bel>Mukosa</label>
              <select name="mukosa" class="form-control" required>
                <option value="Lembab" {if: $penilaian_igd.mukosa == 'Lembab'}selected{/if}>Lembab</option>
                <option value="Kering" {if: $penilaian_igd.mukosa == 'Kering'}selected{/if}>Kering</option>
              </select>
            </div>
          </div>
          <div class="col-md-4">
            <div class="form-group">
              <label>Perdarahan</label>
              <select name="perdarahan" 