<form autocomplete="off" novalidate="novalidate" class="or clearfix" dir="ltr" id="clinic"><!--This form was created by transforming a OpenRosa-flavored (X)Form using an XSL stylesheet created by Enketo LLC.--><section class="form-logo"> </section><h3 dir="auto" id="form-title">{{'clinic.new' | translate}}</h3>
	
	
		<label class="question non-select or-appearance-dbobject "><span lang="" class="question-label active">{{'clinic.loc' | translate}}</span><input type="text" name="/clinic/loc" data-type-xml="place"/><span class="or-constraint-msg active" lang="" data-i18n="constraint.invalid">Value not allowed</span></label>
		<label class="question non-select or-appearance-dbobject or-appearance-allow-new "><span lang="" class="question-label active">{{'clinic.contact' | translate}}</span><input type="text" name="/clinic/contact" data-type-xml="person"/></label>
	
</form>
