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報告完成時間：: 2024年12月22日 09:56:25
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log	other	URL https://ee.kobotoolbox.org/x/js/build/enketo-webform.js Text App in offline-capable mode.
log	other	URL https://ee.kobotoolbox.org/x/js/build/chunks/chunk-KY2TN2NS.js Text Keeping default theme.
log	other	URL https://ee.kobotoolbox.org/x/js/build/enketo-webform.js Text Offline application service worker registration successful with scope: https://ee.kobotoolbox.org/x/
log	other	URL https://ee.kobotoolbox.org/x/js/build/enketo-webform.js Text New offline application service worker activated!
log	other	URL https://ee.kobotoolbox.org/x/js/build/chunks/chunk-KY2TN2NS.js Text Checking for survey update...
log	other	URL https://ee.kobotoolbox.org/x/js/build/chunks/chunk-KY2TN2NS.js Text Cached survey is up to date! md5:917be75b5cd20708089337c2f7380d2a--1d19c3ef44a52ee3ec46de2544237d9b---1
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<!DOCTYPE html><html lang="en-us" dir="ltr"><head><title>تقييم احتياج قرى ومناطق</title><meta charset="utf-8"><meta name="author" content="Martijn van de Rijdt (Enketo LLC)"><meta name="viewport" content="width=device-width, initial-scale=1.0"><link rel="shortcut icon" href="/x/images/favicon.ico"><link rel="icon" type="image/png" sizes="180x180" href="/x/images/icon_180x180.png"><link rel="apple-touch-icon" sizes="180x180" href="/x/images/icon_180x180.png"><script async="" src="//www.google-analytics.com/analytics.js"></script><script>if (navigator.userAgent.indexOf('Trident/') >= 0) {
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.log {
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<!--This form was created by transforming an ODK/OpenRosa-flavored (X)Form using an XSL stylesheet created by Enketo LLC.--><section class="form-logo"></section><h3 dir="auto" id="form-title">تقييم احتياج قرى ومناطق</h3>
  
  
    <label class="question non-select contains-ref-target" data-contains-ref-target="/aranqXBj46B2NqR5VjmUba/text_mp7ml67"><!--refTargetContainers:/aranqXBj46B2NqR5VjmUba/text_mp7ml67--><span lang="" class="question-label active">القرية او المنطقة</span><span class="required">*</span><input type="text" name="/aranqXBj46B2NqR5VjmUba/text_mp7ml67" data-required="true()" data-type-xml="string" class="ref-target" data-ref="/aranqXBj46B2NqR5VjmUba/text_mp7ml67" maxlength="1000000"><span class="or-required-msg active" lang="" data-i18n="constraint.required">This field is required</span></label>
    <fieldset class="question simple-select contains-ref-target" data-contains-ref-target="/aranqXBj46B2NqR5VjmUba/select_multiple_cz49k80"><!--refTargetContainers:/aranqXBj46B2NqR5VjmUba/select_multiple_cz49k80--><fieldset><legend><span lang="" class="question-label active">حالة السكن</span><span class="required">*</span>
                    </legend><div class="option-wrapper"><label class=""><input type="checkbox" name="/aranqXBj46B2NqR5VjmUba/select_multiple_cz49k80" value="______" data-required="true()" data-type-xml="string" class="ref-target" data-ref="/aranqXBj46B2NqR5VjmUba/select_multiple_cz49k80" maxlength="1000000"><span lang="" class="option-label active">قابل للسكن وحالته جيده</span></label><label class=""><input type="checkbox" name="/aranqXBj46B2NqR5VjmUba/select_multiple_cz49k80" value="__" data-required="true()" data-type-xml="string" class="ref-target" data-ref="/aranqXBj46B2NqR5VjmUba/select_multiple_cz49k80" maxlength="1000000"><span lang="" class="option-label active">هدم جزئي</span></label><label class=""><input type="checkbox" name="/aranqXBj46B2NqR5VjmUba/select_multiple_cz49k80" value="___1" data-required="true()" data-type-xml="string" class="ref-target" data-ref="/aranqXBj46B2NqR5VjmUba/select_multiple_cz49k80" maxlength="1000000"><span lang="" class="option-label active">هدم كامل</span></label></div></fieldset><span class="or-required-msg active" lang="" data-i18n="constraint.required">This field is required</span></fieldset>
    <label class="question non-select contains-ref-target" data-contains-ref-target="/aranqXBj46B2NqR5VjmUba/text_fr5pp48"><!--refTargetContainers:/aranqXBj46B2NqR5VjmUba/text_fr5pp48--><span lang="" class="question-label active">الاسم الثلاثي للزوج</span><span class="required">*</span><input type="text" name="/aranqXBj46B2NqR5VjmUba/text_fr5pp48" data-required="true()" data-type-xml="string" class="ref-target" data-ref="/aranqXBj46B2NqR5VjmUba/text_fr5pp48" maxlength="1000000"><span class="or-required-msg active" lang="" data-i18n="constraint.required">This field is required</span></label>
    <label class="question non-select contains-ref-target" data-contains-ref-target="/aranqXBj46B2NqR5VjmUba/text_ns6rl34"><!--refTargetContainers:/aranqXBj46B2NqR5VjmUba/text_ns6rl34--><span lang="" class="question-label active">والدة الزوج</span><span class="required">*</span><input type="text" name="/aranqXBj46B2NqR5VjmUba/text_ns6rl34" data-required="true()" data-type-xml="string" class="ref-target" data-ref="/aranqXBj46B2NqR5VjmUba/text_ns6rl34" maxlength="1000000"><span class="or-required-msg active" lang="" data-i18n="constraint.required">This field is required</span></label>
    <label class="question non-select contains-ref-target" data-contains-ref-target="/aranqXBj46B2NqR5VjmUba/integer_bt0fl67" lang="en-US"><!--refTargetContainers:/aranqXBj46B2NqR5VjmUba/integer_bt0fl67--><span lang="" class="question-label active">مواليد الزوج</span><span class="required">*</span><input type="number" name="/aranqXBj46B2NqR5VjmUba/integer_bt0fl67" data-required="true()" data-type-xml="int" class="ref-target" data-ref="/aranqXBj46B2NqR5VjmUba/integer_bt0fl67" pattern="^-?[0-9]+$"><span class="or-required-msg active" lang="" data-i18n="constraint.required">This field is required</span><div class="invalid-value-msg active"></div></label>
    <label class="question non-select contains-ref-target" data-contains-ref-target="/aranqXBj46B2NqR5VjmUba/text_fd4lf34"><!--refTargetContainers:/aranqXBj46B2NqR5VjmUba/text_fd4lf34--><span lang="" class="question-label active">الاسم الثلاثي للزوجه</span><span class="required">*</span><input type="text" name="/aranqXBj46B2NqR5VjmUba/text_fd4lf34" data-required="true()" data-type-xml="string" class="ref-target" data-ref="/aranqXBj46B2NqR5VjmUba/text_fd4lf34" maxlength="1000000"><span class="or-required-msg active" lang="" data-i18n="constraint.required">This field is required</span></label>
    <label class="question non-select contains-ref-target" data-contains-ref-target="/aranqXBj46B2NqR5VjmUba/integer_fe4qg36" lang="en-US"><!--refTargetContainers:/aranqXBj46B2NqR5VjmUba/integer_fe4qg36--><span lang="" class="question-label active">رقم الثبوتية</span><span class="required">*</span><input type="number" name="/aranqXBj46B2NqR5VjmUba/integer_fe4qg36" data-required="true()" data-type-xml="int" class="ref-target" data-ref="/aranqXBj46B2NqR5VjmUba/integer_fe4qg36" pattern="^-?[0-9]+$"><span class="or-required-msg active" lang="" data-i18n="constraint.required">This field is required</span><div class="invalid-value-msg active"></div></label>
    <label class="question non-select contains-ref-target" data-contains-ref-target="/aranqXBj46B2NqR5VjmUba/integer_yf3yf36" lang="en-US"><!--refTargetContainers:/aranqXBj46B2NqR5VjmUba/integer_yf3yf36--><span lang="" class="question-label active">رقم التواصل</span><input type="number" name="/aranqXBj46B2NqR5VjmUba/integer_yf3yf36" data-type-xml="int" class="ref-target" data-ref="/aranqXBj46B2NqR5VjmUba/integer_yf3yf36" pattern="^-?[0-9]+$"><div class="invalid-value-msg active"></div></label>
    <label class="question non-select contains-ref-target" data-contains-ref-target="/aranqXBj46B2NqR5VjmUba/integer_xg3vu44" lang="en-US"><!--refTargetContainers:/aranqXBj46B2NqR5VjmUba/integer_xg3vu44--><span lang="" class="question-label active">عدد افراد الاسرة</span><span class="required">*</span><input type="number" name="/aranqXBj46B2NqR5VjmUba/integer_xg3vu44" data-required="true()" data-type-xml="int" class="ref-target" data-ref="/aranqXBj46B2NqR5VjmUba/integer_xg3vu44" pattern="^-?[0-9]+$"><span class="or-required-msg active" lang="" data-i18n="constraint.required">This field is required</span><div class="invalid-value-msg active"></div></label>
    <fieldset class="question simple-select contains-ref-target" data-contains-ref-target="/aranqXBj46B2NqR5VjmUba/select_multiple_tk0mt12"><!--refTargetContainers:/aranqXBj46B2NqR5VjmUba/select_multiple_tk0mt12--><fieldset><legend><span lang="" class="question-label active">اسره تديرها امراه</span>
                    </legend><div class="option-wrapper"><label class=""><input type="checkbox" name="/aranqXBj46B2NqR5VjmUba/select_multiple_tk0mt12" value="_" data-type-xml="string" class="ref-target" data-ref="/aranqXBj46B2NqR5VjmUba/select_multiple_tk0mt12" maxlength="1000000"><span lang="" class="option-label active">ارمله</span></label><label class=""><input type="checkbox" name="/aranqXBj46B2NqR5VjmUba/select_multiple_tk0mt12" value="__1" data-type-xml="string" class="ref-target" data-ref="/aranqXBj46B2NqR5VjmUba/select_multiple_tk0mt12" maxlength="1000000"><span lang="" class="option-label active">مطلقه</span></label><label class=""><input type="checkbox" name="/aranqXBj46B2NqR5VjmUba/select_multiple_tk0mt12" value="__2" data-type-xml="string" class="ref-target" data-ref="/aranqXBj46B2NqR5VjmUba/select_multiple_tk0mt12" maxlength="1000000"><span lang="" class="option-label active">ايتام</span></label><label class=""><input type="checkbox" name="/aranqXBj46B2NqR5VjmUba/select_multiple_tk0mt12" value="__3" data-type-xml="string" class="ref-target" data-ref="/aranqXBj46B2NqR5VjmUba/select_multiple_tk0mt12" maxlength="1000000"><span lang="" class="option-label active">معتقل</span></label><label class=""><input type="checkbox" name="/aranqXBj46B2NqR5VjmUba/select_multiple_tk0mt12" value="__4" data-type-xml="string" class="ref-target" data-ref="/aranqXBj46B2NqR5VjmUba/select_multiple_tk0mt12" maxlength="1000000"><span lang="" class="option-label active">مفقود</span></label></div></fieldset></fieldset>
    <label class="question non-select contains-ref-target" data-contains-ref-target="/aranqXBj46B2NqR5VjmUba/integer_ok2zt13" lang="en-US"><!--refTargetContainers:/aranqXBj46B2NqR5VjmUba/integer_ok2zt13--><span lang="" class="question-label active">عدد الاصابات الحربية</span><input type="number" name="/aranqXBj46B2NqR5VjmUba/integer_ok2zt13" data-type-xml="int" class="ref-target" data-ref="/aranqXBj46B2NqR5VjmUba/integer_ok2zt13" pattern="^-?[0-9]+$"><div class="invalid-value-msg active"></div></label>
    <label class="question non-select contains-ref-target" data-contains-ref-target="/aranqXBj46B2NqR5VjmUba/integer_nj7pn56" lang="en-US"><!--refTargetContainers:/aranqXBj46B2NqR5VjmUba/integer_nj7pn56--><span lang="" class="question-label active">ذوي احتياجات خاصه</span><input type="number" name="/aranqXBj46B2NqR5VjmUba/integer_nj7pn56" data-type-xml="int" class="ref-target" data-ref="/aranqXBj46B2NqR5VjmUba/integer_nj7pn56" pattern="^-?[0-9]+$"><div class="invalid-value-msg active"></div></label>
    <label class="question non-select contains-ref-target" data-contains-ref-target="/aranqXBj46B2NqR5VjmUba/integer_eo1kb89" lang="en-US"><!--refTargetContainers:/aranqXBj46B2NqR5VjmUba/integer_eo1kb89--><span lang="" class="question-label active">عدد الايتام</span><input type="number" name="/aranqXBj46B2NqR5VjmUba/integer_eo1kb89" data-type-xml="int" class="ref-target" data-ref="/aranqXBj46B2NqR5VjmUba/integer_eo1kb89" pattern="^-?[0-9]+$"><div class="invalid-value-msg active"></div></label>
    <label class="question non-select contains-ref-target" data-contains-ref-target="/aranqXBj46B2NqR5VjmUba/text_bh8mb68"><!--refTargetContainers:/aranqXBj46B2NqR5VjmUba/text_bh8mb68--><span lang="" class="question-label active">مدخل البيانات</span><span class="required">*</span><input type="text" name="/aranqXBj46B2NqR5VjmUba/text_bh8mb68" data-required="true()" data-type-xml="string" class="ref-target" data-ref="/aranqXBj46B2NqR5VjmUba/text_bh8mb68" maxlength="1000000"><span class="or-required-msg active" lang="" data-i18n="constraint.required">This field is required</span></label>
    <label class="question non-select contains-ref-target" data-contains-ref-target="/aranqXBj46B2NqR5VjmUba/text_sz9vj92"><!--refTargetContainers:/aranqXBj46B2NqR5VjmUba/text_sz9vj92--><span lang="" class="question-label active">ملاحظات</span><input type="text" name="/aranqXBj46B2NqR5VjmUba/text_sz9vj92" data-type-xml="string" class="ref-target" data-ref="/aranqXBj46B2NqR5VjmUba/text_sz9vj92" maxlength="1000000"></label>
  
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name="/aranqXBj46B2NqR5VjmUba/formhub/uuid" data-calculate="'eb33210903594a3ea9c3954f66028144'" data-type-xml="string" value="eb33210903594a3ea9c3954f66028144" maxlength="1000000"></label></fieldset></form><section class="form-footer"><div class="form-footer__content"><div class="form-footer__content__main-controls"><button class="btn btn-default" id="save-draft"><i class="icon icon-info-circle save-draft-info"> </i><i class="icon icon-pencil"> </i><span data-i18n="formfooter.savedraft.btn">Save Draft</span></button><button class="btn btn-primary" id="submit-form"><i class="icon icon-check"> </i><span data-i18n="formfooter.submit.btn">Submit</span></button><a class="btn btn-primary next-page" href="#"><i class="icon icon-arrow-right"></i><span data-i18n="form.pages.next">Next</span></a><div class="logout hide"><a href="/logout" title="log out of all enketo forms that require authentication" data-i18n="form.logout">log out</a></div><!-- If you're considering changing this, be careful 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