{"id":61,"date":"2025-09-16T08:39:52","date_gmt":"2025-09-16T08:39:52","guid":{"rendered":"http:\/\/hia2.shiftproduction.info\/?page_id=61"},"modified":"2025-09-16T08:57:15","modified_gmt":"2025-09-16T08:57:15","slug":"data","status":"publish","type":"page","link":"https:\/\/hia2.shiftproduction.info\/en\/data","title":{"rendered":"Data"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"61\" class=\"elementor elementor-61\">\n\t\t\t\t<div class=\"elementor-element elementor-element-cc42e51 e-con-full e-flex e-con e-parent\" data-id=\"cc42e51\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-a78c59d elementor-widget elementor-widget-shortcode\" data-id=\"a78c59d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"> \n\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form\" id=\"form_contact-form\" novalidate>\n    <!-- Required Formidable Fields -->\n <input type=\"hidden\" name=\"frm_action\" value=\"create\">\n    <input type=\"hidden\" name=\"form_id\" value=\"1\">\n    <input type=\"hidden\" name=\"form_key\" value=\"contact-form\">\n    <input type=\"hidden\" name=\"item_key\" value=\"\">\n    <input type=\"hidden\" name=\"frm_submit_entry_1\" value=\"21923f8bcd\">\n    <input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-admin\/admin-ajax.php?action=frm_forms_preview&form=contact-form\">\n    <div class=\"yourData\">\n        <div class=\"container\">\n            <div class=\"top\">\n                <h1 class=\"title\">\u0627\u062f\u062e\u0644 \u0645\u0639\u0644\u0648\u0645\u0627\u062a\u0643 \u0627\u0644\u0627\u0633\u0627\u0633\u064a\u0629 \u0644\u0644\u0628\u062f\u0621 \u0648\u0645\u0639\u0631\u0641\u0629 \u062d\u0642\u0648\u0642\u0643 \u0627\u0644\u0635\u062d\u064a\u064e\u0651\u0629<\/h1>\n                <h2 class=\"subtitle\">\u0642\u0645 \u0628\u0627\u062f\u062e\u0627\u0644 \u0628\u064a\u0627\u0646\u0627\u062a\u0643 \u0627\u0644\u0634\u062e\u0635\u064a\u0629 \u0648\u0627\u0639\u0631\u0641 \u062d\u0642\u0648\u0642\u0643.<\/h2>\n            <\/div>\n            <div class=\"box\">\n                <ul class=\"list\">\n                    <li>\n                        <div class=\"inputField\" id=\"phone-field-container\">\n                            <label for=\"field_e9smc\" class=\"custlabel\"> \u0631\u0642\u0645 \u0627\u0644\u0647\u0627\u062a\u0641\n                                <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\n                            <\/label>\n                            <div class=\"field\">\n                                <div class=\"icon\"><img decoding=\"async\" src=\"https:\/\/hia2.shiftproduction.info\/wp-content\/themes\/hia-theme\/images\/phone.svg\" \/><\/div>\n                                <!-- Changed type from number to text and added pattern for validation -->\n                                <input autocomplete=\"off\" required placeholder=\"\u0627\u062f\u062e\u0644 \u0631\u0642\u0645 \u0647\u0627\u062a\u0641\u0643 \u0647\u0646\u0627 (\u064a\u062c\u0628 \u0623\u0646 \u064a\u0628\u062f\u0623 \u0628\u0640 07 \u0648\u064a\u062a\u0643\u0648\u0646 \u0645\u0646 11 \u0631\u0642\u0645\u064b\u0627)....\" id=\"field_e9smc\" type=\"text\" class=\"custinput\" name=\"item_meta[9]\" value=\"\" pattern=\"07[0-9]{9}\" data-reqmsg=\"\u0631\u0642\u0645 \u0627\u0644\u0647\u0627\u062a\u0641 cannot be blank.\" aria-required=\"true\" data-invmsg=\"\u0631\u0642\u0645 \u0627\u0644\u0647\u0627\u062a\u0641 \u064a\u062c\u0628 \u0623\u0646 \u064a\u0628\u062f\u0623 \u0628\u0640 07 \u0648\u064a\u062a\u0643\u0648\u0646 \u0645\u0646 11 \u0631\u0642\u0645\u064b\u0627\" aria-invalid=\"false\" \/>\n                            <\/div>\n                            <div id=\"phone-error\" class=\"error-message\" style=\"color: red; display: none; font-size: 12px; margin-top: 5px;\"><\/div>\n                        <\/div>\n                    <\/li>\n                    <li>\n                        <div class=\"inputField\" id=\"name-field-container\">\n                            <label for=\"field_lgpvt\" class=\"custlabel\"> \u0627\u0644\u0627\u0633\u0645 \u0627\u0644\u0643\u0627\u0645\u0644\n                                <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\n                            <\/label>\n                            <div class=\"field\">\n                                <div class=\"icon\"><img decoding=\"async\" src=\"https:\/\/hia2.shiftproduction.info\/wp-content\/themes\/hia-theme\/images\/user.svg\" \/><\/div>\n                                <input autocomplete=\"off\" required placeholder=\"\u0627\u062f\u062e\u0644 \u0627\u0633\u0645\u0643 \u0647\u0646\u0627....\" id=\"field_lgpvt\" type=\"text\" class=\"custinput\" name=\"item_meta[10]\" value=\"\" data-reqmsg=\"\u0627\u0644\u0627\u0633\u0645 \u0627\u0644\u0643\u0627\u0645\u0644 cannot be blank.\" aria-required=\"true\" data-invmsg=\"\u0627\u0644\u0627\u0633\u0645 \u0627\u0644\u0643\u0627\u0645\u0644 is invalid\" aria-invalid=\"false\" \/>\n                            <\/div>\n                            <div id=\"name-error\" class=\"error-message\" style=\"color: red; display: none; font-size: 12px; margin-top: 5px;\"><\/div>\n                        <\/div>\n                    <\/li>\n                    \n                      <li>\n                        <div class=\"inputField\" id=\"age-field-container\">\n                            <label for=\"field_age\" class=\"custlabel\"> \u0627\u0644\u0639\u0645\u0631  \n                                <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\n                            <\/label>\n                            <div class=\"field\">\n                                <div class=\"icon\"><img decoding=\"async\" src=\"https:\/\/hia2.shiftproduction.info\/wp-content\/themes\/hia-theme\/images\/age-icon.png\" \/><\/div>\n                                <select id=\"field_age\" required class=\"custinput\" autocomplete=\"off\" name=\"item_meta[16]\">\n                                    <option value=\"\" selected disabled style=\"opacity: 0.7;\">\u0627\u062f\u062e\u0644 \u0627\u0644\u0639\u0645\u0631 \u0647\u0646\u0627....<\/option>\n                                    <option value=\"False\">\u0623\u0642\u0644 \u0645\u0646 40 \u0633\u0646\u0629<\/option>\n                                    <option value=\"True\">40 \u0633\u0646\u0629 \u0641\u0645\u0627 \u0641\u0648\u0642<\/option>\n                                <\/select>\n                            <\/div>\n                            <div id=\"age-error\" class=\"error-message\" style=\"color: red; display: none; font-size: 12px; margin-top: 5px;\"><\/div>\n                        <\/div>\n                    <\/li>\n                    \n<li>\n    <div class=\"inputField\" id=\"chronic-disease-field-container\">\n        <label for=\"field_chronic_disease\" class=\"custlabel\">\n            \u0647\u0644 \u0644\u062f\u064a\u0643 \u0645\u0631\u0636 \u0645\u0632\u0645\u0646\u061f\n            <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\n        <\/label>\n        <div class=\"field\">\n            <div class=\"icon\">\n                <img decoding=\"async\" src=\"https:\/\/hia2.shiftproduction.info\/wp-content\/themes\/hia-theme\/images\/health-icon.png?v=1\" \/>\n            <\/div>\n            <select id=\"field_chronic_disease\" required class=\"custinput\" autocomplete=\"off\" name=\"item_meta[17]\">\n                <option value=\"\" selected disabled style=\"opacity: 0.7;\">\u0627\u062e\u062a\u0631 \u0627\u0644\u0625\u062c\u0627\u0628\u0629 \u0647\u0646\u0627...<\/option>\n                <option value=\"False\">\u0644\u0627\u060c \u0644\u064a\u0633 \u0644\u062f\u064a \u0645\u0631\u0636 \u0645\u0632\u0645\u0646<\/option>\n                <option value=\"True\">\u0646\u0639\u0645\u060c \u0644\u062f\u064a \u0645\u0631\u0636 \u0645\u0632\u0645\u0646<\/option>\n            <\/select>\n        <\/div>\n        <div id=\"chronic-error\" class=\"error-message\" style=\"color: red; display: none; font-size: 12px; margin-top: 5px;\"><\/div>\n    <\/div>\n<\/li>\n\n                    \n                    \n                <\/ul>\n                <div class=\"note red\">\n                    <img decoding=\"async\" src=\"https:\/\/hia2.shiftproduction.info\/wp-content\/themes\/hia-theme\/images\/mark.svg\" \/>\n                    \u062a\u064f\u0633\u062a\u062e\u062f\u0645 \u0628\u064a\u0627\u0646\u0627\u062a\u0643 \u0641\u0642\u0637 \u0644\u0644\u062a\u062d\u0642\u0642 \u0645\u0646 \u0634\u0645\u0648\u0644\u0643\u060c \u0648\u0633\u064a\u062a\u0645 \u0627\u0644\u062a\u0639\u0627\u0645\u0644 \u0645\u0639\u0647\u0627 \u0628\u0633\u0631\u064a\u0629 \u062a\u0627\u0645\u0629\n                <\/div>\n            <\/div>\n            <div class=\"caption\">\u0627\u062e\u062a\u0631 \u0627\u0644\u0641\u0626\u0629 \u0627\u0644\u062a\u064a \u062a\u0646\u062a\u0645\u064a \u0625\u0644\u064a\u0647\u0627<\/div>\n            <div class=\"note yellow\">\n                <img decoding=\"async\" src=\"https:\/\/hia2.shiftproduction.info\/wp-content\/themes\/hia-theme\/images\/mark2.svg\" \/>\n                \u064a\u0645\u0643\u0646\u0643 \u0627\u062e\u062a\u064a\u0627\u0631 \u0623\u0643\u062b\u0631 \u0645\u0646 \u0641\u0626\u0629 \u0641\u064a \u062d\u0627\u0644 \u0627\u0646\u0637\u0628\u0642\u062a \u0639\u0644\u064a\u0643\n            <\/div>\n            <div class=\"box\">\n                <ul class=\"categs\" id=\"checkbox-container\">\n                    \n                                        <li>\n                        <div class=\"optionselect\">\n                            <input id=\"field_px29w-0\" type=\"checkbox\" class=\"custcheckbox\" name=\"item_meta[12][]\" value=\"24 | \u0645\u0635\u0627\u0628\u064a \u0627\u0644\u0623\u0645\u0631\u0627\u0636 \u0627\u0644\u062e\u0627\u0635\u0629 (\u0627\u0644\u0633\u0631\u0637\u0627\u0646\u060c \u0627\u0644\u0627\u0645\u0631\u0627\u0636 \u0627\u0644\u0646\u0641\u0633\u064a\u0629 \u0648\u0627\u0644\u0639\u0642\u0644\u064a\u0629\u060c \u0627\u0645\u0631\u0627\u0636 \u0627\u0644\u062f\u0645 \u0627\u0644\u0648\u0631\u0627\u062b\u064a\u0629\u060c \u0639\u062c\u0632 \u0627\u0644\u0643\u0644\u0649 \u0627\u0644\u0645\u0639\u0627\u0644\u062c \u0628\u0627\u0644\u062f\u064a\u0644\u0632\u0629\u060c \u0627\u0644\u0639\u0648\u0642 \u0627\u0644\u0630\u0647\u0646\u064a \u0628\u0645\u0627 \u0641\u064a \u0630\u0644\u0643 \u0627\u0644\u062a\u0648\u062d\u062f)\" data-reqmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 cannot be blank.\" data-invmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 is invalid\" aria-invalid=\"false\" aria-required=\"true\" \/>\n                            <label class=\"custlabel\" for=\"field_px29w-0\">\u0645\u0635\u0627\u0628\u064a \u0627\u0644\u0623\u0645\u0631\u0627\u0636 \u0627\u0644\u062e\u0627\u0635\u0629 (\u0627\u0644\u0633\u0631\u0637\u0627\u0646\u060c \u0627\u0644\u0627\u0645\u0631\u0627\u0636 \u0627\u0644\u0646\u0641\u0633\u064a\u0629 \u0648\u0627\u0644\u0639\u0642\u0644\u064a\u0629\u060c \u0627\u0645\u0631\u0627\u0636 \u0627\u0644\u062f\u0645 \u0627\u0644\u0648\u0631\u0627\u062b\u064a\u0629\u060c \u0639\u062c\u0632 \u0627\u0644\u0643\u0644\u0649 \u0627\u0644\u0645\u0639\u0627\u0644\u062c \u0628\u0627\u0644\u062f\u064a\u0644\u0632\u0629\u060c \u0627\u0644\u0639\u0648\u0642 \u0627\u0644\u0630\u0647\u0646\u064a \u0628\u0645\u0627 \u0641\u064a \u0630\u0644\u0643 \u0627\u0644\u062a\u0648\u062d\u062f)<\/label>\n                        <\/div>\n                    <\/li> \n                    \n                                        <li>\n                        <div class=\"optionselect\">\n                            <input id=\"field_px29w-1\" type=\"checkbox\" class=\"custcheckbox\" name=\"item_meta[12][]\" value=\"25 | \u0630\u0648\u064a \u0627\u0644\u0627\u062d\u062a\u064a\u0627\u062c\u0627\u062a \u0627\u0644\u062e\u0627\u0635\u0629\" data-reqmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 cannot be blank.\" data-invmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 is invalid\" aria-invalid=\"false\" aria-required=\"true\" \/>\n                            <label class=\"custlabel\" for=\"field_px29w-1\">\u0630\u0648\u064a \u0627\u0644\u0627\u062d\u062a\u064a\u0627\u062c\u0627\u062a \u0627\u0644\u062e\u0627\u0635\u0629<\/label>\n                        <\/div>\n                    <\/li> \n                    \n                                        <li>\n                        <div class=\"optionselect\">\n                            <input id=\"field_px29w-2\" type=\"checkbox\" class=\"custcheckbox\" name=\"item_meta[12][]\" value=\"27 | \u064a\u062a\u064a\u0645 \u0627\u0644\u0627\u0628\u0648\u064a\u0646\" data-reqmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 cannot be blank.\" data-invmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 is invalid\" aria-invalid=\"false\" aria-required=\"true\" \/>\n                            <label class=\"custlabel\" for=\"field_px29w-2\">\u064a\u062a\u064a\u0645 \u0627\u0644\u0627\u0628\u0648\u064a\u0646<\/label>\n                        <\/div>\n                    <\/li> \n                    \n                                        <li>\n                        <div class=\"optionselect\">\n                            <input id=\"field_px29w-3\" type=\"checkbox\" class=\"custcheckbox\" name=\"item_meta[12][]\" value=\"26 | \u0645\u0639\u0627\u0642\u0648 \u0627\u0644\u0642\u0648\u0627\u062a \u0627\u0644\u0623\u0645\u0646\u064a\u0629 \u0648\u0627\u0644\u0639\u0633\u0643\u0631\u064a\u0629\" data-reqmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 cannot be blank.\" data-invmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 is invalid\" aria-invalid=\"false\" aria-required=\"true\" \/>\n                            <label class=\"custlabel\" for=\"field_px29w-3\">\u0645\u0639\u0627\u0642\u0648 \u0627\u0644\u0642\u0648\u0627\u062a \u0627\u0644\u0623\u0645\u0646\u064a\u0629 \u0648\u0627\u0644\u0639\u0633\u0643\u0631\u064a\u0629<\/label>\n                        <\/div>\n                    <\/li> \n                    \n                                        <li>\n                        <div class=\"optionselect\">\n                            <input id=\"field_px29w-4\" type=\"checkbox\" class=\"custcheckbox\" name=\"item_meta[12][]\" value=\"23 | \u0627\u0644\u0645\u0634\u0648\u0644\u064a\u0646 \u0628\u0627\u0644\u0631\u0639\u0627\u064a\u0629 \u0627\u0644\u0627\u062c\u062a\u0645\u0627\u0639\u064a\u0629\" data-reqmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 cannot be blank.\" data-invmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 is invalid\" aria-invalid=\"false\" aria-required=\"true\" \/>\n                            <label class=\"custlabel\" for=\"field_px29w-4\">\u0627\u0644\u0645\u0634\u0648\u0644\u064a\u0646 \u0628\u0627\u0644\u0631\u0639\u0627\u064a\u0629 \u0627\u0644\u0627\u062c\u062a\u0645\u0627\u0639\u064a\u0629<\/label>\n                        <\/div>\n                    <\/li> \n                    \n                                        <li>\n                        <div class=\"optionselect\">\n                            <input id=\"field_px29w-5\" type=\"checkbox\" class=\"custcheckbox\" name=\"item_meta[12][]\" value=\"30 | \u0627\u0644\u0623\u0637\u0641\u0627\u0644 \u062f\u0648\u0646 \u0633\u0646 \u0627\u0644\u062e\u0627\u0645\u0633\u0629\" data-reqmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 cannot be blank.\" data-invmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 is invalid\" aria-invalid=\"false\" aria-required=\"true\" \/>\n                            <label class=\"custlabel\" for=\"field_px29w-5\">\u0627\u0644\u0623\u0637\u0641\u0627\u0644 \u062f\u0648\u0646 \u0633\u0646 \u0627\u0644\u062e\u0627\u0645\u0633\u0629<\/label>\n                        <\/div>\n                    <\/li> \n                    \n                                        <li>\n                        <div class=\"optionselect\">\n                            <input id=\"field_px29w-6\" type=\"checkbox\" class=\"custcheckbox\" name=\"item_meta[12][]\" value=\"29 | \u0627\u0644\u0623\u0646\u0627\u062b \u0645\u0646 \u063a\u064a\u0631 \u0627\u0644\u0645\u0648\u0638\u0641\u0627\u062a \u0648\u0627\u0644\u0645\u062a\u0642\u0627\u0639\u062f\u0627\u062a \u0641\u0648\u0642 \u0633\u0646 55\" data-reqmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 cannot be blank.\" data-invmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 is invalid\" aria-invalid=\"false\" aria-required=\"true\" \/>\n                            <label class=\"custlabel\" for=\"field_px29w-6\">\u0627\u0644\u0623\u0646\u0627\u062b \u0645\u0646 \u063a\u064a\u0631 \u0627\u0644\u0645\u0648\u0638\u0641\u0627\u062a \u0648\u0627\u0644\u0645\u062a\u0642\u0627\u0639\u062f\u0627\u062a \u0641\u0648\u0642 \u0633\u0646 55<\/label>\n                        <\/div>\n                    <\/li> \n                    \n                                        <li>\n                        <div class=\"optionselect\">\n                            <input id=\"field_px29w-7\" type=\"checkbox\" class=\"custcheckbox\" name=\"item_meta[12][]\" value=\"28 | \u0627\u0644\u0630\u0643\u0648\u0631 \u0645\u0646 \u063a\u064a\u0631 \u0627\u0644\u0645\u0648\u0638\u0641\u064a\u0646 \u0648\u0627\u0644\u0645\u062a\u0642\u0627\u0639\u062f\u064a\u0646 \u0641\u0648\u0642 \u0633\u0646 60\" data-reqmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 cannot be blank.\" data-invmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 is invalid\" aria-invalid=\"false\" aria-required=\"true\" \/>\n                            <label class=\"custlabel\" for=\"field_px29w-7\">\u0627\u0644\u0630\u0643\u0648\u0631 \u0645\u0646 \u063a\u064a\u0631 \u0627\u0644\u0645\u0648\u0638\u0641\u064a\u0646 \u0648\u0627\u0644\u0645\u062a\u0642\u0627\u0639\u062f\u064a\u0646 \u0641\u0648\u0642 \u0633\u0646 60<\/label>\n                        <\/div>\n                    <\/li> \n                    \n                                        <li>\n                        <div class=\"optionselect\">\n                            <input id=\"field_px29w-8\" type=\"checkbox\" class=\"custcheckbox\" name=\"item_meta[12][]\" value=\"21 | \u0645\u0648\u0638\u0641\u0648 \u0627\u0644\u062f\u0648\u0644\u0629 \u0627\u0644\u0645\u062f\u0646\u064a\u064a\u0646 \u0648\u0627\u0644\u0639\u0633\u0643\u0631\u064a\u0646\" data-reqmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 cannot be blank.\" data-invmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 is invalid\" aria-invalid=\"false\" aria-required=\"true\" \/>\n                            <label class=\"custlabel\" for=\"field_px29w-8\">\u0645\u0648\u0638\u0641\u0648 \u0627\u0644\u062f\u0648\u0644\u0629 \u0627\u0644\u0645\u062f\u0646\u064a\u064a\u0646 \u0648\u0627\u0644\u0639\u0633\u0643\u0631\u064a\u0646<\/label>\n                        <\/div>\n                    <\/li> \n                    \n                                        <li>\n                        <div class=\"optionselect\">\n                            <input id=\"field_px29w-9\" type=\"checkbox\" class=\"custcheckbox\" name=\"item_meta[12][]\" value=\"22 | \u0634\u0631\u064a\u062d\u0629 \u0627\u0644\u0645\u062a\u0642\u0627\u0639\u062f\u064a\u0646\" data-reqmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 cannot be blank.\" data-invmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 is invalid\" aria-invalid=\"false\" aria-required=\"true\" \/>\n                            <label class=\"custlabel\" for=\"field_px29w-9\">\u0634\u0631\u064a\u062d\u0629 \u0627\u0644\u0645\u062a\u0642\u0627\u0639\u062f\u064a\u0646<\/label>\n                        <\/div>\n                    <\/li> \n                    \n                                        <li>\n                        <div class=\"optionselect\">\n                            <input id=\"field_px29w-10\" type=\"checkbox\" class=\"custcheckbox\" name=\"item_meta[12][]\" value=\"125 | \u0627\u0644\u062f\u0631\u062c\u0627\u062a \u0627\u0644\u0639\u0644\u064a\u0627 \u0648\u0627\u0644\u062e\u0627\u0635\u0629 \u0645\u0646 \u0645\u062f\u064a\u0631 \u0639\u0627\u0645 \u0641\u0645\u0627 \u0641\u0648\u0642\" data-reqmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 cannot be blank.\" data-invmsg=\"\u0627\u0644\u0641\u0626\u0627\u062a \u0627\u0644\u0645\u0634\u0645\u0648\u0644\u0629 is invalid\" aria-invalid=\"false\" aria-required=\"true\" \/>\n                            <label class=\"custlabel\" for=\"field_px29w-10\">\u0627\u0644\u062f\u0631\u062c\u0627\u062a \u0627\u0644\u0639\u0644\u064a\u0627 \u0648\u0627\u0644\u062e\u0627\u0635\u0629 \u0645\u0646 \u0645\u062f\u064a\u0631 \u0639\u0627\u0645 \u0641\u0645\u0627 \u0641\u0648\u0642<\/label>\n                        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document.getElementById('form_contact-form');\n    const phoneInput = document.getElementById('field_e9smc');\n    const nameInput = document.getElementById('field_lgpvt');\n    const ageSelect = document.getElementById('field_age');\n    const chronicSelect = document.getElementById('field_chronic_disease');\n    const checkboxes = document.querySelectorAll('input[name=\"item_meta[12][]\"]');\n    const phoneContainer = document.getElementById('phone-field-container');\n    const nameContainer = document.getElementById('name-field-container');\n    const ageContainer = document.getElementById('age-field-container');\n    const chronicContainer = document.getElementById('chronic-disease-field-container');\n    const checkboxContainer = document.getElementById('checkbox-container');\n    const phoneError = document.getElementById('phone-error');\n    const nameError = document.getElementById('name-error');\n    const ageError = document.getElementById('age-error');\n    const chronicError = document.getElementById('chronic-error');\n    const checkboxError = document.getElementById('checkbox-error');\n    \n    \/\/ Function to validate phone number\n    function validatePhoneNumber(phone) {\n        \/\/ Check if phone starts with 07 and has exactly 11 digits\n        const phoneRegex = \/^07[0-9]{9}$\/;\n        return phoneRegex.test(phone);\n    }\n    \n    \/\/ Validate phone on input\n    phoneInput.addEventListener('input', function() {\n        const phoneValue = this.value.trim();\n        \n        if (phoneValue) {\n            \/\/ Remove non-digit characters\n            const digitsOnly = phoneValue.replace(\/\\D\/g, '');\n            \n            \/\/ Update input value with digits only\n            if (digitsOnly !== phoneValue) {\n                this.value = digitsOnly;\n            }\n            \n            \/\/ Validate phone format\n            if (validatePhoneNumber(digitsOnly)) {\n                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chronicContainer.classList.remove('error');\n        checkboxContainer.classList.remove('error');\n        phoneError.style.display = 'none';\n        nameError.style.display = 'none';\n        ageError.style.display = 'none';\n        chronicError.style.display = 'none';\n        checkboxError.style.display = 'none';\n        \n        \/\/ Validate phone number\n        const phoneValue = phoneInput.value.trim();\n        if (!phoneValue) {\n            phoneContainer.classList.add('error');\n            phoneError.textContent = '\u0631\u0642\u0645 \u0627\u0644\u0647\u0627\u062a\u0641 \u0645\u0637\u0644\u0648\u0628';\n            phoneError.style.display = 'block';\n            isValid = false;\n        } else if (!validatePhoneNumber(phoneValue)) {\n            phoneContainer.classList.add('error');\n            phoneError.textContent = '\u0631\u0642\u0645 \u0627\u0644\u0647\u0627\u062a\u0641 \u064a\u062c\u0628 \u0623\u0646 \u064a\u0628\u062f\u0623 \u0628\u0640 07 \u0648\u064a\u062a\u0643\u0648\u0646 \u0645\u0646 11 \u0631\u0642\u0645\u064b\u0627';\n            phoneError.style.display = 'block';\n            isValid = false;\n        }\n        \n        \/\/ Validate name\n        const nameValue = nameInput.value.trim();\n        if (!nameValue) {\n            nameContainer.classList.add('error');\n            nameError.textContent = '\u0627\u0644\u0627\u0633\u0645 \u0627\u0644\u0643\u0627\u0645\u0644 \u0645\u0637\u0644\u0648\u0628';\n            nameError.style.display = 'block';\n            isValid = false;\n        }\n        \n        \/\/ Validate age\n        if (!ageSelect.value) {\n            ageContainer.classList.add('error');\n            ageError.textContent = '\u0627\u0644\u0639\u0645\u0631 \u0645\u0637\u0644\u0648\u0628';\n            ageError.style.display = 'block';\n            isValid = false;\n        }\n        \n        \/\/ Validate chronic disease\n        if (!chronicSelect.value) {\n            chronicContainer.classList.add('error');\n            chronicError.textContent = '\u062d\u0642\u0644 \"\u0647\u0644 \u0644\u062f\u064a\u0643 \u0645\u0631\u0636 \u0645\u0632\u0645\u0646\u061f\" \u0645\u0637\u0644\u0648\u0628';\n            chronicError.style.display = 'block';\n            isValid = false;\n        }\n        \n        \/\/ Validate at least one checkbox is selected\n        let checkboxChecked = false;\n        checkboxes.forEach(checkbox => {\n            if (checkbox.checked) {\n                checkboxChecked = true;\n            }\n        });\n        \n        if (!checkboxChecked) {\n            \/\/ Highlight checkbox container\n            checkboxContainer.classList.add('error');\n            checkboxError.textContent = '\u064a\u062c\u0628 \u0627\u062e\u062a\u064a\u0627\u0631 \u0641\u0626\u0629 \u0648\u0627\u062d\u062f\u0629 \u0639\u0644\u0649 \u0627\u0644\u0623\u0642\u0644';\n            checkboxError.style.display = 'block';\n            isValid = false;\n  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