<?php

/* DorcasTabithaBundle:ClientInformation:clientinformationlayout.html.twig */
class __TwigTemplate_1ce8f15e683028b0831bf892ebc6d3a6 extends Twig_Template
{
    public function __construct(Twig_Environment $env)
    {
        parent::__construct($env);

        $this->parent = false;

        $this->blocks = array(
        );
    }

    protected function doDisplay(array $context, array $blocks = array())
    {
        // line 1
        echo "
<div id=\"navbar\" style=\"font-size:18px;\">   
    <ul>     
        <li><a href=\"javascript: submitFormClient(9)\">Home</a></li>
        <li><a href=\"javascript: submitFormClient(1)\" style=\"background-color:#00b5cb; font-size:30px;\">Client Information</a></li> 
        <li><a href=\"javascript: submitFormClient(2)\">Finance</a></li>
        <li><a href=\"javascript: submitFormClient(3)\">Notes</a></li>
        <li><a href=\"javascript: submitFormClient(4)\">Assistance</a></li>
        <li><a href=\"javascript: submitFormClient(5)\">Referrals</a></li>  
    </ul> 
</div>

        <br>&nbsp;
        <input type=\"button\" value=\"Save/Next\" onclick=\"savenext(false)\" style=\"color:#00b5cb; background-color:white;\" >
        <input type=\"button\" value=\"Cancel Changes\" onClick=\"window.location.reload()\" style=\"color:#00b5cb; background-color:white;\">
        <br>&nbsp;<br>

        <div style=\"color:maroon;\">
        ";
        // line 19
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($_form_);
        echo "
        </div>

        <div id=\"ssn\">
            ";
        // line 23
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "ssn"));
        echo "

            ";
        // line 25
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "ssn"), array("attr" => array("size" => "11", "class" => "ssn")));
        echo "
        </div>
        <div id=\"first_name\">
            ";
        // line 28
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "first_name"));
        echo "
            ";
        // line 29
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "first_name"));
        echo "
            ";
        // line 30
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "first_name"), array("attr" => array("size" => "30")));
        echo "
        </div>
        <div id=\"middle_name\">
            ";
        // line 33
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "middle_name"));
        echo "
            ";
        // line 34
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "middle_name"));
        echo "
            ";
        // line 35
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "middle_name"), array("attr" => array("size" => "20")));
        echo "
        </div>
        <div id=\"last_name\">
            ";
        // line 38
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "last_name"));
        echo "
            ";
        // line 39
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "last_name"));
        echo "
            ";
        // line 40
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "last_name"), array("attr" => array("size" => "30")));
        echo "
        </div>


        <div id=\"current_address\">
        ";
        // line 45
        if (isset($context["client"])) { $_client_ = $context["client"]; } else { $_client_ = null; }
        if ($this->getAttribute($_client_, "currentaddress", array(), "any", true, true)) {
            // line 46
            echo "            <a href=\"#\" onclick='warnUsersSearch(\"../search/false?clientinformationform%5Bcurrent_address%5D=";
            if (isset($context["client"])) { $_client_ = $context["client"]; } else { $_client_ = null; }
            echo twig_escape_filter($this->env, $this->getAttribute($_client_, "currentaddress"), "html", null, true);
            echo " \")'>Current Address:</a>
        ";
        } else {
            // line 48
            echo "            ";
            if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
            echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "current_address"));
            echo "
        ";
        }
        // line 50
        echo "            ";
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "current_address"));
        echo "
            ";
        // line 51
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "current_address"), array("attr" => array("size" => "50")));
        echo "
        </div>
        <div id=\"email\">
            ";
        // line 54
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "email"));
        echo "
            ";
        // line 55
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "email"));
        echo "
            ";
        // line 56
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "email"), array("attr" => array("size" => "30")));
        echo "
        </div>
        <div id=\"city\">
            ";
        // line 59
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "city"));
        echo "
            ";
        // line 60
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "city"));
        echo "
            ";
        // line 61
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "city"), array("attr" => array("size" => "30")));
        echo "
        </div>
        <div id=\"state\">
            ";
        // line 64
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "state"));
        echo "
            ";
        // line 65
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "state"));
        echo "
            ";
        // line 66
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "state"), array("attr" => array("size" => "2")));
        echo "
        </div>
        <div id=\"zipcode\">
            ";
        // line 69
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "zipcode"));
        echo "
            ";
        // line 70
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "zipcode"));
        echo "
            ";
        // line 71
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "zipcode"), array("attr" => array("size" => "6", "class" => "zip")));
        echo "
        </div>
        <div id=\"genderLabel\">
            ";
        // line 74
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "gender"));
        echo "
            ";
        // line 75
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "gender"));
        echo "
        </div>
        <div id=\"genderWidget\">
            ";
        // line 78
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "gender"));
        echo "
        </div>
<br/>
        <div id=\"home_phone\">
            ";
        // line 82
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "home_phone"));
        echo "
            ";
        // line 83
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "home_phone"));
        echo "
            ";
        // line 84
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "home_phone"), array("attr" => array("size" => "15", "class" => "phone")));
        echo "
        </div>
        <div id=\"cell_phone\">
            ";
        // line 87
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "cell_phone"));
        echo "
            ";
        // line 88
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "cell_phone"));
        echo "
            ";
        // line 89
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "cell_phone"), array("attr" => array("size" => "15", "class" => "phone")));
        echo "
        </div>
        <div id=\"work_phone\">
            ";
        // line 92
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "work_phone"));
        echo "
            ";
        // line 93
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "work_phone"));
        echo "
            ";
        // line 94
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "work_phone"), array("attr" => array("size" => "15", "class" => "phone")));
        echo "
        </div>
        <div id=\"birth_date\">
            ";
        // line 97
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "birth_date"));
        echo "
            ";
        // line 98
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "birth_date"));
        echo "
            ";
        // line 99
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "birth_date"), array("attr" => array("size" => "11", "class" => "datepicker")));
        echo "
        </div>

        <div id=\"prev_address1\">
            ";
        // line 103
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "prev_address1"));
        echo "
            ";
        // line 104
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "prev_address1"));
        echo "
            ";
        // line 105
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "prev_address1"), array("attr" => array("size" => "100")));
        echo "
        </div>
        <div id=\"prev_address2\">
            ";
        // line 108
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "prev_address2"));
        echo "
            ";
        // line 109
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "prev_address2"));
        echo "
            ";
        // line 110
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "prev_address2"), array("attr" => array("size" => "100")));
        echo "
        </div>
        
\t\t<div id=\"license_no\">
            ";
        // line 114
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "license_no"));
        echo "
            ";
        // line 115
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "license_no"));
        echo "
            ";
        // line 116
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "license_no"), array("attr" => array("size" => "13")));
        echo "
        </div>
\t\t<div id=\"license_state\">
            ";
        // line 119
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "license_state"));
        echo "
            ";
        // line 120
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "license_state"));
        echo "
            ";
        // line 121
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "license_state"), array("attr" => array("size" => "2")));
        echo "
        </div>
        <div id=\"ethnicity\">
            ";
        // line 124
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "ethnicity"));
        echo "
            ";
        // line 125
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "ethnicity"));
        echo "
            ";
        // line 126
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "ethnicity"), array("attr" => array("style" => "width: 160px;")));
        echo "
        </div>

        <div id=\"employer\">
            ";
        // line 130
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "employer"));
        echo "
            ";
        // line 131
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "employer"));
        echo "
            ";
        // line 132
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "employer"), array("attr" => array("size" => "27")));
        echo "
        </div>
        <div id=\"employment_type\">
            ";
        // line 135
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "employment_type"));
        echo "
            ";
        // line 136
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "employment_type"));
        echo "
        </div>
<br/>
        <div id=\"alias\">
            ";
        // line 140
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "alias"));
        echo "
            ";
        // line 141
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "alias"));
        echo "
            ";
        // line 142
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "alias"), array("attr" => array("size" => "30")));
        echo "
        </div>
\t\t<div id=\"church_affiliation\">
            ";
        // line 145
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "church_affiliation"));
        echo "
            ";
        // line 146
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "church_affiliation"));
        echo "
            ";
        // line 147
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "church_affiliation"), array("attr" => array("size" => "30")));
        echo "
        </div>
\t\t

        <div style=\"float: left;\">
\t\t
            <div id=\"other_adult_oneFirstName\">
                ";
        // line 154
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "other_adult_oneFirstName"));
        echo "
                ";
        // line 155
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "other_adult_oneFirstName"));
        echo "
                ";
        // line 156
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "other_adult_oneFirstName"), array("attr" => array("size" => "30")));
        echo "
            </div>
            <div id=\"other_adult_oneLastName\">
                ";
        // line 159
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "other_adult_oneLastName"));
        echo "
                ";
        // line 160
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "other_adult_oneLastName"));
        echo "
                ";
        // line 161
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "other_adult_oneLastName"), array("attr" => array("size" => "30")));
        echo "
            </div>
            <div id=\"other_adult_oneSsn\">
                ";
        // line 164
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "other_adult_oneSsn"));
        echo "
                ";
        // line 165
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "other_adult_oneSsn"));
        echo "
                ";
        // line 166
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "other_adult_oneSsn"), array("attr" => array("size" => "11", "class" => "ssn")));
        echo "
            </div>
         
        </div>
\t\t
\t\t
\t\t
        <div style=\"float: left; padding:3px;\">
\t\t
        <div id=\"other_adult_twoFirstName\">
            ";
        // line 176
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "other_adult_twoFirstName"));
        echo "
            ";
        // line 177
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "other_adult_twoFirstName"));
        echo "
            ";
        // line 178
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "other_adult_twoFirstName"), array("attr" => array("size" => "30")));
        echo "
        </div>
        <div id=\"other_adult_twoLastName\">
            ";
        // line 181
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "other_adult_twoLastName"));
        echo "
            ";
        // line 182
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "other_adult_twoLastName"));
        echo "
            ";
        // line 183
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "other_adult_twoLastName"), array("attr" => array("size" => "30")));
        echo "
        </div>
        <div id=\"other_adult_twoSsn\">
            ";
        // line 186
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "other_adult_twoSsn"));
        echo "
            ";
        // line 187
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "other_adult_twoSsn"));
        echo "
            ";
        // line 188
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "other_adult_twoSsn"), array("attr" => array("size" => "11", "class" => "ssn")));
        echo "
        </div>
\t\t
\t\t</div>
\t\t

\t\t<br>&nbsp;<br>
\t\t<br>&nbsp;<br>
\t\t<br>&nbsp;<br>
\t\t
        <div id=\"children\">
            ";
        // line 199
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "children"));
        echo "
            ";
        // line 200
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderErrors($this->getAttribute($_form_, "children"));
        echo "
\t\t\t
<br/>
            ";
        // line 203
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "children"), array("attr" => array("rows" => "4", "cols" => "100", "title" => "Name(s), Sex, Date of Birth")));
        echo "
        </div>
        ";
        // line 205
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderRest($_form_);
        echo "
<br/>


\t
";
    }

    public function getTemplateName()
    {
        return "DorcasTabithaBundle:ClientInformation:clientinformationlayout.html.twig";
    }

    public function isTraitable()
    {
        return false;
    }

    public function getDebugInfo()
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}
