<div id="form_assesment">
  <div class="panel panel-default">
    <div class="panel-heading">
      <h3 class="panel-title">Assessment Awal Keperawatan IGD</h3>
    </div>
    <div class="panel-body">
      <form id="assesmentForm">
        <input type="hidden" name="no_rawat" value="{$penilaian_igd.no_rawat}">
        
        <!-- Informasi Dasar -->
        <div class="row">
          <div class="col-md-6">
            <div class="form-group">
              <label>Tanggal</label>
              <input typ