3">
            <div class="form-group">
              <label>Durasi</label>
              <input type="text" name="durasi" class="form-control" value="{$penilaian_igd.durasi}" maxlength="25" required>
            </div>
          </div>
          <div class="col-md-3">
            <div class="form-group">
              <label>Nyeri Hilang</label>
              <select name="nyeri_hilang" class="form-control" required>
                <option value="Istirahat" {if: $penilaian_igd.nyeri_hilang == 'Istirahat'