Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0700DrinkType" id="cp_D2H0700DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H0700Urine" id="cp_D2H0700Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0700Leak" id="cp_D2H0700Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>07:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H0730Drinks" id="cp_D2H0730Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0730DrinkType" id="cp_D2H0730DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H0730Urine" id="cp_D2H0730Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0730Leak" id="cp_D2H0730Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>08:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H0800Drinks" id="cp_D2H0800Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0800DrinkType" id="cp_D2H0800DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H0800Urine" id="cp_D2H0800Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0800Leak" id="cp_D2H0800Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>08:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H0830Drinks" id="cp_D2H0830Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0830DrinkType" id="cp_D2H0830DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H0830Urine" id="cp_D2H0830Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0830Leak" id="cp_D2H0830Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>09:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H0900Drinks" id="cp_D2H0900Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0900DrinkType" id="cp_D2H0900DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H0900Urine" id="cp_D2H0900Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0900Leak" id="cp_D2H0900Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>09:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H0930Drinks" id="cp_D2H0930Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0930DrinkType" id="cp_D2H0930DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H0930Urine" id="cp_D2H0930Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0930Leak" id="cp_D2H0930Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>10:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H1000Drinks" id="cp_D2H1000Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1000DrinkType" id="cp_D2H1000DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H1000Urine" id="cp_D2H1000Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1000Leak" id="cp_D2H1000Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>10:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H1030Drinks" id="cp_D2H1030Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1030DrinkType" id="cp_D2H1030DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H1030Urine" id="cp_D2H1030Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1030Leak" id="cp_D2H1030Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>11:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H1100Drinks" id="cp_D2H1100Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1100DrinkType" id="cp_D2H1100DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H1100Urine" id="cp_D2H1100Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1100Leak" id="cp_D2H1100Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>11:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H1130Drinks" id="cp_D2H1130Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1130DrinkType" id="cp_D2H1130DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H1130Urine" id="cp_D2H1130Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1130Leak" id="cp_D2H1130Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>12:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H1200Drinks" id="cp_D2H1200Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1200DrinkType" id="cp_D2H1200DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H1200Urine" id="cp_D2H1200Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1200Leak" id="cp_D2H1200Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>12:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H1230Drinks" id="cp_D2H1230Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1230DrinkType" id="cp_D2H1230DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H1230Urine" id="cp_D2H1230Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1230Leak" id="cp_D2H1230Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>13:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H1300Drinks" id="cp_D2H1300Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1300DrinkType" id="cp_D2H1300DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H1300Urine" id="cp_D2H1300Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1300Leak" id="cp_D2H1300Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>13:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H1330Drinks" id="cp_D2H1330Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1330DrinkType" id="cp_D2H1330DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H1330Urine" id="cp_D2H1330Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1330Leak" id="cp_D2H1330Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>14:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H1400Drinks" id="cp_D2H1400Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1400DrinkType" id="cp_D2H1400DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H1400Urine" id="cp_D2H1400Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1400Leak" id="cp_D2H1400Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>14:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H1430Drinks" id="cp_D2H1430Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1430DrinkType" id="cp_D2H1430DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H1430Urine" id="cp_D2H1430Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1430Leak" id="cp_D2H1430Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>15:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H1500Drinks" id="cp_D2H1500Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1500DrinkType" id="cp_D2H1500DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H1500Urine" id="cp_D2H1500Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1500Leak" id="cp_D2H1500Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>15:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H1530Drinks" id="cp_D2H1530Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1530DrinkType" id="cp_D2H1530DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H1530Urine" id="cp_D2H1530Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1530Leak" id="cp_D2H1530Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>16:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H1600Drinks" id="cp_D2H1600Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1600DrinkType" id="cp_D2H1600DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H1600Urine" id="cp_D2H1600Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1600Leak" id="cp_D2H1600Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>16:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H1630Drinks" id="cp_D2H1630Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1630DrinkType" id="cp_D2H1630DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H1630Urine" id="cp_D2H1630Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1630Leak" id="cp_D2H1630Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>17:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H1700Drinks" id="cp_D2H1700Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1700DrinkType" id="cp_D2H1700DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H1700Urine" id="cp_D2H1700Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1700Leak" id="cp_D2H1700Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>17:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H1730Drinks" id="cp_D2H1730Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1730DrinkType" id="cp_D2H1730DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H1730Urine" id="cp_D2H1730Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1730Leak" id="cp_D2H1730Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>18:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H1800Drinks" id="cp_D2H1800Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1800DrinkType" id="cp_D2H1800DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H1800Urine" id="cp_D2H1800Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1800Leak" id="cp_D2H1800Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>18:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H1830Drinks" id="cp_D2H1830Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1830DrinkType" id="cp_D2H1830DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H1830Urine" id="cp_D2H1830Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1830Leak" id="cp_D2H1830Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>19:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H1900Drinks" id="cp_D2H1900Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1900DrinkType" id="cp_D2H1900DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H1900Urine" id="cp_D2H1900Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1900Leak" id="cp_D2H1900Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>19:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H1930Drinks" id="cp_D2H1930Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1930DrinkType" id="cp_D2H1930DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H1930Urine" id="cp_D2H1930Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H1930Leak" id="cp_D2H1930Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>20:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H2000Drinks" id="cp_D2H2000Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H2000DrinkType" id="cp_D2H2000DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H2000Urine" id="cp_D2H2000Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H2000Leak" id="cp_D2H2000Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>20:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H2030Drinks" id="cp_D2H2030Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H2030DrinkType" id="cp_D2H2030DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H2030Urine" id="cp_D2H2030Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H2030Leak" id="cp_D2H2030Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>21:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H2100Drinks" id="cp_D2H2100Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H2100DrinkType" id="cp_D2H2100DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H2100Urine" id="cp_D2H2100Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H2100Leak" id="cp_D2H2100Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>21:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H2130Drinks" id="cp_D2H2130Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H2130DrinkType" id="cp_D2H2130DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H2130Urine" id="cp_D2H2130Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H2130Leak" id="cp_D2H2130Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>22:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H2200Drinks" id="cp_D2H2200Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H2200DrinkType" id="cp_D2H2200DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H2200Urine" id="cp_D2H2200Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H2200Leak" id="cp_D2H2200Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>22:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H2230Drinks" id="cp_D2H2230Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H2230DrinkType" id="cp_D2H2230DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H2230Urine" id="cp_D2H2230Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H2230Leak" id="cp_D2H2230Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>23:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H2300Drinks" id="cp_D2H2300Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H2300DrinkType" id="cp_D2H2300DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H2300Urine" id="cp_D2H2300Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H2300Leak" id="cp_D2H2300Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>23:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H2330Drinks" id="cp_D2H2330Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H2330DrinkType" id="cp_D2H2330DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H2330Urine" id="cp_D2H2330Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H2330Leak" id="cp_D2H2330Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>00:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H0000Drinks" id="cp_D2H0000Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0000DrinkType" id="cp_D2H0000DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H0000Urine" id="cp_D2H0000Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0000Leak" id="cp_D2H0000Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>00:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H0030Drinks" id="cp_D2H0030Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0030DrinkType" id="cp_D2H0030DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H0030Urine" id="cp_D2H0030Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0030Leak" id="cp_D2H0030Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>01:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H0100Drinks" id="cp_D2H0100Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0100DrinkType" id="cp_D2H0100DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H0100Urine" id="cp_D2H0100Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0100Leak" id="cp_D2H0100Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>01:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H0130Drinks" id="cp_D2H0130Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0130DrinkType" id="cp_D2H0130DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H0130Urine" id="cp_D2H0130Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0130Leak" id="cp_D2H0130Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>02:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H0200Drinks" id="cp_D2H0200Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0200DrinkType" id="cp_D2H0200DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H0200Urine" id="cp_D2H0200Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0200Leak" id="cp_D2H0200Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>02:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H0230Drinks" id="cp_D2H0230Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0230DrinkType" id="cp_D2H0230DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H0230Urine" id="cp_D2H0230Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0230Leak" id="cp_D2H0230Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>03:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H0300Drinks" id="cp_D2H0300Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0300DrinkType" id="cp_D2H0300DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H0300Urine" id="cp_D2H0300Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0300Leak" id="cp_D2H0300Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>03:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H0330Drinks" id="cp_D2H0330Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0330DrinkType" id="cp_D2H0330DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H0330Urine" id="cp_D2H0330Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0330Leak" id="cp_D2H0330Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>04:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H0400Drinks" id="cp_D2H0400Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0400DrinkType" id="cp_D2H0400DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H0400Urine" id="cp_D2H0400Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0400Leak" id="cp_D2H0400Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>04:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H0430Drinks" id="cp_D2H0430Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0430DrinkType" id="cp_D2H0430DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H0430Urine" id="cp_D2H0430Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0430Leak" id="cp_D2H0430Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>05:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H0500Drinks" id="cp_D2H0500Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0500DrinkType" id="cp_D2H0500DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H0500Urine" id="cp_D2H0500Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0500Leak" id="cp_D2H0500Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>05:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D2H0530Drinks" id="cp_D2H0530Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0530DrinkType" id="cp_D2H0530DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D2H0530Urine" id="cp_D2H0530Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D2H0530Leak" id="cp_D2H0530Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p><b>Total</b></p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Total Drink (ml)</p>
<input type="text" name="cp_D2TotalDrinks" id="cp_D2TotalDrinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm"> </p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Total Urine (ml)</p>
<input type="text" name="cp_D2TotalUrine" id="cp_D2TotalUrine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm"> </p>
</div>
</div>
</div>
<div class="row">
<div class="col-sm-3" style="margin-top: 30px; margin-bottom: 30px;">
<a href="#Day1" class="btn arrow btn-primary" title="Day1" alt="Click here to go to Day 1">Day 1</a>
</div>
<div class="col-sm-3" style="margin-top: 30px; margin-bottom: 30px;">
<a href="#Day2" class="btn arrow btn-primary" title="Day2" alt="Click here to go to Day 2">Day 2</a>
</div>
<div class="col-sm-3" style="margin-top: 30px; margin-bottom: 30px;">
<a href="#Day3" class="btn arrow btn-primary" title="Day3" alt="Click here to go to Day 3">Day 3</a>
</div>
<div class="col-sm-3" style="margin-top: 30px; margin-bottom: 30px;">
<a href="#end" class="btn arrow btn-primary" title="Bottom" alt="Click here to go to go to bottom to save">Jump to Save</a>
</div>
</div>
<div class="cp_whiteBox">
<h2 id="Day3">Day 3</h2>
<div class="row hidden-xs" style="margin-top: 15px;">
<div class="col-sm-2">
<h4>Time</h4>
</div>
<div class="col-sm-2">
<h4>Drink (ml)</h4>
</div>
<div class="col-sm-3">
<h4>Drink Type</h4>
</div>
<div class="col-sm-2">
<h4>Urine (ml)</h4>
</div>
<div class="col-sm-3">
<h4>Leak</h4>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>06:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H0600Drinks" id="cp_D3H0600Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0600DrinkType" id="cp_D3H0600DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H0600Urine" id="cp_D3H0600Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0600Leak" id="cp_D3H0600Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>06:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H0630Drinks" id="cp_D3H0630Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0630DrinkType" id="cp_D3H0630DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H0630Urine" id="cp_D3H0630Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0630Leak" id="cp_D3H0630Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>07:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H0700Drinks" id="cp_D3H0700Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0700DrinkType" id="cp_D3H0700DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H0700Urine" id="cp_D3H0700Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0700Leak" id="cp_D3H0700Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>07:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H0730Drinks" id="cp_D3H0730Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0730DrinkType" id="cp_D3H0730DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H0730Urine" id="cp_D3H0730Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0730Leak" id="cp_D3H0730Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>08:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H0800Drinks" id="cp_D3H0800Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0800DrinkType" id="cp_D3H0800DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H0800Urine" id="cp_D3H0800Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0800Leak" id="cp_D3H0800Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>08:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H0830Drinks" id="cp_D3H0830Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0830DrinkType" id="cp_D3H0830DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H0830Urine" id="cp_D3H0830Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0830Leak" id="cp_D3H0830Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>09:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H0900Drinks" id="cp_D3H0900Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0900DrinkType" id="cp_D3H0900DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H0900Urine" id="cp_D3H0900Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0900Leak" id="cp_D3H0900Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>09:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H0930Drinks" id="cp_D3H0930Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0930DrinkType" id="cp_D3H0930DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H0930Urine" id="cp_D3H0930Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0930Leak" id="cp_D3H0930Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>10:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H1000Drinks" id="cp_D3H1000Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1000DrinkType" id="cp_D3H1000DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H1000Urine" id="cp_D3H1000Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1000Leak" id="cp_D3H1000Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>10:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H1030Drinks" id="cp_D3H1030Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1030DrinkType" id="cp_D3H1030DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H1030Urine" id="cp_D3H1030Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1030Leak" id="cp_D3H1030Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>11:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H1100Drinks" id="cp_D3H1100Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1100DrinkType" id="cp_D3H1100DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H1100Urine" id="cp_D3H1100Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1100Leak" id="cp_D3H1100Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>11:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H1130Drinks" id="cp_D3H1130Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1130DrinkType" id="cp_D3H1130DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H1130Urine" id="cp_D3H1130Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1130Leak" id="cp_D3H1130Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>12:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H1200Drinks" id="cp_D3H1200Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1200DrinkType" id="cp_D3H1200DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H1200Urine" id="cp_D3H1200Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1200Leak" id="cp_D3H1200Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>12:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H1230Drinks" id="cp_D3H1230Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1230DrinkType" id="cp_D3H1230DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H1230Urine" id="cp_D3H1230Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1230Leak" id="cp_D3H1230Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>13:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H1300Drinks" id="cp_D3H1300Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1300DrinkType" id="cp_D3H1300DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H1300Urine" id="cp_D3H1300Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1300Leak" id="cp_D3H1300Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>13:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H1330Drinks" id="cp_D3H1330Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1330DrinkType" id="cp_D3H1330DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H1330Urine" id="cp_D3H1330Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1330Leak" id="cp_D3H1330Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>14:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H1400Drinks" id="cp_D3H1400Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1400DrinkType" id="cp_D3H1400DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H1400Urine" id="cp_D3H1400Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1400Leak" id="cp_D3H1400Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>14:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H1430Drinks" id="cp_D3H1430Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1430DrinkType" id="cp_D3H1430DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H1430Urine" id="cp_D3H1430Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1430Leak" id="cp_D3H1430Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>15:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H1500Drinks" id="cp_D3H1500Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1500DrinkType" id="cp_D3H1500DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H1500Urine" id="cp_D3H1500Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1500Leak" id="cp_D3H1500Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>15:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H1530Drinks" id="cp_D3H1530Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1530DrinkType" id="cp_D3H1530DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H1530Urine" id="cp_D3H1530Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1530Leak" id="cp_D3H1530Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>16:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H1600Drinks" id="cp_D3H1600Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1600DrinkType" id="cp_D3H1600DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H1600Urine" id="cp_D3H1600Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1600Leak" id="cp_D3H1600Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>16:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H1630Drinks" id="cp_D3H1630Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1630DrinkType" id="cp_D3H1630DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H1630Urine" id="cp_D3H1630Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1630Leak" id="cp_D3H1630Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>17:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H1700Drinks" id="cp_D3H1700Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1700DrinkType" id="cp_D3H1700DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H1700Urine" id="cp_D3H1700Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1700Leak" id="cp_D3H1700Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>17:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H1730Drinks" id="cp_D3H1730Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1730DrinkType" id="cp_D3H1730DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H1730Urine" id="cp_D3H1730Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1730Leak" id="cp_D3H1730Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>18:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H1800Drinks" id="cp_D3H1800Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1800DrinkType" id="cp_D3H1800DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H1800Urine" id="cp_D3H1800Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1800Leak" id="cp_D3H1800Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>18:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H1830Drinks" id="cp_D3H1830Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1830DrinkType" id="cp_D3H1830DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H1830Urine" id="cp_D3H1830Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1830Leak" id="cp_D3H1830Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>19:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H1900Drinks" id="cp_D3H1900Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1900DrinkType" id="cp_D3H1900DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H1900Urine" id="cp_D3H1900Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1900Leak" id="cp_D3H1900Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>19:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H1930Drinks" id="cp_D3H1930Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1930DrinkType" id="cp_D3H1930DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H1930Urine" id="cp_D3H1930Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H1930Leak" id="cp_D3H1930Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>20:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H2000Drinks" id="cp_D3H2000Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H2000DrinkType" id="cp_D3H2000DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H2000Urine" id="cp_D3H2000Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H2000Leak" id="cp_D3H2000Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>20:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H2030Drinks" id="cp_D3H2030Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H2030DrinkType" id="cp_D3H2030DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H2030Urine" id="cp_D3H2030Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H2030Leak" id="cp_D3H2030Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>21:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H2100Drinks" id="cp_D3H2100Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H2100DrinkType" id="cp_D3H2100DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H2100Urine" id="cp_D3H2100Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H2100Leak" id="cp_D3H2100Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>21:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H2130Drinks" id="cp_D3H2130Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H2130DrinkType" id="cp_D3H2130DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H2130Urine" id="cp_D3H2130Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H2130Leak" id="cp_D3H2130Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>22:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H2200Drinks" id="cp_D3H2200Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H2200DrinkType" id="cp_D3H2200DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H2200Urine" id="cp_D3H2200Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H2200Leak" id="cp_D3H2200Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>22:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H2230Drinks" id="cp_D3H2230Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H2230DrinkType" id="cp_D3H2230DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H2230Urine" id="cp_D3H2230Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H2230Leak" id="cp_D3H2230Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>23:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H2300Drinks" id="cp_D3H2300Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H2300DrinkType" id="cp_D3H2300DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H2300Urine" id="cp_D3H2300Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H2300Leak" id="cp_D3H2300Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>23:30 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H2330Drinks" id="cp_D3H2330Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H2330DrinkType" id="cp_D3H2330DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H2330Urine" id="cp_D3H2330Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H2330Leak" id="cp_D3H2330Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>00:00 PM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H0000Drinks" id="cp_D3H0000Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0000DrinkType" id="cp_D3H0000DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H0000Urine" id="cp_D3H0000Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0000Leak" id="cp_D3H0000Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>00:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H0030Drinks" id="cp_D3H0030Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0030DrinkType" id="cp_D3H0030DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H0030Urine" id="cp_D3H0030Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0030Leak" id="cp_D3H0030Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>01:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H0100Drinks" id="cp_D3H0100Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0100DrinkType" id="cp_D3H0100DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H0100Urine" id="cp_D3H0100Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0100Leak" id="cp_D3H0100Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>01:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H0130Drinks" id="cp_D3H0130Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0130DrinkType" id="cp_D3H0130DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H0130Urine" id="cp_D3H0130Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0130Leak" id="cp_D3H0130Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>02:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H0200Drinks" id="cp_D3H0200Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0200DrinkType" id="cp_D3H0200DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H0200Urine" id="cp_D3H0200Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0200Leak" id="cp_D3H0200Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>02:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H0230Drinks" id="cp_D3H0230Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0230DrinkType" id="cp_D3H0230DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H0230Urine" id="cp_D3H0230Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0230Leak" id="cp_D3H0230Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>03:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H0300Drinks" id="cp_D3H0300Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0300DrinkType" id="cp_D3H0300DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H0300Urine" id="cp_D3H0300Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0300Leak" id="cp_D3H0300Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>03:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H0330Drinks" id="cp_D3H0330Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0330DrinkType" id="cp_D3H0330DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H0330Urine" id="cp_D3H0330Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0330Leak" id="cp_D3H0330Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>04:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H0400Drinks" id="cp_D3H0400Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0400DrinkType" id="cp_D3H0400DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H0400Urine" id="cp_D3H0400Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0400Leak" id="cp_D3H0400Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>04:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H0430Drinks" id="cp_D3H0430Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0430DrinkType" id="cp_D3H0430DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H0430Urine" id="cp_D3H0430Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0430Leak" id="cp_D3H0430Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>05:00 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H0500Drinks" id="cp_D3H0500Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0500DrinkType" id="cp_D3H0500DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H0500Urine" id="cp_D3H0500Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0500Leak" id="cp_D3H0500Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p>05:30 AM</p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Drink (ml)</p>
<input type="text" name="cp_D3H0530Drinks" id="cp_D3H0530Drinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Drink Type</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0530DrinkType" id="cp_D3H0530DrinkType">
<option value="--">Select</option>
<option value="Tea">Tea</option>
<option value="Coffee">Coffee</option>
<option value="Water">Water</option>
<option value="Juice">Juice</option>
<option value="Fizzy drink">Fizzy drink</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Urine (ml)</p>
<input type="text" name="cp_D3H0530Urine" id="cp_D3H0530Urine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm">Leak</p>
<select class="form-control" style="width: 100%;" name="cp_D3H0530Leak" id="cp_D3H0530Leak">
<option value="--">Select</option>
<option value="Damp">Damp</option>
<option value="Wet">Wet</option>
<option value="Very wet">Very wet</option>
</select>
</div>
</div>
<div class="row" style="margin-top: 15px;">
<div class="col-sm-2">
<p><b>Total</b></p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Total Drink (ml)</p>
<input type="text" name="cp_D3TotalDrinks" id="cp_D3TotalDrinks" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm"> </p>
</div>
<div class="col-sm-2">
<p class="hidden-lg hidden-md hidden-sm">Total Urine (ml)</p>
<input type="text" name="cp_D3TotalUrine" id="cp_D3TotalUrine" class="form-control" style="width: 100%;"></input>
</div>
<div class="col-sm-3">
<p class="hidden-lg hidden-md hidden-sm"> </p>
</div>
</div>
</div>
<div class="row" id="end">
<div class="col-sm-3" style="margin-top: 30px; margin-bottom: 30px;">
<a href="#Day1" class="btn arrow btn-primary" title="Day1" alt="Click here to go to Day 1">Day 1</a>
</div>
<div class="col-sm-3" style="margin-top: 30px; margin-bottom: 30px;">
<a href="#Day2" class="btn arrow btn-primary" title="Day2" alt="Click here to go to Day 2">Day 2</a>
</div>
<div class="col-sm-3" style="margin-top: 30px; margin-bottom: 30px;">
<a href="#Day3" class="btn arrow btn-primary" title="Day3" alt="Click here to go to Day 3">Day 3</a>
</div>
<div class="col-sm-3" style="margin-top: 30px; margin-bottom: 30px;">
<a href="#end" class="btn arrow btn-primary" title="Bottom" alt="Click here to go to go to bottom to save">Jump to Save</a>
</div>
</div>
</div>
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