{"id":7807,"date":"2021-07-09T05:07:36","date_gmt":"2021-07-09T05:07:36","guid":{"rendered":"https:\/\/20.ebaraha.in\/nutrition\/?page_id=7807"},"modified":"2021-07-28T05:29:33","modified_gmt":"2021-07-28T05:29:33","slug":"initial-screening-form","status":"publish","type":"page","link":"https:\/\/20.ebaraha.in\/nutrition\/index.php\/initial-screening-form\/","title":{"rendered":"Initial Screening form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"7807\" class=\"elementor elementor-7807\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2965567 elementor-hidden-phone elementor-section-boxed elementor-section-height-default elementor-section-height-default qodef-elementor-content-no\" data-id=\"2965567\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-aa2d860\" data-id=\"aa2d860\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-0b4ce11 elementor-widget elementor-widget-wpforms\" data-id=\"0b4ce11\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wpforms.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-7295\"><form id=\"wpforms-form-7295\" class=\"wpforms-validate wpforms-form\" data-formid=\"7295\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/nutrition\/index.php\/wp-json\/wp\/v2\/pages\/7807\" data-token=\"0bc8724923fa15b3314d76a840a6a9a2\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-7295-field_2-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_2\">Name <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-7295-field_2\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][2]\" required><\/div><div id=\"wpforms-7295-field_1-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_1\">Email <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-7295-field_1\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][1]\" required><\/div><div id=\"wpforms-7295-field_3-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_3\">Phone No. <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-7295-field_3\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][3]\" required><\/div><div id=\"wpforms-7295-field_4-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_4\">Age<\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-7295-field_4\" class=\"wpforms-field-medium\" name=\"wpforms[fields][4]\" ><\/div><div id=\"wpforms-7295-field_5-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_5\">Weight <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-7295-field_5\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][5]\" required><\/div><div id=\"wpforms-7295-field_6-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_6\">Height <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-7295-field_6\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][6]\" required><\/div><div id=\"wpforms-7295-field_7-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-3-columns\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_7\">Please select  if you have any of these diseases\/conditions <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-7295-field_7\" class=\"wpforms-randomize wpforms-field-required wpforms-image-choices wpforms-image-choices-classic\" data-choice-limit=\"10\"><li class=\"choice-1 depth-1 wpforms-image-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-7295-field_7_1\" tabindex=\"0\"><input type=\"checkbox\" id=\"wpforms-7295-field_7_1\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][7][]\" value=\"Diabetes\" tabindex=\"-1\" required ><span class=\"wpforms-image-choices-label\">Diabetes<\/span><\/label><\/li><li class=\"choice-2 depth-1 wpforms-image-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-7295-field_7_2\" tabindex=\"0\"><input type=\"checkbox\" id=\"wpforms-7295-field_7_2\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][7][]\" value=\"Hypertension\" tabindex=\"-1\" required ><span class=\"wpforms-image-choices-label\">Hypertension<\/span><\/label><\/li><li class=\"choice-3 depth-1 wpforms-image-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-7295-field_7_3\" tabindex=\"0\"><input type=\"checkbox\" id=\"wpforms-7295-field_7_3\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][7][]\" value=\"Overweight\" tabindex=\"-1\" required ><span class=\"wpforms-image-choices-label\">Overweight<\/span><\/label><\/li><li class=\"choice-10 depth-1 wpforms-image-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-7295-field_7_10\" tabindex=\"0\"><input type=\"checkbox\" id=\"wpforms-7295-field_7_10\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][7][]\" value=\"Tiredness\/fatigue\" tabindex=\"-1\" required ><span class=\"wpforms-image-choices-label\">Tiredness\/fatigue<\/span><\/label><\/li><li class=\"choice-9 depth-1 wpforms-image-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-7295-field_7_9\" tabindex=\"0\"><input type=\"checkbox\" id=\"wpforms-7295-field_7_9\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][7][]\" value=\"No appetite\/not hungry  \" tabindex=\"-1\" required ><span class=\"wpforms-image-choices-label\">No appetite\/not hungry  <\/span><\/label><\/li><li class=\"choice-8 depth-1 wpforms-image-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-7295-field_7_8\" tabindex=\"0\"><input type=\"checkbox\" id=\"wpforms-7295-field_7_8\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][7][]\" value=\"Acidity\/Heartburn\" tabindex=\"-1\" required ><span class=\"wpforms-image-choices-label\">Acidity\/Heartburn<\/span><\/label><\/li><li class=\"choice-5 depth-1 wpforms-image-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-7295-field_7_5\" tabindex=\"0\"><input type=\"checkbox\" id=\"wpforms-7295-field_7_5\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][7][]\" value=\"Kidney diseases\" tabindex=\"-1\" required ><span class=\"wpforms-image-choices-label\">Kidney diseases<\/span><\/label><\/li><li class=\"choice-11 depth-1 wpforms-image-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-7295-field_7_11\" tabindex=\"0\"><input type=\"checkbox\" id=\"wpforms-7295-field_7_11\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][7][]\" value=\"Liver disease\" tabindex=\"-1\" required ><span class=\"wpforms-image-choices-label\">Liver disease<\/span><\/label><\/li><li class=\"choice-12 depth-1 wpforms-image-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-7295-field_7_12\" tabindex=\"0\"><input type=\"checkbox\" id=\"wpforms-7295-field_7_12\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][7][]\" value=\"Nill\" tabindex=\"-1\" required ><span class=\"wpforms-image-choices-label\">Nill<\/span><\/label><\/li><\/ul><\/div><div id=\"wpforms-7295-field_16-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_16\">Any gastro-intestinal disease Please specify<\/label><input type=\"text\" id=\"wpforms-7295-field_16\" class=\"wpforms-field-medium\" name=\"wpforms[fields][16]\" ><\/div><div id=\"wpforms-7295-field_17-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"17\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_17\">Any other pyschosocial concerns <\/label><input type=\"text\" id=\"wpforms-7295-field_17\" class=\"wpforms-field-medium\" name=\"wpforms[fields][17]\" ><\/div><div id=\"wpforms-7295-field_18-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"18\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_18\">Any  heart disease please specify the type<\/label><input type=\"text\" id=\"wpforms-7295-field_18\" class=\"wpforms-field-medium\" name=\"wpforms[fields][18]\" ><\/div><div id=\"wpforms-7295-field_20-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"20\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_20\">Any cancer please specify type<\/label><input type=\"text\" id=\"wpforms-7295-field_20\" class=\"wpforms-field-medium\" name=\"wpforms[fields][20]\" ><\/div><div id=\"wpforms-7295-field_21-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"21\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_21\">Any other Diseases<\/label><input type=\"text\" id=\"wpforms-7295-field_21\" class=\"wpforms-field-medium\" name=\"wpforms[fields][21]\" ><\/div><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"7295\"><input type=\"hidden\" name=\"wpforms[author]\" value=\"1\"><button type=\"submit\" name=\"wpforms[submit]\" class=\"wpforms-submit \" id=\"wpforms-submit-7295\" value=\"wpforms-submit\" aria-live=\"assertive\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\">Submit<\/button><\/div><\/form><\/div>  <!-- .wpforms-container -->\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-4571ed0 elementor-section-boxed elementor-section-height-default elementor-section-height-default qodef-elementor-content-no\" data-id=\"4571ed0\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7e61522\" data-id=\"7e61522\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e23bdfb elementor-hidden-desktop elementor-hidden-tablet elementor-widget elementor-widget-wpforms\" data-id=\"e23bdfb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wpforms.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-7295\"><form id=\"wpforms-form-7295\" class=\"wpforms-validate wpforms-form\" data-formid=\"7295\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/nutrition\/index.php\/wp-json\/wp\/v2\/pages\/7807\" data-token=\"0bc8724923fa15b3314d76a840a6a9a2\"><div class=\"wpforms-head-container\"><div class=\"wpforms-title\">Intake Form<\/div><\/div><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-7295-field_2-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_2\">Name <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-7295-field_2\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][2]\" required><\/div><div id=\"wpforms-7295-field_1-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_1\">Email <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-7295-field_1\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][1]\" required><\/div><div id=\"wpforms-7295-field_3-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_3\">Phone No. <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-7295-field_3\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][3]\" required><\/div><div id=\"wpforms-7295-field_4-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_4\">Age<\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-7295-field_4\" class=\"wpforms-field-medium\" name=\"wpforms[fields][4]\" ><\/div><div id=\"wpforms-7295-field_5-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_5\">Weight <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-7295-field_5\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][5]\" required><\/div><div id=\"wpforms-7295-field_6-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_6\">Height <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-7295-field_6\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][6]\" required><\/div><div id=\"wpforms-7295-field_7-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-3-columns\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_7\">Please select  if you have any of these diseases\/conditions <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-7295-field_7\" class=\"wpforms-randomize wpforms-field-required wpforms-image-choices wpforms-image-choices-classic\" data-choice-limit=\"10\"><li class=\"choice-1 depth-1 wpforms-image-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-7295-field_7_1\" tabindex=\"0\"><input type=\"checkbox\" id=\"wpforms-7295-field_7_1\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][7][]\" value=\"Diabetes\" tabindex=\"-1\" required ><span class=\"wpforms-image-choices-label\">Diabetes<\/span><\/label><\/li><li class=\"choice-2 depth-1 wpforms-image-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-7295-field_7_2\" tabindex=\"0\"><input type=\"checkbox\" id=\"wpforms-7295-field_7_2\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][7][]\" value=\"Hypertension\" tabindex=\"-1\" required ><span class=\"wpforms-image-choices-label\">Hypertension<\/span><\/label><\/li><li class=\"choice-3 depth-1 wpforms-image-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-7295-field_7_3\" tabindex=\"0\"><input type=\"checkbox\" id=\"wpforms-7295-field_7_3\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][7][]\" value=\"Overweight\" tabindex=\"-1\" required ><span class=\"wpforms-image-choices-label\">Overweight<\/span><\/label><\/li><li class=\"choice-10 depth-1 wpforms-image-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-7295-field_7_10\" tabindex=\"0\"><input type=\"checkbox\" id=\"wpforms-7295-field_7_10\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][7][]\" value=\"Tiredness\/fatigue\" tabindex=\"-1\" required ><span class=\"wpforms-image-choices-label\">Tiredness\/fatigue<\/span><\/label><\/li><li class=\"choice-9 depth-1 wpforms-image-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-7295-field_7_9\" tabindex=\"0\"><input type=\"checkbox\" id=\"wpforms-7295-field_7_9\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][7][]\" value=\"No appetite\/not hungry  \" tabindex=\"-1\" required ><span class=\"wpforms-image-choices-label\">No appetite\/not hungry  <\/span><\/label><\/li><li class=\"choice-8 depth-1 wpforms-image-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-7295-field_7_8\" tabindex=\"0\"><input type=\"checkbox\" id=\"wpforms-7295-field_7_8\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][7][]\" value=\"Acidity\/Heartburn\" tabindex=\"-1\" required ><span class=\"wpforms-image-choices-label\">Acidity\/Heartburn<\/span><\/label><\/li><li class=\"choice-5 depth-1 wpforms-image-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-7295-field_7_5\" tabindex=\"0\"><input type=\"checkbox\" id=\"wpforms-7295-field_7_5\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][7][]\" value=\"Kidney diseases\" tabindex=\"-1\" required ><span class=\"wpforms-image-choices-label\">Kidney diseases<\/span><\/label><\/li><li class=\"choice-11 depth-1 wpforms-image-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-7295-field_7_11\" tabindex=\"0\"><input type=\"checkbox\" id=\"wpforms-7295-field_7_11\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][7][]\" value=\"Liver disease\" tabindex=\"-1\" required ><span class=\"wpforms-image-choices-label\">Liver disease<\/span><\/label><\/li><li class=\"choice-12 depth-1 wpforms-image-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-7295-field_7_12\" tabindex=\"0\"><input type=\"checkbox\" id=\"wpforms-7295-field_7_12\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][7][]\" value=\"Nill\" tabindex=\"-1\" required ><span class=\"wpforms-image-choices-label\">Nill<\/span><\/label><\/li><\/ul><\/div><div id=\"wpforms-7295-field_16-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_16\">Any gastro-intestinal disease Please specify<\/label><input type=\"text\" id=\"wpforms-7295-field_16\" class=\"wpforms-field-medium\" name=\"wpforms[fields][16]\" ><\/div><div id=\"wpforms-7295-field_17-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"17\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_17\">Any other pyschosocial concerns <\/label><input type=\"text\" id=\"wpforms-7295-field_17\" class=\"wpforms-field-medium\" name=\"wpforms[fields][17]\" ><\/div><div id=\"wpforms-7295-field_18-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"18\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_18\">Any  heart disease please specify the type<\/label><input type=\"text\" id=\"wpforms-7295-field_18\" class=\"wpforms-field-medium\" name=\"wpforms[fields][18]\" ><\/div><div id=\"wpforms-7295-field_20-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"20\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_20\">Any cancer please specify type<\/label><input type=\"text\" id=\"wpforms-7295-field_20\" class=\"wpforms-field-medium\" name=\"wpforms[fields][20]\" ><\/div><div id=\"wpforms-7295-field_21-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"21\"><label class=\"wpforms-field-label\" for=\"wpforms-7295-field_21\">Any other Diseases<\/label><input type=\"text\" id=\"wpforms-7295-field_21\" class=\"wpforms-field-medium\" name=\"wpforms[fields][21]\" ><\/div><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"7295\"><input type=\"hidden\" name=\"wpforms[author]\" value=\"1\"><button type=\"submit\" name=\"wpforms[submit]\" class=\"wpforms-submit \" id=\"wpforms-submit-7295\" value=\"wpforms-submit\" aria-live=\"assertive\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\">Submit<\/button><\/div><\/form><\/div>  <!-- .wpforms-container -->\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-7807","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/20.ebaraha.in\/nutrition\/index.php\/wp-json\/wp\/v2\/pages\/7807","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/20.ebaraha.in\/nutrition\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/20.ebaraha.in\/nutrition\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/20.ebaraha.in\/nutrition\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/20.ebaraha.in\/nutrition\/index.php\/wp-json\/wp\/v2\/comments?post=7807"}],"version-history":[{"count":26,"href":"https:\/\/20.ebaraha.in\/nutrition\/index.php\/wp-json\/wp\/v2\/pages\/7807\/revisions"}],"predecessor-version":[{"id":8358,"href":"https:\/\/20.ebaraha.in\/nutrition\/index.php\/wp-json\/wp\/v2\/pages\/7807\/revisions\/8358"}],"wp:attachment":[{"href":"https:\/\/20.ebaraha.in\/nutrition\/index.php\/wp-json\/wp\/v2\/media?parent=7807"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}