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                border-bottom:.5pt solid windowtext;
                border-left:none;}
            .xl132
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                text-align:center;
                vertical-align:middle;
                border-top:none;
                border-right:none;
                border-bottom:.5pt solid windowtext;
                border-left:none;}
            .xl133
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                mso-number-format:"dd\\-mmm";
                text-align:center;
                vertical-align:middle;
                border-top:none;
                border-right:none;
                border-bottom:.5pt solid windowtext;
                border-left:none;}
            .xl134
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                mso-number-format:"dd\\-mmm";
                text-align:center;
                vertical-align:middle;}
            .xl135
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                vertical-align:middle;
                border-top:none;
                border-right:none;
                border-bottom:.5pt solid windowtext;
                border-left:none;}
            .xl136
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                vertical-align:middle;
                border-top:none;
                border-right:.5pt solid windowtext;
                border-bottom:.5pt solid windowtext;
                border-left:none;}
            .xl137
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                mso-number-format:"dd\\-mmm";
                text-align:center;
                vertical-align:middle;
                border-top:.5pt solid windowtext;
                border-right:none;
                border-bottom:none;
                border-left:none;}
            .xl138
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                vertical-align:middle;
                border-top:none;
                border-right:none;
                border-bottom:.5pt solid windowtext;
                border-left:.5pt solid windowtext;}
            .xl139
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-weight:700;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                text-align:left;
                vertical-align:top;
                border-top:.5pt solid windowtext;
                border-right:none;
                border-bottom:none;
                border-left:.5pt solid windowtext;}
            .xl140
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-weight:700;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                text-align:left;
                vertical-align:top;
                border-top:.5pt solid windowtext;
                border-right:none;
                border-bottom:none;
                border-left:none;}
            .xl141
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-weight:700;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                text-align:left;
                vertical-align:top;
                border-top:.5pt solid windowtext;
                border-right:.5pt solid windowtext;
                border-bottom:none;
                border-left:none;}
            .xl142
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                text-align:left;
                vertical-align:middle;}
            .xl143
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                text-align:left;
                vertical-align:middle;
                border-top:none;
                border-right:.5pt solid windowtext;
                border-bottom:none;
                border-left:none;}
            .xl144
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                text-align:left;
                vertical-align:top;
                border-top:none;
                border-right:.5pt solid windowtext;
                border-bottom:none;
                border-left:none;}
            .xl145
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                text-align:left;
                vertical-align:top;
                border-top:none;
                border-right:none;
                border-bottom:none;
                border-left:.5pt solid windowtext;}
            .xl146
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                text-align:left;
                vertical-align:top;
                border-top:none;
                border-right:none;
                border-bottom:.5pt solid windowtext;
                border-left:.5pt solid windowtext;}
            .xl147
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                text-align:left;
                vertical-align:top;
                border-top:none;
                border-right:none;
                border-bottom:.5pt solid windowtext;
                border-left:none;}
            .xl148
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                text-align:left;
                vertical-align:top;
                border-top:none;
                border-right:.5pt solid windowtext;
                border-bottom:.5pt solid windowtext;
                border-left:none;}
            .xl149
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                text-align:right;}
            .xl150
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-weight:700;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                text-align:left;
                border-top:.5pt solid windowtext;
                border-right:none;
                border-bottom:none;
                border-left:.5pt solid windowtext;}
            .xl151
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-weight:700;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                text-align:left;
                border-top:.5pt solid windowtext;
                border-right:none;
                border-bottom:none;
                border-left:none;}
            .xl152
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                text-align:center;
                vertical-align:top;
                border:.5pt solid windowtext;}
            .xl153
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                text-align:center;
                vertical-align:middle;
                border:.5pt solid windowtext;}
            .xl154
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                text-align:left;
                vertical-align:middle;
                border-top:none;
                border-right:none;
                border-bottom:none;
                border-left:.5pt solid windowtext;}
            .xl155
                {mso-style-parent:style0;
                font-size:11.0pt;
                font-family:Arial, sans-serif;
                mso-font-charset:0;
                vertical-align:middle;
                border-top:none;
                border-right:.5pt solid windowtext;
                border-bottom:none;
                border-left:none;}
        </style>
    </head>
    <body link="#467886" vlink="#96607D" class=xl64>
        <div id="biakan_4931" align=center x:publishsource="Excel">
            @php 
                $data               = [];
                $data['keterangan'] = $periksa->keterangan;
                if (!empty($komponens)) {
                    foreach ($komponens as $rows) {
                        $key = trim($rows->komponen);
                        if (!empty($key)) {
                            if ($key == 'keterangan') {
                            } else {
                                $data[$key] = $rows->isidata;
                            }
                        }
                    }
                }
            @endphp
            <table border=0 cellpadding=0 cellspacing=0 width=961 style='border-collapse: collapse;table-layout:fixed;width:713pt'>
                <col class=xl64 width=31 style='mso-width-source:userset;mso-width-alt:981; width:23pt'>
                <col class=xl64 width=15 style='mso-width-source:userset;mso-width-alt:469; width:11pt'>
                <col class=xl64 width=23 style='mso-width-source:userset;mso-width-alt:725; width:17pt'>
                <col class=xl64 width=168 style='mso-width-source:userset;mso-width-alt:5376; width:126pt'>
                <col class=xl64 width=23 span=3 style='mso-width-source:userset;mso-width-alt: 725;width:17pt'>
                <col class=xl64 width=20 span=4 style='mso-width-source:userset;mso-width-alt: 640;width:15pt'>
                <col class=xl64 width=23 span=25 style='mso-width-source:userset;mso-width-alt: 725;width:17pt'>
                <col class=xl64 width=31 style='mso-width-source:userset;mso-width-alt:981;width:23pt'>
                <tr>
                    <td class=xl64 width=31 style='width:23pt'>&nbsp;</td>
                    <td class=xl64 width=15 style='width:11pt'>&nbsp;</td>
                    <td colspan=6 class=xl63 width=280 style='width:209pt'>Barcode NIK</td>
                    <td class=xl63 width=20 style='width:15pt'>&nbsp;</td>
                    <td class=xl63 width=20 style='width:15pt'>&nbsp;</td>
                    <td class=xl63 width=20 style='width:15pt'>&nbsp;</td>
                    <td class=xl64 width=23 style='width:17pt'>&nbsp;</td>
                    <td class=xl64 width=23 style='width:17pt'>&nbsp;</td>
                    <td class=xl64 width=23 style='width:17pt'>&nbsp;</td>
                    <td class=xl64 width=23 style='width:17pt'>&nbsp;</td>
                    <td class=xl64 width=23 style='width:17pt'>&nbsp;</td>
                    <td class=xl64 width=23 style='width:17pt'>&nbsp;</td>
                    <td class=xl64 width=23 style='width:17pt'>&nbsp;</td>
                    <td class=xl64 width=23 style='width:17pt'>&nbsp;</td>
                    <td class=xl64 width=23 style='width:17pt'>&nbsp;</td>
                    <td class=xl64 width=23 style='width:17pt'>&nbsp;</td>
                    <td class=xl64 width=23 style='width:17pt'>&nbsp;</td>
                    <td class=xl64 width=23 style='width:17pt'>&nbsp;</td>
                    <td class=xl64 width=23 style='width:17pt'>&nbsp;</td>
                    <td class=xl64 width=23 style='width:17pt'>&nbsp;</td>
                    <td class=xl64 width=23 style='width:17pt'>&nbsp;</td>
                    <td class=xl64 width=23 style='width:17pt'>&nbsp;</td>
                    <td colspan=9 class=xl63 width=207 style='width:153pt'>Barcode TBC.05</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=6 class=xl63><img src="{!! route('generate.barcode', ['data' => $nik ?? $periksa->nofoto]) !!}" alt="Barcode" style="max-width: 100%; height: auto;">&nbsp;</td>
                    <td class=xl63>&nbsp;</td>
                    <td class=xl63>&nbsp;</td>
                    <td class=xl63>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=9 class=xl63><img src="{!! route('generate.barcode', ['data' => $nik ?? $periksa->nofoto]) !!}" alt="Barcode" style="max-width: 100%; height: auto;">&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=6 class=xl65 style='border-right:.5pt solid black'>PENANGGULANGAN TBC NASIONAL</td>
                    <td class=xl63>&nbsp;</td>
                    <td class=xl63>&nbsp;</td>
                    <td class=xl63>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=9 class=xl65 style='border-right:.5pt solid black'>TBC.05</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl63>&nbsp;</td>
                    <td class=xl63>&nbsp;</td>
                    <td class=xl63>&nbsp;</td>
                    <td class=xl63>&nbsp;</td>
                    <td class=xl63>&nbsp;</td>
                    <td class=xl63>&nbsp;</td>
                    <td class=xl63>&nbsp;</td>
                    <td class=xl63>&nbsp;</td>
                    <td class=xl63>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=9 class=xl68>INDONESIA 2020/EDISI 3</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=34 class=xl63>FORMULIR PERMOHONAN PEMERIKSAAN BAKTERIOLOGIS TBC</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=3 class=xl70>Nama Fasyankes</td>
                    <td class=xl64>:</td>
                    <td colspan=11 class=xl72>{!! $periksa->nmrs !!}</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=7 class=xl70>Nama Dokter Pengirim</td>
                    <td class=xl71>:</td>
                    <td colspan=10 class=xl72>{!! $periksa->klinisi !!}</td>
                </tr>
                <tr height=3 style='mso-height-source:userset;height:2.0pt'><td height=3 style='height:2.0pt'></td><td></td><td colspan=34></td></tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=3 class=xl70>Kode Fasyankes</td>
                    <td class=xl64>:</td>
                    <td colspan=11 class=xl72>{!! $periksa->ruangan_id !!}</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                </tr>
                <tr height=3 style='mso-height-source:userset;height:2.0pt'><td height=3 style='height:2.0pt'></td><td></td><td colspan=34></td></tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=3 class=xl70>No. Rekam Medis</td>
                    <td class=xl64>:</td>
                    <td colspan=11 class=xl72>{!! $periksa->noregister !!}</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                </tr>
                <tr height=3 style='mso-height-source:userset;height:2.0pt'><td height=3 style='height:2.0pt'></td><td></td><td colspan=34></td></tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=3 class=xl70>Nama Terduga</td>
                    <td class=xl64>:</td>
                    <td colspan=11 class=xl72>{!! $periksa->nmpasien !!}</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=7 class=xl70>No. Telp. Pasien</td>
                    <td class=xl71>:</td>
                    <td colspan=10 class=xl72>{!! $periksa->tlppasien !!}</td>
                </tr>
                <tr height=3 style='mso-height-source:userset;height:2.0pt'><td height=3 style='height:2.0pt'></td><td></td><td colspan=34></td></tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=3 class=xl70>No. Induk Kependudukan</td>
                    <td class=xl64>:</td>
                    <td colspan=11 class=xl72>{{$nik}}</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=7 class=xl70>No. BPJS</td>
                    <td class=xl71>:</td>
                    <td colspan=10 class=xl72>{{$bpjs}}</td>
                </tr>
                <tr height=3 style='mso-height-source:userset;height:2.0pt'><td height=3 style='height:2.0pt'></td><td></td><td colspan=34></td></tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=3 class=xl70>Jenis Kelamin</td>
                    <td class=xl64>:</td>
                    <td class=xl77>
                        @if ($periksa->jkpasien == 'L')
                            &#8730;
                        @else 
                            &nbsp;
                        @endif
                    </td>
                    <td colspan=4 class=xl82 style='border-right:.5pt solid black;border-left: none'>Laki - Laki</td>
                    <td class=xl77>
                        @if ($periksa->jkpasien != 'L')
                            &#8730;
                        @else 
                            &nbsp;
                        @endif
                    </td>
                    <td colspan=5 class=xl82>Perempuan</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=7 class=xl70>Umur</td>
                    <td class=xl71>:</td>
                    <td colspan=10 class=xl72>{!! $periksa->usia !!}</td>
                </tr>
                <tr height=3 style='mso-height-source:userset;height:2.0pt'><td height=3 style='height:2.0pt'></td><td></td><td colspan=34></td></tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=3 class=xl70>Alamat Lengkap</td>
                    <td class=xl64>:</td>
                    <td colspan=30 class=xl72>{!! $periksa->alamatpasien !!}</td>
                </tr>
                <tr height=3 style='mso-height-source:userset;height:2.0pt'><td height=3 style='height:2.0pt'></td><td></td><td colspan=34></td></tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=30 class=xl72>&nbsp;</td>
                </tr>
                <tr height=3 style='mso-height-source:userset;height:2.0pt'><td height=3 style='height:2.0pt'></td><td></td><td colspan=34></td></tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=3 class=xl70>Kabupaten / Kota</td>
                    <td class=xl64>:</td>
                    <td colspan=10 class=xl147>{!! $periksa->getPasien->kota ?? '-' !!}</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=19 class=xl122>Jenis Terduga / Pasien TBC</td>
                </tr>
                <tr height=3 style='mso-height-source:userset;height:2.0pt'><td height=3 style='height:2.0pt'></td><td></td><td colspan=34></td></tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=3 class=xl70>Provinsi</td>
                    <td class=xl64>:</td>
                    <td colspan=10 class=xl98>{!! $periksa->getPasien->keterangan ?? '-' !!}</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl153>
                        @if (isset($data['inlineCheckbox1']) && $data['inlineCheckbox1'] != '')
                            &#8730;
                        @else 
                            &nbsp;
                        @endif
                    </td>
                    <td colspan=3 class=xl154 style='border-right:.5pt solid black;border-left: none'>TBC SO</td>
                    <td class=xl153>
                        @if (isset($data['inlineCheckbox2']) && $data['inlineCheckbox2'] != '')
                            &#8730;
                        @else 
                            &nbsp;
                        @endif
                    </td>
                    <td colspan=3 class=xl154 style='border-right:.5pt solid black;border-left:none'>TBC RO</td>
                    <td class=xl153>
                        @if (isset($data['inlineCheckbox3']) && $data['inlineCheckbox3'] != '')
                            &#8730;
                        @else 
                            &nbsp;
                        @endif
                    </td>
                    <td colspan=3 class=xl154 style='border-right:.5pt solid black;border-left:none'>Anak</td>
                    <td class=xl153>
                        @if (isset($data['inlineCheckbox4']) && $data['inlineCheckbox4'] != '')
                            &#8730;
                        @else 
                            &nbsp;
                        @endif
                    </td>
                    <td colspan=2 class=xl154>HIV</td>
                    <td class=xl155>&nbsp;</td>
                    <td class=xl153>
                        @if (isset($data['inlineCheckbox5']) && $data['inlineCheckbox5'] != '')
                            &#8730;
                        @else 
                            &nbsp;
                        @endif
                    </td>
                    <td colspan=2 class=xl123>DM</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl93>&nbsp;</td>
                    <td colspan=15 class=xl78 style='border-right:.5pt solid black'>No. Identitas Sediaan</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=18 class=xl80>Lama Riwayat Pengobatan Terduga / Pasien TBC</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td colspan=15 class=xl71 style='border-right:.5pt solid black'>{{$data['id_noidsediaan'] ?? ''}}</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl152>
                        @php
                            if (isset($data['id_lamariwayatpengobatantb']) && $data['id_lamariwayatpengobatantb'] == 'Riwayat Pengobatan &lt; 5 tahun'){
                                $rw1 = '&nbsp;';
                                $rw2 = '&#8730;';
                            } else {
                                $rw2 = '&nbsp;';
                                $rw1 = '&#8730;';
                            }
                            echo $rw1;
                        @endphp
                    </td>
                    <td colspan=16 class=xl145>Riwayat Pengobatan &gt;=5 tahun</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td colspan=5 class=xl98>Tanggal pengambilan contoh uji</td>
                    <td class=xl64>:</td>
                    <td colspan=9 class=xl98 style='border-right:.5pt solid black'>{{ $data['id_tanggalpengambilancontohuji'] ?? ''}}</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl152>{!! $rw2 !!}</td>
                    <td colspan=16 class=xl145>Riwayat Pengobatan &lt; 5tahun</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td colspan=5 class=xl98>Tanggal pengiriman contoh uji</td>
                    <td class=xl64>:</td>
                    <td colspan=9 class=xl98 style='border-right:.5pt solid black'>{{ $data['id_tanggalpengirimancontohuji'] ?? ''}}</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td colspan=5 class=xl98>Tanda tangan pengambilan contoh uji</td>
                    <td class=xl64>:</td>
                    <td colspan=9 class=xl98 style='border-right:.5pt solid black'>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=16 class=xl150>Alasan Pemeriksaan :</td>
                    <td class=xl121>&nbsp;</td>
                    <td class=xl84>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl89>&nbsp;</td>
                    <td colspan=15 class=xl85 style='border-right:.5pt solid black'>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl77>
                        @php
                            if (isset($data['id_alasanpemeriksaan']) && $data['id_alasanpemeriksaan'] == 'Diagnosis TBS'){
                                $d2 = '&nbsp;';
                                $d1 = '&#8730;';
                                $d3 = '&nbsp;';
                            } else if (isset($data['id_alasanpemeriksaan']) && $data['id_alasanpemeriksaan'] == 'Diagnosis Baseline TBC'){
                                $d1 = '&nbsp;';
                                $d2 = '&#8730;';
                                $d3 = '&nbsp;';
                            } else {
                                $d1 = '&nbsp;';
                                $d3 = '&#8730;';
                                $d2 = '&nbsp;';
                            }
                            echo $d1;
                        @endphp
                    </td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=12 class=xl70>Diagnosis TBC</td>
                    <td class=xl70>&nbsp;</td>
                    <td class=xl87>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl77>{!! $d2 !!}</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=12 class=xl70>Diagnosis Baseline TBC</td>
                    <td class=xl70>&nbsp;</td>
                    <td class=xl87>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=4 class=xl139 style='border-right:.5pt solid black'>Jenis Pemeriksaan</td>
                    <td class=xl63>&nbsp;</td>
                    <td colspan=11 class=xl139 style='border-right:.5pt solid black'>Lokasi Anatomi</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl77>{!! $d3 !!}</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=12 class=xl70>Akhir Pengobatan</td>
                    <td class=xl70>&nbsp;</td>
                    <td class=xl87>&nbsp;</td>
                </tr>
                @php
                    if (isset($data['id_jenispemeriksaantb']) && $data['id_jenispemeriksaantb'] == 'Mikroskopis'){
                        $j1 = '&#8730;';
                        $j2 = '&nbsp;';
                        $j3 = '&nbsp;';
                        $j4 = '&nbsp;';
                        $j5 = '&nbsp;';
                        $j6 = '&nbsp;';
                        $j7 = '&nbsp;';
                        $j8 = '&nbsp;';
                        $j9 = '&nbsp;';
                        $j10 = '&nbsp;';
                    } else if (isset($data['id_jenispemeriksaantb']) && $data['id_jenispemeriksaantb'] == 'TCM MTB Rif (Xpert)'){
                        $j2 = '&#8730;';
                        $j1 = '&nbsp;';
                        $j3 = '&nbsp;';
                        $j4 = '&nbsp;';
                        $j5 = '&nbsp;';
                        $j6 = '&nbsp;';
                        $j7 = '&nbsp;';
                        $j8 = '&nbsp;';
                        $j9 = '&nbsp;';
                        $j10 = '&nbsp;';
                    } else if (isset($data['id_jenispemeriksaantb']) && $data['id_jenispemeriksaantb'] == 'TCM XDR (Xpert)'){
                        $j3 = '&#8730;';
                        $j2 = '&nbsp;';
                        $j1 = '&nbsp;';
                        $j4 = '&nbsp;';
                        $j5 = '&nbsp;';
                        $j6 = '&nbsp;';
                        $j7 = '&nbsp;';
                        $j8 = '&nbsp;';
                        $j9 = '&nbsp;';
                        $j10 = '&nbsp;';
                    } else if (isset($data['id_jenispemeriksaantb']) && $data['id_jenispemeriksaantb'] == 'TCM MTB Rif (Truenat)'){
                        $j4 = '&#8730;';
                        $j2 = '&nbsp;';
                        $j3 = '&nbsp;';
                        $j1 = '&nbsp;';
                        $j5 = '&nbsp;';
                        $j6 = '&nbsp;';
                        $j7 = '&nbsp;';
                        $j8 = '&nbsp;';
                        $j9 = '&nbsp;';
                        $j10 = '&nbsp;';
                    } else if (isset($data['id_jenispemeriksaantb']) && $data['id_jenispemeriksaantb'] == 'TCM MTB Rif INH (BDMAX)'){
                        $j5 = '&#8730;';
                        $j2 = '&nbsp;';
                        $j3 = '&nbsp;';
                        $j4 = '&nbsp;';
                        $j1 = '&nbsp;';
                        $j6 = '&nbsp;';
                        $j7 = '&nbsp;';
                        $j8 = '&nbsp;';
                        $j9 = '&nbsp;';
                        $j10 = '&nbsp;';
                    } else if (isset($data['id_jenispemeriksaantb']) && $data['id_jenispemeriksaantb'] == 'PCR Open System'){
                        $j6 = '&#8730;';
                        $j2 = '&nbsp;';
                        $j3 = '&nbsp;';
                        $j4 = '&nbsp;';
                        $j5 = '&nbsp;';
                        $j1 = '&nbsp;';
                        $j7 = '&nbsp;';
                        $j8 = '&nbsp;';
                        $j9 = '&nbsp;';
                        $j10 = '&nbsp;';
                    } else if (isset($data['id_jenispemeriksaantb']) && $data['id_jenispemeriksaantb'] == 'LPA lini 1'){
                        $j7 = '&#8730;';
                        $j2 = '&nbsp;';
                        $j3 = '&nbsp;';
                        $j4 = '&nbsp;';
                        $j5 = '&nbsp;';
                        $j6 = '&nbsp;';
                        $j1 = '&nbsp;';
                        $j8 = '&nbsp;';
                        $j9 = '&nbsp;';
                        $j10 = '&nbsp;';
                    }  else if (isset($data['id_jenispemeriksaantb']) && $data['id_jenispemeriksaantb'] == 'LPA lini 2'){
                        $j8 = '&#8730;';
                        $j2 = '&nbsp;';
                        $j3 = '&nbsp;';
                        $j4 = '&nbsp;';
                        $j5 = '&nbsp;';
                        $j6 = '&nbsp;';
                        $j7 = '&nbsp;';
                        $j1 = '&nbsp;';
                        $j9 = '&nbsp;';
                        $j10 = '&nbsp;';
                    }  else if (isset($data['id_jenispemeriksaantb']) && $data['id_jenispemeriksaantb'] == 'Biakan'){
                        $j9 = '&#8730;';
                        $j2 = '&nbsp;';
                        $j3 = '&nbsp;';
                        $j4 = '&nbsp;';
                        $j5 = '&nbsp;';
                        $j6 = '&nbsp;';
                        $j7 = '&nbsp;';
                        $j8 = '&nbsp;';
                        $j1 = '&nbsp;';
                        $j10 = '&nbsp;';
                    } else {
                        $j10 = '&#8730;';
                        $j2 = '&nbsp;';
                        $j3 = '&nbsp;';
                        $j4 = '&nbsp;';
                        $j5 = '&nbsp;';
                        $j6 = '&nbsp;';
                        $j7 = '&nbsp;';
                        $j8 = '&nbsp;';
                        $j9 = '&nbsp;';
                        $j1 = '&nbsp;';
                    }
                    if (isset($data['tekslokasianatomi']) && $data['tekslokasianatomi'] != ''){
                        $p2 = '&#8730;';
                        $p1 = '&nbsp;';
                    } else {
                        $p1 = '&#8730;';
                        $p2 = '&nbsp;';
                    }
                @endphp
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl77>{!! $j1 !!}</td>
                    <td colspan=2 class=xl70 style='border-right:.5pt solid black'>Mikroskopis</td>
                    <td class=xl70>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl77>{!! $p1 !!}</td>
                    <td colspan=9 class=xl82 style='border-right:.5pt solid black;border-left: none'>Paru</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=16 class=xl82>Pemantauan kemajuan pengobatan (Follow up)</td>
                    <td class=xl70>&nbsp;</td>
                    <td class=xl87>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl77>{!! $j2 !!}</td>
                    <td colspan=2 class=xl70 style='border-right:.5pt solid black'>TCM MTB Rif (Xpert)</td>
                    <td class=xl70>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl77>{!! $p2 !!}</td>
                    <td colspan=9 class=xl82 style='border-right:.5pt solid black;border-left: none'>Ekstraparu</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=5 class=xl149>Bulan ke :</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl77>{!! $data['id_bulankemajuantbfollow'] ?? '' !!}</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl87>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl77>{!! $j3 !!}</td>
                    <td colspan=2 class=xl70 style='border-right:.5pt solid black'>TCM CDR (Xpert)</td>
                    <td class=xl70>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=3 class=xl70>Lokasi :</td>
                    <td colspan=6 class=xl70 style='border-right:.5pt solid black'>{!! $data['id_ekstraparu'] ?? '' !!}</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=16 class=xl82>Pemeriksaan ulang ke- :</td>
                    <td class=xl70>&nbsp;</td>
                    <td class=xl87>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl77>{!! $j4 !!}</td>
                    <td colspan=2 class=xl70 style='border-right:.5pt solid black'>TCM MTB Rif (Truenant)</td>
                    <td class=xl70>&nbsp;</td>
                    <td class=xl89>&nbsp;</td>
                    <td class=xl90>&nbsp;</td>
                    <td class=xl90>&nbsp;</td>
                    <td class=xl90>&nbsp;</td>
                    <td class=xl90>&nbsp;</td>
                    <td class=xl90>&nbsp;</td>
                    <td class=xl90>&nbsp;</td>
                    <td class=xl90>&nbsp;</td>
                    <td class=xl90>&nbsp;</td>
                    <td class=xl90>&nbsp;</td>
                    <td class=xl91>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=5 class=xl149>Bulan ke :</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl77>{!! $data['id_bulanpemeriksaanulang'] ?? '' !!}</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl87>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl77>{!! $j5 !!}</td>
                    <td colspan=2 class=xl70 style='border-right:.5pt solid black'>TCM (MTB (Rif INH (BDMAX)</td>
                    <td class=xl70>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=16 class=xl82>Pemeriksaan setelah selesai pengobatan :</td>
                    <td class=xl70>&nbsp;</td>
                    <td class=xl87>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl77>{!! $j6 !!}</td>
                    <td colspan=2 class=xl70 style='border-right:.5pt solid black'>PCR Open System</td>
                    <td class=xl70>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=5 class=xl149>Bulan ke :</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl77>{!! $data['id_bulanpemeriksaansetelahselesai'] ?? '' !!}</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl87>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl77>{!! $j7 !!}</td>
                    <td colspan=2 class=xl70 style='border-right:.5pt solid black'>LPA lini 1</td>
                    <td class=xl70>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=11 class=xl145>No. Reg. TBC/TBC RO Fasyankes</td>
                    <td class=xl64>:</td>
                    <td colspan=6 class=xl98 style='border-right:.5pt solid black'>{!! $data['id_noregfasyankes'] ?? '' !!}</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl77>{!! $j8 !!}</td>
                    <td colspan=2 class=xl70 style='border-right:.5pt solid black'>LPA lini 2</td>
                    <td class=xl70>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=11 class=xl146>No. Reg. TBC/TBC RO Kota</td>
                    <td class=xl90>:</td>
                    <td colspan=6 class=xl147 style='border-right:.5pt solid black'>{!! $data['id_noregkota'] ?? '' !!}</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl77>{!! $j9 !!}</td>
                    <td colspan=2 class=xl70 style='border-right:.5pt solid black'>Biakan</td>
                    <td class=xl70>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl77>{!! $j10 !!}</td>
                    <td colspan=2 class=xl70 style='border-right:.5pt solid black'>Paket standar uji kepekaan</td>
                    <td class=xl70>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                </tr>
                <tr height=3 style='mso-height-source:userset;height:2.0pt'>
                    <td height=3 class=xl64 style='height:2.0pt'>&nbsp;</td>
                    <td class=xl89>&nbsp;</td>
                    <td class=xl90>&nbsp;</td>
                    <td class=xl90>&nbsp;</td>
                    <td class=xl91>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=30 class=xl92>Secara visual dahak tampak (berilah tanda V pada kotak)</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=3 class=xl139 style='border-right:.5pt solid black'>Contoh Uji</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl93>&nbsp;</td>
                    <td class=xl94>&nbsp;</td>
                    <td class=xl94>&nbsp;</td>
                    <td class=xl94>&nbsp;</td>
                    <td class=xl94>&nbsp;</td>
                    <td class=xl94>&nbsp;</td>
                    <td class=xl94>&nbsp;</td>
                    <td class=xl94>&nbsp;</td>
                    <td class=xl84>&nbsp;</td>
                    <td class=xl93>&nbsp;</td>
                    <td colspan=5 class=xl75>Nanah lendir</td>
                    <td class=xl84>&nbsp;</td>
                    <td class=xl93>&nbsp;</td>
                    <td colspan=5 class=xl75>Bercak darah</td>
                    <td class=xl84>&nbsp;</td>
                    <td class=xl93>&nbsp;</td>
                    <td colspan=5 class=xl75>Air Liur</td>
                    <td class=xl84>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl77>
                        @if (isset($data['id_contohuji']) && $data['id_contohuji'] == 'Dahak')
                            &#8730;
                        @else
                            &nbsp;
                        @endif
                    </td>
                    <td class=xl87>Dahak</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=8 class=xl82>Sewaktu / Pagi</td>
                    <td class=xl87>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td colspan=5 class=xl95 style='border-right:.5pt solid black'>
                        @if (isset($data['inlineCheckbox6']) && $data['inlineCheckbox6'] != '')
                            &#8730;
                        @else
                            &nbsp;
                        @endif
                    </td>
                    <td class=xl87>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td colspan=5 class=xl95 style='border-right:.5pt solid black'>
                        @if (isset($data['inlineCheckbox7']) && $data['inlineCheckbox7'] != '')
                            &#8730;
                        @else
                            &nbsp;
                        @endif
                    </td>
                    <td class=xl87>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td colspan=5 class=xl95 style='border-right:.5pt solid black'>
                        @if (isset($data['inlineCheckbox8']) && $data['inlineCheckbox8'] != '')
                            &#8730;
                        @else
                            &nbsp;
                        @endif
                    </td>
                    <td class=xl87>&nbsp;</td>
                </tr>
                <tr height=3 style='mso-height-source:userset;height:2.0pt'>
                    <td height=3 class=xl64 style='height:2.0pt'></td>
                    <td class=xl88></td>
                    <td class=xl71></td>
                    <td class=xl87></td>
                    <td class=xl64></td>
                    <td class=xl64></td>
                    <td class=xl82></td>
                    <td class=xl70></td>
                    <td class=xl70></td>
                    <td class=xl70></td>
                    <td class=xl70></td>
                    <td class=xl70></td>
                    <td class=xl70></td>
                    <td class=xl70></td>
                    <td class=xl87></td>
                    <td class=xl88></td>
                    <td class=xl64></td>
                    <td class=xl64></td>
                    <td class=xl71></td>
                    <td class=xl71></td>
                    <td class=xl71></td>
                    <td class=xl81></td>
                    <td class=xl102></td>
                    <td class=xl64></td>
                    <td class=xl64></td>
                    <td class=xl64></td>
                    <td class=xl71></td>
                    <td class=xl71></td>
                    <td class=xl81></td>
                    <td class=xl88></td>
                    <td class=xl64></td>
                    <td class=xl64></td>
                    <td class=xl71></td>
                    <td class=xl71></td>
                    <td class=xl71></td>
                    <td class=xl81></td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl77>
                        @if (isset($data['id_contohuji']) && $data['id_contohuji'] != 'Dahak')
                            &#8730;
                        @else
                            &nbsp;
                        @endif
                    </td>
                    <td class=xl87>Lainnya : {!! $data['id_contohujilainnya'] ?? '' !!}</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=8 class=xl82>Sewaktu / Pagi</td>
                    <td class=xl87>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td colspan=5 class=xl95 style='border-right:.5pt solid black'>
                        @if (isset($data['inlineCheckbox9']) && $data['inlineCheckbox9'] != '')
                            &#8730;
                        @else
                            &nbsp;
                        @endif
                    </td>
                    <td class=xl87>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td colspan=5 class=xl95 style='border-right:.5pt solid black'>
                        @if (isset($data['inlineCheckbox10']) && $data['inlineCheckbox10'] != '')
                            &#8730;
                        @else
                            &nbsp;
                        @endif
                    </td>
                    <td class=xl81>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td colspan=5 class=xl95 style='border-right:.5pt solid black'>
                        @if (isset($data['inlineCheckbox11']) && $data['inlineCheckbox11'] != '')
                            &#8730;
                        @else
                            &nbsp;
                        @endif
                    </td>
                    <td class=xl81>&nbsp;</td>
                </tr>
                <tr height=3 style='mso-height-source:userset;height:2.0pt'>
                    <td height=3 class=xl64 style='height:2.0pt'></td>
                    <td class=xl89></td>
                    <td class=xl90></td>
                    <td class=xl91></td>
                    <td class=xl64></td>
                    <td class=xl64></td>
                    <td class=xl89></td>
                    <td class=xl90></td>
                    <td class=xl90></td>
                    <td class=xl90></td>
                    <td class=xl90></td>
                    <td class=xl90></td>
                    <td class=xl90></td>
                    <td class=xl90></td>
                    <td class=xl91></td>
                    <td class=xl89></td>
                    <td class=xl90></td>
                    <td class=xl90></td>
                    <td class=xl90></td>
                    <td class=xl90></td>
                    <td class=xl90></td>
                    <td class=xl91></td>
                    <td class=xl89></td>
                    <td class=xl90></td>
                    <td class=xl90></td>
                    <td class=xl90></td>
                    <td colspan=3 class=xl85 style='border-right:.5pt solid black'></td>
                    <td class=xl89></td>
                    <td class=xl90></td>
                    <td class=xl90></td>
                    <td colspan=4 class=xl85 style='border-right:.5pt solid black'></td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=30 class=xl121>* Lingkari yang sesuai</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=10 class=xl71>Malang, {{$tanggal}}</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=10 class=xl71>{{$periksa->klinisi}}</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=34 class=xl63>HASIL PEMERIKSAAN BAKTERIOLOGIS TBC</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td class=xl64 colspan=12 style='mso-ignore:colspan'>No. Register Lab. (sesuai Buku Register Lab TBC.04) : .....</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                </tr>
                <tr height=3 style='mso-height-source:userset;height:2.0pt'>
                    <td height=3 class=xl64 style='height:2.0pt'>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td colspan=34 class=xl63>&nbsp;</td>
                </tr>
                <tr style='mso-height-source:userset;height:50.0pt'>
                    <td class=xl64 style='height:50.0pt'>&nbsp;</td>
                    <td colspan=3 class=xl106 style='border-right:.5pt solid black'>Contoh uji *)</td>
                    <td colspan=4 class=xl109 width=89 style='border-right:.5pt solid black;border-left:none;width:66pt'>Tanggal Hasil Dilaporkan</td>
                    <td colspan=28 class=xl106 style='border-right:.5pt solid black;border-left:none'>Hasil Pemeriksaan Mikroskopis (BTA/lainnya) **)</td>
                </tr>
                <tr style='mso-height-source:userset;height:16.0pt'>
                    <td class=xl64 style='height:16.0pt'>&nbsp;</td>
                    <td class=xl74>&nbsp;</td>
                    <td class=xl78>&nbsp;</td>
                    <td class=xl79>&nbsp;</td>
                    <td colspan=4 rowspan=6 class=xl113 style='border-right:.5pt solid black;border-bottom:.5pt solid black'>{!! $data['hasilpemeriksaantbbiakan_tgl'] ?? '' !!}</td>
                    <td class=xl116>&nbsp;</td>
                    <td class=xl116>&nbsp;</td>
                    <td colspan=3 class=xl123>+++</td>
                    <td class=xl116>&nbsp;</td>
                    <td class=xl116>&nbsp;</td>
                    <td colspan=3 class=xl124>++</td>
                    <td class=xl116>&nbsp;</td>
                    <td class=xl116>&nbsp;</td>
                    <td colspan=3 class=xl124>+</td>
                    <td class=xl116>&nbsp;</td>
                    <td class=xl116>&nbsp;</td>
                    <td colspan=3 class=xl124>1-9 ***)</td>
                    <td class=xl116>&nbsp;</td>
                    <td class=xl116>&nbsp;</td>
                    <td colspan=3 class=xl124>Neg</td>
                    <td class=xl125>&nbsp;</td>
                    <td class=xl123>&nbsp;</td>
                    <td class=xl117>&nbsp;</td>
                </tr>
                <tr style='mso-height-source:userset;height:16.0pt'>
                    <td class=xl64 style='height:16.0pt'>&nbsp;</td>
                    <td class=xl102>&nbsp;</td>
                    <td class=xl77>{!! $data['hasilpemeriksaantbbiakan_mikroskopispagi'] ?? '' !!}</td>
                    <td class=xl87>Pagi</td>
                    <td class=xl116>&nbsp;</td>
                    <td class=xl116>&nbsp;</td>
                    <td colspan=3 class=xl126 style='border-right:.5pt solid black'>
                        @if (isset($data['inlineCheckbox12']) && $data['inlineCheckbox12'] != '')
                            &#8730;
                        @else
                            &nbsp;
                        @endif
                    </td>
                    <td class=xl116>&nbsp;</td>
                    <td class=xl116>&nbsp;</td>
                    <td colspan=3 class=xl126 style='border-right:.5pt solid black'>
                        @if (isset($data['inlineCheckbox13']) && $data['inlineCheckbox13'] != '')
                            &#8730;
                        @else
                            &nbsp;
                        @endif
                    </td>
                    <td class=xl116>&nbsp;</td>
                    <td class=xl116>&nbsp;</td>
                    <td colspan=3 class=xl126 style='border-right:.5pt solid black'>
                        @if (isset($data['inlineCheckbox14']) && $data['inlineCheckbox14'] != '')
                            &#8730;
                        @else
                            &nbsp;
                        @endif
                    </td>
                    <td class=xl116>&nbsp;</td>
                    <td class=xl116>&nbsp;</td>
                    <td colspan=3 class=xl129 style='border-right:.5pt solid black'>
                        @if (isset($data['inlineCheckbox15']) && $data['inlineCheckbox15'] != '')
                            &#8730;
                        @else
                            &nbsp;
                        @endif
                    </td>
                    <td class=xl116>&nbsp;</td>
                    <td class=xl116>&nbsp;</td>
                    <td colspan=3 class=xl126 style='border-right:.5pt solid black'>
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                    <td class=xl125>&nbsp;</td>
                    <td class=xl123>&nbsp;</td>
                    <td class=xl117>&nbsp;</td>
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                <tr height=3 style='mso-height-source:userset;height:2.0pt'>
                    <td height=3 class=xl64 style='height:2.0pt'></td>
                    <td class=xl102></td>
                    <td class=xl63></td>
                    <td class=xl101></td>
                    <td class=xl118></td>
                    <td class=xl119></td>
                    <td class=xl119></td>
                    <td class=xl119></td>
                    <td class=xl132></td>
                    <td class=xl132></td>
                    <td class=xl119></td>
                    <td class=xl119></td>
                    <td class=xl119></td>
                    <td class=xl132></td>
                    <td class=xl132></td>
                    <td class=xl119></td>
                    <td class=xl119></td>
                    <td class=xl119></td>
                    <td class=xl132></td>
                    <td class=xl132></td>
                    <td class=xl119></td>
                    <td class=xl119></td>
                    <td class=xl119></td>
                    <td class=xl133></td>
                    <td class=xl132></td>
                    <td class=xl119></td>
                    <td class=xl119></td>
                    <td class=xl119></td>
                    <td class=xl132></td>
                    <td class=xl132></td>
                    <td class=xl132></td>
                    <td class=xl120></td>
                </tr>
                <tr height=3 style='mso-height-source:userset;height:2.0pt'>
                    <td height=3 class=xl64 style='height:2.0pt'></td>
                    <td class=xl102></td>
                    <td class=xl63></td>
                    <td class=xl101></td>
                    <td class=xl116></td>
                    <td class=xl116></td>
                    <td class=xl116></td>
                    <td class=xl116></td>
                    <td class=xl123></td>
                    <td class=xl123></td>
                    <td class=xl116></td>
                    <td class=xl116></td>
                    <td class=xl116></td>
                    <td class=xl123></td>
                    <td class=xl123></td>
                    <td class=xl116></td>
                    <td class=xl116></td>
                    <td class=xl116></td>
                    <td class=xl123></td>
                    <td class=xl123></td>
                    <td class=xl116></td>
                    <td class=xl116></td>
                    <td class=xl116></td>
                    <td class=xl134></td>
                    <td class=xl123></td>
                    <td class=xl116></td>
                    <td class=xl116></td>
                    <td class=xl116></td>
                    <td class=xl123></td>
                    <td class=xl123></td>
                    <td class=xl123></td>
                    <td class=xl117></td>
                </tr>
                <tr style='mso-height-source:userset;height:16.0pt'>
                    <td class=xl64 style='height:16.0pt'>&nbsp;</td>
                    <td class=xl102>&nbsp;</td>
                    <td class=xl77>{!! $data['hasilpemeriksaantbbiakan_mikroskopisswaktu'] ?? '' !!}</td>
                    <td class=xl87>Sewaktu / Pagi</td>
                    <td class=xl116>&nbsp;</td>
                    <td class=xl116>&nbsp;</td>
                    <td colspan=3 class=xl126 style='border-right:.5pt solid black'>
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                    <td class=xl116>&nbsp;</td>
                    <td colspan=3 class=xl126 style='border-right:.5pt solid black'>
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                    <td class=xl116>&nbsp;</td>
                    <td class=xl116>&nbsp;</td>
                    <td colspan=3 class=xl126 style='border-right:.5pt solid black'>
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                    <td colspan=3 class=xl129 style='border-right:.5pt solid black'>
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                    <td class=xl116>&nbsp;</td>
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                    <td class=xl125>&nbsp;</td>
                    <td class=xl123>&nbsp;</td>
                    <td class=xl117>&nbsp;</td>
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                <tr height=3 style='mso-height-source:userset;height:2.0pt'>
                    <td height=3 class=xl64 style='height:2.0pt'></td>
                    <td class=xl103></td>
                    <td class=xl90></td>
                    <td class=xl91></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl136></td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=34 class=xl63>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td class=xl64 colspan=12 style='mso-ignore:colspan'>No. Register Lab. (sesuai Buku Register Lab TBC.04) : ...</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                </tr>
                <tr height=3 style='mso-height-source:userset;height:2.0pt'>
                    <td height=3 class=xl64 style='height:2.0pt'>&nbsp;</td>
                    <td class=xl71>&nbsp;</td>
                    <td colspan=34 class=xl63>&nbsp;</td>
                </tr>
                <tr style='mso-height-source:userset;height:50.0pt'>
                    <td class=xl64 style='height:50.0pt'>&nbsp;</td>
                    <td colspan=3 class=xl106 style='border-right:.5pt solid black'>Contoh uji *)</td>
                    <td colspan=4 class=xl109 width=89 style='border-right:.5pt solid black; border-left:none;width:66pt'>Tanggal Hasil Dilaporkan</td>
                    <td colspan=3 class=xl109 width=60 style='border-right:.5pt solid black; border-left:none;width:45pt'>Metode Uji</td>
                    <td colspan=25 class=xl106 style='border-right:.5pt solid black;border-left: none'>Hasil Pemeriksaan Mikroskopis (BTA/lainnya) **)</td>
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                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=3 class=xl74 style='border-right:.5pt solid black'>&nbsp;</td>
                    <td colspan=4 rowspan=7 class=xl112 style='border-right:.5pt solid black; border-bottom:.5pt solid black'>{!! $data['hasilpemeriksaantbbiakan_tglbiakan'] ?? '' !!}</td>
                    <td colspan=3 rowspan=2 class=xl112 style='border-right:.5pt solid black'>MGIT</td>
                    <td class=xl112 style='border-top:none;border-left:none'>&nbsp;</td>
                    <td colspan=3 class=xl124>Pos</td>
                    <td class=xl113>&nbsp;</td>
                    <td class=xl113>&nbsp;</td>
                    <td colspan=3 class=xl124>Neg</td>
                    <td class=xl113>&nbsp;</td>
                    <td class=xl113>&nbsp;</td>
                    <td colspan=3 class=xl124>NTM</td>
                    <td class=xl113>&nbsp;</td>
                    <td class=xl113>&nbsp;</td>
                    <td colspan=3 class=xl124>KTM</td>
                    <td class=xl113>&nbsp;</td>
                    <td class=xl113>&nbsp;</td>
                    <td colspan=3 class=xl124>TDL</td>
                    <td class=xl114>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl102>&nbsp;</td>
                    <td class=xl77>{!! $data['hasilpemeriksaantbbiakan_mgitpagi'] ?? '' !!}</td>
                    <td class=xl87>Pagi</td>
                    <td class=xl115>&nbsp;</td>
                    <td colspan=3 class=xl126 style='border-right:.5pt solid black'>
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                    <td class=xl116>&nbsp;</td>
                    <td class=xl116>&nbsp;</td>
                    <td colspan=3 class=xl126 style='border-right:.5pt solid black'>
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                    <td class=xl116>&nbsp;</td>
                    <td class=xl116>&nbsp;</td>
                    <td colspan=3 class=xl126 style='border-right:.5pt solid black'>
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                    <td class=xl116>&nbsp;</td>
                    <td class=xl116>&nbsp;</td>
                    <td colspan=3 class=xl129 style='border-right:.5pt solid black'>
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                    <td class=xl116>&nbsp;</td>
                    <td colspan=3 class=xl126 style='border-right:.5pt solid black'>
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                    <td class=xl117>&nbsp;</td>
                </tr>
                <tr height=3 style='mso-height-source:userset;height:2.0pt'>
                    <td height=3 class=xl64 style='height:2.0pt'></td>
                    <td class=xl88></td>
                    <td class=xl64></td>
                    <td class=xl87></td>
                    <td colspan=3 class=xl104 style='border-right:.5pt solid black;border-left:none'></td>
                    <td class=xl118></td>
                    <td class=xl132></td>
                    <td class=xl132></td>
                    <td class=xl119></td>
                    <td class=xl119></td>
                    <td class=xl119></td>
                    <td class=xl132></td>
                    <td class=xl132></td>
                    <td class=xl119></td>
                    <td class=xl119></td>
                    <td class=xl119></td>
                    <td class=xl132></td>
                    <td class=xl132></td>
                    <td class=xl119></td>
                    <td class=xl119></td>
                    <td class=xl119></td>
                    <td class=xl133></td>
                    <td class=xl132></td>
                    <td class=xl119></td>
                    <td class=xl119></td>
                    <td class=xl119></td>
                    <td class=xl132></td>
                    <td class=xl132></td>
                    <td class=xl132></td>
                    <td class=xl120></td>
                </tr>
                <tr height=3 style='mso-height-source:userset;height:2.0pt'>
                    <td height=3 class=xl64 style='height:2.0pt'></td>
                    <td class=xl88></td>
                    <td class=xl64></td>
                    <td class=xl87></td>
                    <td class=xl63></td>
                    <td class=xl63></td>
                    <td class=xl63></td>
                    <td class=xl112></td>
                    <td class=xl124></td>
                    <td class=xl124></td>
                    <td class=xl113></td>
                    <td class=xl113></td>
                    <td class=xl113></td>
                    <td class=xl124></td>
                    <td class=xl124></td>
                    <td class=xl113></td>
                    <td class=xl113></td>
                    <td class=xl113></td>
                    <td class=xl124></td>
                    <td class=xl124></td>
                    <td class=xl113></td>
                    <td class=xl113></td>
                    <td class=xl113></td>
                    <td class=xl137></td>
                    <td class=xl124></td>
                    <td class=xl113></td>
                    <td class=xl113></td>
                    <td class=xl113></td>
                    <td class=xl124></td>
                    <td class=xl124></td>
                    <td class=xl124></td>
                    <td class=xl114></td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl87>&nbsp;</td>
                    <td colspan=3 rowspan=3 class=xl115 style='border-right:.5pt solid black;border-bottom:.5pt solid black'>LJ</td>
                    <td class=xl115>&nbsp;</td>
                    <td colspan=2 class=xl123>3+</td>
                    <td class=xl116>&nbsp;</td>
                    <td colspan=2 class=xl123>2+</td>
                    <td class=xl125>&nbsp;</td>
                    <td colspan=2 class=xl123>1+</td>
                    <td class=xl116>&nbsp;</td>
                    <td colspan=2 class=xl123>1-9 ***)</td>
                    <td class=xl125>&nbsp;</td>
                    <td colspan=2 class=xl123>Neg</td>
                    <td class=xl116>&nbsp;</td>
                    <td colspan=2 class=xl123>NTM</td>
                    <td class=xl116>&nbsp;</td>
                    <td colspan=2 class=xl123>KTM</td>
                    <td class=xl125>&nbsp;</td>
                    <td colspan=2 class=xl123>TDL</td>
                    <td class=xl117>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl88>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl87>&nbsp;</td>
                    <td class=xl115>&nbsp;</td>
                    <td colspan=2 class=xl126 style='border-right:.5pt solid black'>
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                    <td class=xl116>&nbsp;</td>
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                        @if (isset($data['inlineCheckbox28']) && $data['inlineCheckbox28'] != '')
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                    <td class=xl125>&nbsp;</td>
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                        @if (isset($data['inlineCheckbox29']) && $data['inlineCheckbox29'] != '')
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                            &nbsp;
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                    <td class=xl116>&nbsp;</td>
                    <td colspan=2 class=xl129 style='border-right:.5pt solid black'>
                        @if (isset($data['inlineCheckbox30']) && $data['inlineCheckbox30'] != '')
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                    <td class=xl125>&nbsp;</td>
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                    <td class=xl116>&nbsp;</td>
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                        @if (isset($data['inlineCheckbox32']) && $data['inlineCheckbox32'] != '')
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                            &nbsp;
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                    <td class=xl116>&nbsp;</td>
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                        @if (isset($data['inlineCheckbox33']) && $data['inlineCheckbox33'] != '')
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                            &nbsp;
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                    <td class=xl125>&nbsp;</td>
                    <td colspan=2 class=xl126 style='border-right:.5pt solid black'>
                        @if (isset($data['inlineCheckbox34']) && $data['inlineCheckbox34'] != '')
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                            &nbsp;
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                    <td class=xl117>&nbsp;</td>
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                <tr height=3 style='mso-height-source:userset;height:2.0pt'>
                    <td height=3 class=xl64 style='height:2.0pt'></td>
                    <td class=xl89></td>
                    <td class=xl90></td>
                    <td class=xl91></td>
                    <td class=xl138></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl135></td>
                    <td class=xl136></td>
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                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=34 class=xl63>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=12 class=xl70>Mengetahui</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=21 class=xl70>Tanda tangan pemeriksa</td>
                    <td colspan=12 class=xl70>Dokter PJ pemeriksaan Lab</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=21 class=xl98><!-- $ttdexecutor -->&nbsp;</td>
                    <td colspan=12 class=xl98>{!! $tandatangan !!}</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=21 class=xl70>{{ $periksa->nmanalis }}</td>
                    <td colspan=12 class=xl70>{!! $periksa->nmdokter !!}</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td colspan=34 class=xl63>&nbsp;</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>*)</td>
                    <td colspan=33 class=xl70>Diisi sesuai dengan kode huruf sesuai identitas sediaan/waktu pengambilan dahak</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>**)</td>
                    <td colspan=33 class=xl70>Hasil pemeriksaan Mikroskopis, TCM dan Biakan : beri tanda rumput pada hasil pemeriksaan yang sesuai</td>
                </tr>
                <tr>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl64>&nbsp;</td>
                    <td class=xl99>****)</td>
                    <td colspan=33>Isi dengan jumlah BTA (misalnya 2 BTA, 7 BTA) / koloni yang ditemukan</td>
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                    <td width=168 style='width:126pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=20 style='width:15pt'>&nbsp;</td>
                    <td width=20 style='width:15pt'>&nbsp;</td>
                    <td width=20 style='width:15pt'>&nbsp;</td>
                    <td width=20 style='width:15pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
                    <td width=23 style='width:17pt'>&nbsp;</td>
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