/* 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 !important;
}
.divTableRow {
    display: table-row;
    }
    
.divTableCell {
    display: table-cell;
    }
.divTableCellN {
    display: table-cell;
    padding-top: 6px;
    padding-inline-end: 3px;
    width: 65%;
    text-align: end !important;
    vertical-align: bottom;
    }

:lang(ar).divTableCellN,
:lang(fa).divTableCellN
 {
    display: table-cell;
    padding-top: 6px;
    padding-inline-end: 3px;
    width: 65%;
    text-align: end !important;
    vertical-align: baseline;
    }
.blank-line1 {
    display: inline-block;
    border-bottom: 2px solid black;
    width: 200px;
    padding-inline-start: 2px;
    padding-inline-end: 2px;
    height: 17px;
}
.LLeft {
    
}
:lang(ar) .LLeft,
:lang(fa) .LLeft {
     margin-top: 85px;
}
.URight {
   padding-inline-end:100px;
   margin-top:20px;
}
.ListStyle
{
    margin-inline-start:20px;
}



.form-row {
  display: flex;
  align-items: baseline;
  flex-wrap: wrap-reverse;

}

.form-row.full-width {
  width: 100%; /* this is actually the default, but fine to keep */
}

.labelText {
  margin-inline-end: 7px;
  white-space: nowrap;
}
/* GreyBox with rounded corners*/ 



 

.grey-box {
    background-color: #e5e5e5;
    width: 400px;
    border-radius: 10px;
    padding-bottom: 26%;
    float: left;
    position: relative;
}
 

.sub-label {
    text-align: start !important;
  align-self: flex-start;
     margin-inline-start: 3px;
}
 

.jtext {
      margin-top: -20px;
    display: block;
    margin-inline-start: 30px;
}


.blankLong {
  border-bottom: 2px solid #000;
  height: 18px;
  width: 98%;    
  margin-top:30px;       /* fills the field-group width */
}
.blank {
  border-bottom: 2px solid #000;
  height: 18px;
  width: 100%;    
  margin-top:30px;       /* fills the field-group width */
}

.field-group {
  display: flex;
  flex-direction: column;
  align-items: flex-start;
  flex: 0 0 auto;        /* no stretching */
  border-top: none;      /* remove top border */
  height: auto;
  margin-inline-end: 20px;
  width:100%;
}

 

/* field widths matching PDF proportions */
.field-group.doctor  { width: 100%; }
.field-group.street  { flex: 2 1 0; min-width: 0; }
.field-group.city    { flex: 1 1 0; min-width: 0; }
.field-group.state   { flex: 0 0 55px; }
.field-group.month      { flex: 0 0 250px; }
.field-group.date       { flex: 0 0 80px; }
.field-group.year       { flex: 0 0 90px; }
.field-group.sig        { flex: 2 1 0; min-width: 0; }
.field-group.datesigned { flex: 0 0 155px; }
.field-group.claimid    { flex: 0 0 180px; }

 .divTableCellNm {
    display: table-cell;
    padding-top: 6px;
    padding-inline-end: 3px;
    /* width: 65%; */
   
    vertical-align: bottom;
    padding-inline-start: 20px;
}
 .divTableCellN1 {
    display: table-cell;
    padding-top: 6px;
    padding-inline-end: 3px;
   
    text-align: end !important;
    vertical-align: bottom;
    padding-inline-start: 5px;
}

:lang(ar).divTableCellNm,
:lang(fa).divTableCellNm {
    display: table-cell;
    padding-top: 6px;
    padding-inline-end: 3px;
    
    text-align: end !important;
    vertical-align: baseline;
    padding-inline-start: 20px;
}
.FrontGap{
      padding-inline-start: 20px;
}
.field-gap {
  display: inline-block;
  width: 30px;
}

.NewFlex{display: flex; align-items: flex-end;
}
  @media only screen and (max-width: 768px)
 {
        .header_container {
        flex-direction: column;
        justify-content: center;
        align-items: center !important;
    }
        .LLeft {
         margin-top: 0px !important;
         margin-bottom: 40px;
    }
       .Lright {
        padding-inline-end: 0px !important;
       }
       .flexLine {
        width: 200px !important;
       }

       .form-row {
    display: block;
   
}

.grey-box {
    background-color: #e5e5e5;
    width: 350px;
    margin-bottom: 30px;
    border-radius: 10px;
    padding-bottom: 26%;
    float: left;
    position: relative;
}


.blankLong {
  border-bottom: 2px solid #000;
  height: 18px;
  width: 100%;           /* fills the field-group width */
}
.blank {
  border-bottom: 2px solid #000;
  height: 18px;
  width: 100%;  
  margin-top: 20px;         
}
.divTableCellNm {
    display:  block;}
    .URight{
        text-align: center !important;
             padding-inline-end: 0px;
    }
    .L1right {
        text-align: center !important;
    }
    .form-row{
        margin-bottom: 0px;
    }
    :lang(ar).divTableCellNm,
:lang(fa).divTableCellNm {
    display: inline-block;
    padding-top: 6px;
    padding-inline-end: 3px;
    
    text-align: end !important;
    vertical-align: baseline;
    padding-inline-start: 20px;
}
}