l>Intoksikasi</label>
              <select name="intoksikasi" class="form-control" required>
                <option value="Tidak Ada" {if: $penilaian_igd.intoksikasi == 'Tidak Ada'}selected{/if}>Tidak Ada</option>
                <option value="Ada" {if: $penilaian_igd.intoksikasi == 'Ada'}selected{/if}>Ada</option>
                <option value="Gigitan Binatang" {if: $penilaian_igd.intoksikasi == 'Gigitan Binatang'}selected{/if}>Gigitan Binatang</option>
                <option value="Zat Kimia" {if: $p