/* Hide Submit Button */
.form-submit-button {
    display: none !important;
  }
  
  /* Hide Print Button */
  #print-preview {
    display: none !important;
  }

  /* Hiding Language dropdown*/
  #form-element-wrapper_1 {
      visibility: hidden !important;
    }
    
#form-element-wrapper_2{
    display: none;
}
    /* TO CONTROL SCREEN SCROLL*/
.form-section, .form-item {
    display: block;
    overflow: hidden;
    padding-left: inherit;
    padding-bottom: 16px;
}
.blanklinecallout {
    position: absolute;
    width: 1px;
    height: 1px;
    padding: 0;
    margin: -1px;
    overflow: hidden;
    clip: rect(0, 0, 0, 0);
    border: 0;
}
.header_container {
    display: flex;
    justify-content: space-between;
    column-gap: 30px ;
}
.pg1header_container {
    display: flex;
    justify-content: space-between;
    column-gap: 30px ;
}
.MailDateBlock {
    text-align: end;
    vertical-align: bottom;
    padding-inline-end: 10px;
} 
.divTableRowAddress {
    display: table-row;
}

.divTableCellAddress {
    display: table-cell;
}
.blank-line {
    display: inline-block; 
    border-bottom: 1.5px solid black;
    width: 170px;
    margin-inline-start: 10px;
       }
.headerlistBlock {
    border: 3px solid black;
    padding: 10px;
    width: 55%;
    margin-top: 20px;
    margin-inline-end: 10px;
}

ul {
    margin-inline-start: 20px;
    margin-inline-end: 20px;
}
ul li {
    margin-top: 5px;
}
.form-fieldDeclaration {
    display: flex;
    margin-inline-end: 10px;
    /* align-items: center; */
    /* margin-bottom: 5px; */
    grid-template-columns: 33% 41% 11% 14%;
    /* gap: 10px; */
}
:lang(ko) .form-fieldDeclaration,
:lang(th) .form-fieldDeclaration {
     margin-inline-end: 0px !important;
}
.divTableCellWS { 

    display: table-cell; 
    padding-inline-end: 10px; 
    text-align: center; 
    padding-top: 5px; 
    padding-bottom: 0px; 

}
.divTableCellWSPage2 { 

    display: table-cell; 
    padding-inline-end: 10px; 
    text-align: center; 
    padding-top: 5px; 
    padding-bottom: 0px; 

}
.form-fieldW .halflineWp1 { 

    border-bottom: 1.5px solid black; 
    width: 98%; 
    height:12px;
    margin-inline-start: 5px;
    display: inline-block; 

} 
:lang(ar) .form-fieldW .halflineWp1,
:lang(fa) .form-fieldW .halflineWp1{ 

    height:16px !important;
    margin-inline-start: 5px !important;

} 
.form-fieldW .halflineWp11 { 

    border-bottom: 1.5px solid black; 
    width: 98%; 
    height:12px;
    margin-inline-start: 1px;
    display: inline-block; 

} 
:lang(ar) .form-fieldW .halflineWp11,
:lang(fa) .form-fieldW .halflineWp11{ 

    height:16px !important;
    margin-inline-start: 5px !important;

} 
.form-fieldW .halflineWp2 { 

    border-bottom: 1.5px solid black; 
    width: 98%; 
    height:12px;
    margin-inline-start: 5px;
    display: inline-block; 

} 
:lang(ar) .form-fieldW .halflineWp2,
:lang(fa) .form-fieldW .halflineWp2{ 

    height:16px !important;
    margin-inline-start: 5px !important;

} 
:lang(hy) .form-fieldW .halflineWp2 {
    width: 100% !important;
    margin-inline-start: 15px !important;
}
.form-fieldW div {
    text-align: center !important;
    margin-top: -7px;
    /* Adds space between the line and the text */
}
.declaration {
    margin-inline-start: 5px;
    margin-inline-end: 10px;
    white-space: nowrap;
}
.CountyBlockDeclaration {
    margin-inline-end: 10px;
    margin-inline-start: 30px;
    margin-bottom: 10px;
}
.page1Table1 {
    width: 100%;
    border-collapse: collapse;
    border: none;
    margin-bottom: 20px;
}
.page1Table2 {
    width: 100%;
    border: 3px solid black;
    margin-bottom: 20px;
}
.page1Table2 td {
    padding-inline-start: 20px;
    padding-inline-end: 20px;
    padding-top: 10px;
    padding-bottom: 5px;
}
.declareWidth {
    width: 60%;
}
.DateWidth{
    width:60%;
}
:lang(ja) .DateWidth {
    width: 75%;
}
.signRepBlock {
    width: 58%;
}
.relationshipWidth {
    width: 80%;
    padding-bottom: 10px;
}
.Checkboxsize {
   width: 14px;
   height: 14px;
   background-color: white;
   border-radius: 5%;
   border: 1px solid black;
   appearance: none;
   -webkit-appearance: none;
   outline: none;
   cursor: pointer;
   margin-right: 8px;
}

.jText {
    display: flex;
    margin-top: -20px;
    padding-inline-start: 30px;
    white-space: nowrap;
  }
:lang(ar) .jText,
:lang(fa) .jText {
    margin-top: -25px !important;
}
.jTextList {
    display: flex;
    margin-top: -20px;
    padding-inline-start: 30px;
  }
:lang(ar) .jTextList,
:lang(fa) .jTextList {
    margin-top: -25px !important;
}
.PhysTypeWidth {
    width: 90%;
}
.form-fieldW .halflinePhysType { 

    border-bottom: 1.5px solid black; 
    width: 100%; 
    height:15px;
    margin-inline-start: 5px;
    display: inline-block; 

} 
:lang(ar) .form-fieldW .halflinePhysType,
:lang(fa) .form-fieldW .halflinePhysType{ 

    height:18px !important;
    margin-inline-start: 5px !important;

} 
.new-cols {
    display: grid;
    grid-template-columns: 1fr 1fr;
    column-gap: 60px;
    row-gap: 22px;
}
.new-colsPage2 {
    display: grid;
    grid-template-columns: 3.5fr 1fr;
    column-gap: 20px;
    row-gap: 22px;
}
.new-colsByBlock {
    display: grid;
    grid-template-columns: 1fr 1fr;
    column-gap: 5px;
    row-gap: 9px;
}
.new-field{
  display:grid;
  grid-template-columns:auto 1fr auto;
  grid-template-rows:20px auto;
  align-items:end;
 margin-top:10px;
  row-gap:4px;
}
.new-line{
 
  grid-row:1;
  height:18px;
  
  border-bottom:1.5px solid black
}
.new-field .new-line + .new-label-bottom[style]{
  grid-column:3;
  grid-row:2;
  text-align:center;
}
.new-label-bottom{
  grid-column:2;
  grid-row:2;
  text-align:center;
  margin-top:0;
  line-height:1.1;

}
:lang(ar).new-label-bottom,
:lang(fa).new-label-bottom {
  grid-column:2;
  grid-row:2;
  text-align:center;
  margin-top:0;
  line-height:1.1;
  margin-inline-start:20px;
}
 .new-label-left{
grid-column:2; grid-row:1; height:18px; border-bottom:1.5px solid #000;
margin-inline-end: 10px;
}
.form-field1{
    display:flex;
   white-space:nowrap;
}
 :lang(hy).form-field1,
 :lang(ru).form-field1,
 :lang(vi).form-field1,
 :lang(fil).form-field1,
 :lang(km).form-field1 {
    display:flex;
   white-space:normal;
align-items: end;
}
.form-fieldWh div {
    text-align: center !important;
    margin-top: -10px;
    /* Adds space between the line and the text */
}
.form-fieldWh .halflineWp { 

    border-bottom: 1.5px solid black; 

    width:98%; 
height:11px;
    margin-inline-start: 5px;

    display: inline-block; 

} 
:lang(hy) .form-fieldWh .halflineWp,
:lang(fil) .form-fieldWh .halflineW,
:lang(ru) .form-fieldWh .halflineWp{

  border-bottom: 1.5px solid black; 
 margin-inline-start: 0px;
    width:99%; 
height:11px;
    display: inline-block; 



}
:lang(ar) .form-fieldWh .halflineWp,
:lang(fa) .form-fieldWh .halflineWp {

 border-bottom: 1.5px solid black; 

    width:95%; 
height:17px;
    margin-inline-start: 8px;

    display: inline-block; 
}
.newWidth{
    width:30%;
    height:17px;
    white-space: nowrap;
}
:lang(ar).newWidth,
:lang(fa).newWidth{
    width:12%;
     margin-inline-start: 15px;
}

.form-box {
    border: 2px solid black;
    padding: 10px;
    max-width: 900px;
}
.location-row {
  display: flex;
  gap: 16px;
  align-items: flex-start;
}
.row {
   display: flex;
    flex-wrap: wrap;
    align-items: baseline;
    gap: 12px;
    /* margin-bottom: 12px;*/
}
.page2row {
       display: flex;
    flex-wrap: wrap;
    align-items: baseline;
    padding-top: 15px;
    gap: 10px;
}
.checkbox {
    display: flex;
    align-items: center;
    gap: 8px;
    flex-wrap: wrap;
}
.field {
    display: flex;
    flex-direction: column;
    align-items: center;
    min-width: 0;
    flex: 1;
}
.page2appBlockField {
    display: flex;
    flex-direction: column;
    align-items: center;
    min-width: 0;
    flex: 1;
}
.line-row {
    display: flex;
    align-items: flex-end;
    width: 100%;
}
:lang(ar) .line-row,
:lang(fa) .line-row {
    align-items: baseline;
}
.line {
     flex: 1;
     border-bottom:  1.5px solid black;
     height: 18px;
}
.page2appBlockLine {
     flex: 1;
     border-bottom:  1.5px solid black;
     height: 18px;
}
.linepage2 {
    flex: 1;
    border-bottom: 1.5px solid black;
    height: 8px;
    margin-inline-end: 10px;
    margin-inline-start: 10px;
}
.hint {
    margin-top: 6px;
  text-align: center;
  width: 100%;
}
:lang(ar) .hint,
:lang(fa) .hint {
    margin-top: -10px;
}
.with-comma {
    padding-inline-end: 14px;
    position: relative;
}
.comma,
.dot {
   margin-inline-start: 4px;

}
.cityBlockDeclaration {
    margin-inline-start: 20px;
}
.appointmentBlock {
    MARGIN-TOP: 10PX;
    MARGIN-INLINE-END: 10PX;
}
.claimList {
    margin-inline-start: 10px;
}
.byJtext {
    display: flex;
    margin-top: -2px;
    white-space: nowrap;
}
.docCert {
    display: inline;
}
.docCertPadding {
    margin-inline-start: 30px;
}
.form-fieldDeclarationByBlock {
    display: grid;
    grid-template-columns: 3% 68% 0% 0%;
    gap: 50px;
}
:lang(hy) .form-fieldDeclarationByBlock {
    display: grid;
    grid-template-columns: 6% 65% 0% 0%;
    gap: 20px;
}
.witnessBlock {
    margin-inline-start: 80px;
    margin-bottom: 20px;
}

.doctor-cert {
  font-family: Arial, sans-serif;
  font-size: 16px;
  line-height: 1.6;
}

/* Inline field container */
.inline-field {
  display: inline-flex;
  flex-direction: column;
  align-items: center;
  vertical-align: baseline;
  min-width: 320px;      /* stable underline width */
  margin: 0 6px;
}
:lang(hi) .inline-field,
:lang(ja) .inline-field {
    min-width: 215px;
}
/* Underline */
.inline-field .physline {
  width: 100%;
  border-bottom: 1.5px solid #000;
  height: 1.2em;
}

/* Label under line */
.inline-field .physlabel {
  color: black;
  text-align: center;
  margin-top: 4px;
  white-space: normal;  /* allows translation wrapping */
}


@media only screen and (max-width: 768px)
 {
    .responsive-table-container {
            overflow-x: auto;
            -webkit-overflow-scrolling: touch; /* Enables smooth scrolling on iOS */
        }
    
    .responsive-table-container table {
            width: 100%; /* Ensure table takes up the full width of the container */
            min-width: 850px; /* Set a minimum width to maintain table readability */
        }
                .header_container {
      flex-direction: column;
        justify-content: center;
        align-items: center !important;
    }
        .pg1header_container {
      flex-direction: column;
        justify-content: center;
        align-items: center !important;
    }
        :lang(ar) .pg1header_container,
        :lang(fa) .pg1header_container {
        align-items: flex-start !important;
    }
    .divTableRowAddress {
    display: grid !important;
    text-align: center;
}
        :lang(ar) .blank-line,
        :lang(fa) .blank-line {
        margin-inline-start: 0px !important;
    }
           .blank-line {
        width: 400px !important;
        padding-top: 20px !important;
    }
     .headerlistBlock {
        width: 85% !important;
        margin-top: 0px !important;
        margin-inline-end: 0px !important;

     }
            .DateWidth {
        width: 2%;
        padding-inline-start: 30px;
        padding-inline-end: 0px;
        padding-bottom: 15px;
    }
            .declareWidth {
        width: 2%;
        padding-inline-start: 0px;
        padding-inline-end: 0px;
        padding-bottom: 15px;
    }
          .relationshipWidth {
        width: 2%;
        padding-inline-start: 0px;
        padding-inline-end: 0px;
    }
              .PhysTypeWidth {
        width: 2%;
        padding-inline-start: 0px;
        padding-inline-end: 0px;
    }
    .form-fieldW .halflineWp1 { 

    border-bottom: 1.5px solid black; 
    width: 100%; 
    height:12px;
    margin-inline-start: 0px;
    display: inline-block; 

} 
    .form-fieldW .halflineWp11 { 

    border-bottom: 1.5px solid black; 
    width: 100%; 
    height:12px;
    margin-inline-start: 0px;
    display: inline-block; 

} 
    .form-fieldW .halflineWp2 { 

    border-bottom: 1.5px solid black; 
    width: 100%; 
    height:12px;
    margin-inline-start: 0px;
    display: inline-block; 

} 
.divTableRowed {
    display: inline;
}
.jText {
    white-space: normal !important;
    display: inline-block;
}
.new-cols{
    display:block;
}
   .new-field{row-gap:10px;}

   .form-field1{
    display: block;
    white-space: normal;}

 :lang(hy).form-field1,
 :lang(ru).form-field1,
 :lang(vi).form-field1,
 :lang(km).form-field1,
 :lang(fil).form-field1 {
display: block;
    white-space: normal;}

    .form-fieldWh .halflineWp {
    width:165%;
margin-inline-start:0px;}
:lang(ar).newWidth,
:lang(fa).newWidth{
    width:12%;
     margin-inline-start: 15px;
}
:lang(ar) .form-fieldWh .halflineWp, :lang(fa) .form-fieldWh .halflineWp {
    border-bottom: 1.5px solid black;
    width: 111%;
    height: 17px;
    margin-inline-start: 8px;
    display: inline-block;
}
.CountyBlockDeclaration {
    margin-inline-start: 30px !important;
    margin-inline-end: 0px !important;
}
.new-col-employer {
    margin-inline-start: 30px !important;
    margin-inline-end: 0px !important;
}
.declaration {
    margin-inline-start: 10px !important;
}
.row {
    flex-direction: column;
    align-items: stretch;
}
.page2row {
    flex-direction: column;
    align-items: stretch;
}
.field {
    width: 100%;
}

  .location-row {
    flex-direction: column;
  }
  .new-label-left {
    margin-inline-end: 0px !important;
  }
  .linepage2 {
    margin-inline-start: 30px !important;
        margin-inline-end: 0px !important;
    }
  
  .form-fieldDeclaration {
    display: inline !important;
    /* align-items: center; */
    /* margin-bottom: 5px; */
    /* gap: 10px; */
}
.new-colsPage2 {
        display: inline !important;
}
.cityBlockDeclaration {
    margin-inline-start: 30px !important;
}
.inline-field {
  min-width: 265px ;  
  margin-bottom: 10px;
  margin-inline-start: 0px;
}
.docCertPadding {
    margin-inline-start: 30px !important;
}
.new-label-bottom {
    margin-bottom: 10px;
}
.new-colsByBlock {
    display: block !important;
}
.witnessBlock {
    margin-inline-start: 30px !important;
}

.page2appBlockLine {
        margin-inline-start: 30px !important;
    }
.truerepBlock {
        padding-inline-start: 30px;
        display: block;
}
.divTableCellWSPage2 {
     padding-inline-end: 0px !important;
    padding-inline-start: 30px;
}
.byJtext {
    margin-inline-start: 30px;
}
:lang(ar).signRepBlock,
:lang(fa).signRepBlock {
    width: 38%;
}
:lang(hy) .form-fieldW .halflineWp2 {
    margin-inline-start: 0px !important; 
}
:lang(hy) .form-fieldDeclarationByBlock {
    display: inline !important;
}
:lang(hi) .inline-field, :lang(ja) .inline-field {
    min-width: 248px !important;
}
:lang(zh-CN) .inline-field, :lang(zh-TW) .inline-field {
    min-width: 245px !important;
}
:lang(ja) .DateWidth {
    width: 40% !important;
}
:lang(zh-CN).signRepBlock,
:lang(zh-TW).signRepBlock {
    width: 31%;
}
:lang(hi) .pg2ByBlockLine,
:lang(ja) .pg2ByBlockLine,
:lang(ko) .pg2ByBlockLine,
:lang(pa) .pg2ByBlockLine,
:lang(th) .pg2ByBlockLine {
    width: 270px !important;
}
}

@media only screen 
  and (min-device-width: 768px) 
  and (max-device-width: 768px) 
  and (min-device-height: 1024px) 
  and (max-device-height: 1024px) 
  and (-webkit-min-device-pixel-ratio: 1) 

{    .newWidth {
        width: 6%!important;
        margin-inline-start: 15px;
    }  .moveaBit {
        display: inline-block;
    }
        :lang(ar).signRepBlock, :lang(fa).signRepBlock {
        width: 16% !important;
    }
    .signRepBlock {
    width: 41% !important;
}
:lang(hi) .pg2ByBlockLine,
:lang(ja) .pg2ByBlockLine,
:lang(ko) .pg2ByBlockLine,
:lang(pa) .pg2ByBlockLine,
:lang(th) .pg2ByBlockLine {
    width: 625px !important;
}
}