{"id":2329,"date":"2019-09-09T09:05:29","date_gmt":"2019-09-09T13:05:29","guid":{"rendered":"http:\/\/aamac.ca\/?page_id=2329"},"modified":"2019-09-19T14:41:16","modified_gmt":"2019-09-19T18:41:16","slug":"wallet-card-aa","status":"publish","type":"page","link":"https:\/\/aamac.ca\/fr\/wallet-card-aa\/","title":{"rendered":"An\u00e9mie aplasique (AA)"},"content":{"rendered":"<p><div class=\"frm_forms  with_frm_style frm_center_submit frm_style_formidable-style\" id=\"frm_form_17_container\" >\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_walletcardaa-fr\" >\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_screen_reader\">Wallet Card AA -FR<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"17\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_17\" id=\"frm_hide_fields_17\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"walletcardaa-fr\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_17\" name=\"frm_submit_entry_17\" value=\"4521db338f\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/fr\/wp-json\/wp\/v2\/pages\/2329\" \/><div id=\"frm_field_147_container\" class=\"frm_form_field  frm_html_container form-field\">\n<h3 style=\"text-align: center;\">RENSEIGNEMENTS POUR L'URGENCE<\/h3>\n<h4 style=\"text-align: center;\">An\u00e9mie aplasique (AA) <\/h4>\n<\/p><\/div>\n<div id=\"frm_field_148_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third\">\r\n    <label for=\"field_c91sw2\" id=\"field_c91sw2_label\" class=\"frm_primary_label\">Nom :\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_c91sw2\" name=\"item_meta[148]\" value=\"\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_213_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_third\">\r\n    <label for=\"field_mu1co\" id=\"field_mu1co_label\" class=\"frm_primary_label\">Adresse courriel :\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_mu1co\" name=\"item_meta[213]\" value=\"\"  data-reqmsg=\"Adresse courriel : cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_149_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_eli5b2\" id=\"field_eli5b2_label\" class=\"frm_primary_label\">Date du diagnostic :\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_eli5b2\" name=\"item_meta[149]\" value=\"\"  data-invmsg=\"Text is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_150_container\" class=\"frm_form_field form-field  frm_top_container frm_half frm_first\">\r\n    <label for=\"field_1oobv2\" id=\"field_1oobv2_label\" class=\"frm_primary_label\">Type sanguin :\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_1oobv2\" name=\"item_meta[150]\" value=\"\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_151_container\" class=\"frm_form_field form-field  frm_top_container frm_half\">\r\n    <label for=\"field_g3eot2\" id=\"field_g3eot2_label\" class=\"frm_primary_label\">Anticorps connus :\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_g3eot2\" name=\"item_meta[151]\" value=\"\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_152_container\" class=\"frm_form_field form-field  frm_top_container frm_third frm_first\">\r\n    <label for=\"field_4cwiq2\" id=\"field_4cwiq2_label\" class=\"frm_primary_label\">Allergies m\u00e9dicamenteuses :\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_4cwiq2\" name=\"item_meta[152]\" value=\"\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_153_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_sah0n2\" id=\"field_sah0n2_label\" class=\"frm_primary_label\">M\u00e9decin :\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_sah0n2\" name=\"item_meta[153]\" value=\"\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_154_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_w2pjz2\" id=\"field_w2pjz2_label\" class=\"frm_primary_label\">H\u00f4pital : \r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_w2pjz2\" name=\"item_meta[154]\" value=\"\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_155_container\" class=\"frm_form_field  frm_html_container form-field\"><strong>G\u00e9n\u00e9ralit\u00e9s : <\/strong>Maladie rare caract\u00e9ris\u00e9e par une insu\ufb03sance m\u00e9dullaire qui s'accompagne de divers degr\u00e9s de cytop\u00e9nies. Les patients peuvent pr\u00e9senter de l'an\u00e9mie, un taux d'infection plus \u00e9lev\u00e9 d\u00fb \u00e0 la neutrop\u00e9nie et des saignements dus \u00e0 la thrombocytop\u00e9nie. <\/div>\n<div id=\"frm_field_156_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_9z11q2\" id=\"field_9z11q2_label\" class=\"frm_primary_label\">Sp\u00e9cificit\u00e9s :\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[156]\" id=\"field_9z11q2\" rows=\"5\"  data-invmsg=\"Sp\u00e9cificit\u00e9s : est non valide\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_157_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_tbd9m2\" id=\"field_tbd9m2_label\" class=\"frm_primary_label\">Traitement actuel : \r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[157]\" id=\"field_tbd9m2\" rows=\"5\"  data-invmsg=\"Traitement actuel :  est non valide\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_158_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_5qahk2\" id=\"field_5qahk2_label\" class=\"frm_primary_label\">Autres renseignements :\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[158]\" id=\"field_5qahk2\" rows=\"5\"  data-invmsg=\"Autres renseignements : est non valide\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t<div id=\"frm_field_311_container\">\n\t\t\t<label for=\"field_vd5f9\" >\n\t\t\t\tSi vous \u00eates un humain, ne remplissez pas ce champ.\t\t\t<\/label>\n\t\t\t<input  id=\"field_vd5f9\" type=\"text\" class=\"frm_form_field form-field frm_verify\" name=\"item_meta[311]\" value=\"\"  \/>\n\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"o0SmQgc+HgerWGf9VQwl\/BTTa2r65\/SkwJdTkkazVvzOHs8hGl8\/Imb+g94upTxQ\" \/><div class=\"frm_submit\">\r\n\r\n<button class=\"frm_button_submit frm_final_submit\" type=\"submit\"   formnovalidate=\"formnovalidate\">Submit<\/button>\r\n\r\n<\/div><\/div>\n<\/fieldset>\n<\/div>\n\n<\/form>\n<\/div>\n<\/p>","protected":false},"excerpt":{"rendered":"","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"inline_featured_image":false,"footnotes":""},"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/aamac.ca\/fr\/wp-json\/wp\/v2\/pages\/2329"}],"collection":[{"href":"https:\/\/aamac.ca\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/aamac.ca\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/aamac.ca\/fr\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/aamac.ca\/fr\/wp-json\/wp\/v2\/comments?post=2329"}],"version-history":[{"count":0,"href":"https:\/\/aamac.ca\/fr\/wp-json\/wp\/v2\/pages\/2329\/revisions"}],"wp:attachment":[{"href":"https:\/\/aamac.ca\/fr\/wp-json\/wp\/v2\/media?parent=2329"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}