{"id":2529,"date":"2025-10-04T13:09:22","date_gmt":"2025-10-04T13:09:22","guid":{"rendered":"https:\/\/dryasserrifay.com\/?page_id=2529"},"modified":"2025-10-06T14:48:19","modified_gmt":"2025-10-06T14:48:19","slug":"fiche-patient","status":"publish","type":"page","link":"https:\/\/dryasserrifay.com\/ar\/fiche-patient\/","title":{"rendered":"Fiche patient"},"content":{"rendered":"<style>.elementor-2529 .elementor-element.elementor-element-140e6745{--display:flex;--flex-direction:column;--container-widget-width:calc( ( 1 - var( --container-widget-flex-grow ) ) * 100% );--container-widget-height:initial;--container-widget-flex-grow:0;--container-widget-align-self:initial;--flex-wrap-mobile:wrap;--align-items:stretch;--gap:20px 20px;--row-gap:20px;--column-gap:20px;--overlay-opacity:0.89;--margin-top:0%;--margin-bottom:0%;--margin-left:0%;--margin-right:0%;--padding-top:20px;--padding-bottom:30px;--padding-left:20px;--padding-right:20px;overflow:visible;}.elementor-2529 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class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t\u0627\u0644\u0645\u0644\u0641 \u0627\u0644\u0634\u062e\u0635\u064a \u0639\u0644\u0649 \u0648\u0633\u0627\u0626\u0644 \u0627\u0644\u062a\u0648\u0627\u0635\u0644 \u0627\u0644\u0627\u062c\u062a\u0645\u0627\u0639\u064a:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_511b8e4]\" id=\"form-field-field_511b8e4\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_dd31fdd elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_dd31fdd\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t1\/ \u0623\u064f\u062d\u064a\u0644 \u0645\u0646 \u0637\u0631\u0641:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Ophtalmologiste\" id=\"form-field-field_dd31fdd-0\" name=\"form_fields[field_dd31fdd]\"> <label for=\"form-field-field_dd31fdd-0\">\u0637\u0628\u064a\u0628 \u0639\u064a\u0648\u0646<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"M\u00e9decin non ophtalmologiste\" id=\"form-field-field_dd31fdd-1\" name=\"form_fields[field_dd31fdd]\"> <label for=\"form-field-field_dd31fdd-1\">\u0637\u0628\u064a\u0628 \u063a\u064a\u0631 \u0645\u062e\u062a\u0635 \u0641\u064a \u0627\u0644\u0639\u064a\u0648\u0646<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Opticien\" id=\"form-field-field_dd31fdd-2\" name=\"form_fields[field_dd31fdd]\"> <label for=\"form-field-field_dd31fdd-2\">\u0623\u062e\u0635\u0627\u0626\u064a \u0628\u0635\u0631\u064a\u0627\u062a<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Orthoptiste\" id=\"form-field-field_dd31fdd-3\" name=\"form_fields[field_dd31fdd]\"> <label for=\"form-field-field_dd31fdd-3\">\u0627\u062e\u062a\u0635\u0627\u0635\u064a \u062a\u0642\u0648\u064a\u0645 \u0628\u0635\u0631\u064a<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Oculariste\" id=\"form-field-field_dd31fdd-4\" name=\"form_fields[field_dd31fdd]\"> <label for=\"form-field-field_dd31fdd-4\">\u0635\u0627\u0646\u0639 \u0639\u064a\u0648\u0646 \u0635\u0646\u0627\u0639\u064a\u0629<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Pharmacien\" id=\"form-field-field_dd31fdd-5\" name=\"form_fields[field_dd31fdd]\"> <label for=\"form-field-field_dd31fdd-5\">\u0635\u064a\u062f\u0644\u064a<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Autre\" id=\"form-field-field_dd31fdd-6\" name=\"form_fields[field_dd31fdd]\"> <label for=\"form-field-field_dd31fdd-6\">\u0622\u062e\u0631<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_a5c9257 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_a5c9257]\" id=\"form-field-field_a5c9257\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"\u064a\u0631\u062c\u0649 \u0627\u0644\u062a\u062d\u062f\u064a\u062f\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_cdb580f elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_cdb580f\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t2\/ \u0639\u0646 \u0637\u0631\u064a\u0642 \u0627\u0644\u062a\u0648\u0635\u064a\u0629 \u0627\u0644\u0634\u0641\u0648\u064a\u0629 (\u0645\u0646 \u0634\u062e\u0635 \u0644\u0622\u062e\u0631):\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Oui\" id=\"form-field-field_cdb580f-0\" name=\"form_fields[field_cdb580f]\"> <label for=\"form-field-field_cdb580f-0\">\u0646\u0639\u0645<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Non\" id=\"form-field-field_cdb580f-1\" name=\"form_fields[field_cdb580f]\"> <label for=\"form-field-field_cdb580f-1\">\u0644\u0627<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_8ea58e6 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_8ea58e6\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t \u0625\u0630\u0627 \u0643\u0627\u0646\u062a \u0627\u0644\u0625\u062c\u0627\u0628\u0629 \u0646\u0639\u0645\u060c \u064a\u0631\u062c\u0649 \u062a\u062d\u062f\u064a\u062f \u0627\u0644\u0634\u062e\u0635:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_8ea58e6]\" id=\"form-field-field_8ea58e6\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_fbcc59d elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_fbcc59d\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t3\/ \u0648\u0633\u0627\u0626\u0644 \u0627\u0644\u062a\u0648\u0627\u0635\u0644 \u0627\u0644\u0627\u062c\u062a\u0645\u0627\u0639\u064a\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Instagram\" id=\"form-field-field_fbcc59d-0\" name=\"form_fields[field_fbcc59d]\"> <label for=\"form-field-field_fbcc59d-0\">\u0625\u0646\u0633\u062a\u063a\u0631\u0627\u0645<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Facebook\" id=\"form-field-field_fbcc59d-1\" name=\"form_fields[field_fbcc59d]\"> <label for=\"form-field-field_fbcc59d-1\">\u0641\u064a\u0633\u0628\u0648\u0643<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"TikTok\" id=\"form-field-field_fbcc59d-2\" name=\"form_fields[field_fbcc59d]\"> <label for=\"form-field-field_fbcc59d-2\">\u062a\u064a\u0643 \u062a\u0648\u0643<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Threads\" id=\"form-field-field_fbcc59d-3\" name=\"form_fields[field_fbcc59d]\"> <label for=\"form-field-field_fbcc59d-3\">\u062b\u0631\u064a\u062f\u0632<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"YouTube (vid\u00e9o explicative \/ short)\" id=\"form-field-field_fbcc59d-4\" name=\"form_fields[field_fbcc59d]\"> <label for=\"form-field-field_fbcc59d-4\">\u064a\u0648\u062a\u064a\u0648\u0628 (\u0641\u064a\u062f\u064a\u0648 \u062a\u0648\u0636\u064a\u062d\u064a \/ \u0642\u0635\u064a\u0631)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Story Whatsapp\" id=\"form-field-field_fbcc59d-5\" name=\"form_fields[field_fbcc59d]\"> <label for=\"form-field-field_fbcc59d-5\">\u0633\u062a\u0648\u0631\u064a \u0648\u0627\u062a\u0633\u0627\u0628<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Groupe Facebook (\u00ab J\u2019ai test\u00e9\u2026 \u00bb)\" id=\"form-field-field_fbcc59d-6\" name=\"form_fields[field_fbcc59d]\"> <label for=\"form-field-field_fbcc59d-6\">\u0645\u062c\u0645\u0648\u0639\u0629 \u0641\u064a\u0633\u0628\u0648\u0643<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Autres\" id=\"form-field-field_fbcc59d-7\" name=\"form_fields[field_fbcc59d]\"> <label for=\"form-field-field_fbcc59d-7\">\u0623\u062e\u0631\u0649<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_ee76d59 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_ee76d59]\" id=\"form-field-field_ee76d59\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"\u064a\u0631\u062c\u0649 \u0627\u0644\u062a\u062d\u062f\u064a\u062f\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_0808a07 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_0808a07\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t4\/ \u0646\u0648\u0639 \u0627\u0644\u062a\u0641\u0627\u0639\u0644\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Commentaire\" id=\"form-field-field_0808a07-0\" name=\"form_fields[field_0808a07]\"> <label for=\"form-field-field_0808a07-0\">\u062a\u0639\u0644\u064a\u0642<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Inbox \/ Message priv\u00e9\" id=\"form-field-field_0808a07-1\" name=\"form_fields[field_0808a07]\"> <label for=\"form-field-field_0808a07-1\">\u0635\u0646\u062f\u0648\u0642 \u0627\u0644\u0631\u0633\u0627\u0626\u0644 \/ \u0631\u0633\u0627\u0644\u0629 \u062e\u0627\u0635\u0629<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Story vue \/ partag\u00e9e\" id=\"form-field-field_0808a07-2\" name=\"form_fields[field_0808a07]\"> <label for=\"form-field-field_0808a07-2\">\u0642\u0635\u0629 \u062a\u0645 \u0645\u0634\u0627\u0647\u062f\u062a\u0647\u0627 \/ \u0645\u0634\u0627\u0631\u0643\u062a\u0647\u0627<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Vid\u00e9o explicative regard\u00e9e\" id=\"form-field-field_0808a07-3\" name=\"form_fields[field_0808a07]\"> <label for=\"form-field-field_0808a07-3\">\u0641\u064a\u062f\u064a\u0648 \u062a\u0648\u0636\u064a\u062d\u064a \u062a\u0645\u062a \u0645\u0634\u0627\u0647\u062f\u062a\u0647<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Autre\" id=\"form-field-field_0808a07-4\" name=\"form_fields[field_0808a07]\"> <label for=\"form-field-field_0808a07-4\">\u0622\u062e\u0631<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_8c197db elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_8c197db]\" id=\"form-field-field_8c197db\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"\u064a\u0631\u062c\u0649 \u0627\u0644\u062a\u062d\u062f\u064a\u062f\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"jki jki-send-line\"><\/i>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">\u0625\u0631\u0633\u0627\u0644 <\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<input type=\"hidden\" name=\"trp-form-language\" value=\"ar\"\/><\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Fiche de R\u00e9f\u00e9rence \u2013 Origine du Patient Cette fiche nous aide \u00e0 savoir comment vous avez d\u00e9couvert le cabinet et \u00e0 mieux organiser votre suivi. Toutes vos r\u00e9ponses seront trait\u00e9es de mani\u00e8re confidentielle.<\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_canvas","meta":{"footnotes":""},"class_list":["post-2529","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/dryasserrifay.com\/ar\/wp-json\/wp\/v2\/pages\/2529","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dryasserrifay.com\/ar\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dryasserrifay.com\/ar\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dryasserrifay.com\/ar\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/dryasserrifay.com\/ar\/wp-json\/wp\/v2\/comments?post=2529"}],"version-history":[{"count":58,"href":"https:\/\/dryasserrifay.com\/ar\/wp-json\/wp\/v2\/pages\/2529\/revisions"}],"predecessor-version":[{"id":3065,"href":"https:\/\/dryasserrifay.com\/ar\/wp-json\/wp\/v2\/pages\/2529\/revisions\/3065"}],"wp:attachment":[{"href":"https:\/\/dryasserrifay.com\/ar\/wp-json\/wp\/v2\/media?parent=2529"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}