interface/new/new_dutch.php

   1 <?php
   2 include_once("../globals.php");
   3
   4 // Determine if the registration date should be requested.
   5 $crow = sqlQuery("SELECT count(*) AS count FROM layout_options WHERE " .
   6   "form_id = 'DEM' AND field_id = 'regdate' AND uor > 0");
   7 $regstyle = $crow['count'] ? "" : " style='display:none'";
   8 ?>
   9 <html>
  10
  11 <head>
  12 <?php html_header_show();?>
  13 <link rel="stylesheet" href="<?php echo xl($css_header,'e');?>" type="text/css">
  14 <link rel="stylesheet" href="../themes/style_dbc.css" type="text/css">
  15
  16 <script type="text/javascript" src="../../library/js/jquery.js"></script>
  17 <script type="text/javascript" src="../../library/js/jquery-calendar.js"></script>
  18 <link rel="stylesheet" type="text/css" href="../../library/js/jquery-calendar.css">
  19
  20 <script type="text/javascript">
  21 $(document).ready(function(){
  22     popUpCal.regional['nl'] = {
  23         clearText: 'sterge | ',
  24         closeText: 'inchide',
  25         prevText: '&laquo;&nbsp; | ',
  26         nextText: ' | &nbsp;&raquo;',
  27         currentText: 'Azi',
  28
  29         firstDay: 1,
  30         dayNames: [
  31                 'D', 'L', 'Ma', 'Mi', 'J', 'V', 'S'
  32         ],
  33         monthNames: [
  34                 'Januarie', 'Februarie', 'Martie', 'Aprilie', 'Mai', 'Junie',
  35                 'Julie', 'August', 'Septembrie', 'Octombrie', 'Noiembrie', 'Decembrie'
  36         ],
  37
  38         dateFormat: 'YMD-'
  39     };
  40
  41     //popUpCal.setDefaults(popUpCal.regional['nl']);
  42     $('#dbc_insdatum').calendar({autoPopUp: 'button', buttonImageOnly: false,
  43         buttonImage: '', buttonText: '...', yearRange: '-1:+1', dateFormat: 'YMD-'});
  44
  45     $('#dbc_policy').attr("disabled","disabled");
  46     $('#dbc_insdatum').attr("disabled","disabled");
  47
  48     $('#dbc_insurance').bind('change', function(){
  49         if ( $('#dbc_insurance').val() == '0' ) {
  50             $('#dbc_policy').attr("disabled","disabled");
  51             $('#dbc_insdatum').attr("disabled","disabled");
  52         } else {
  53             $('#dbc_policy').attr("disabled","");
  54             $('#dbc_insdatum').attr("disabled","");
  55         }
  56     });
  57
  58     $('#dbc_insdatum').bind('change', function(){
  59         checkdate($('#dbc_insdatum').val());
  60     });
  61
  62     $('#dbc_geboort').bind('change', function(){
  63         checkdate($('#dbc_geboort').val());
  64     });
  65
  66 })
  67 </script>
  68
  69 <script type="text/javascript">
  70 /*
  71  * CHECKING DATE FUNCTION
  72  */
  73 function checkdate(date) {
  74    var pattern = new RegExp("19|20[0-9]{2}-0|1[0-9]-[0-3][0-9]");
  75
  76 if (date.match(pattern)) {
  77     var date_array = date.value.split('-');
  78     var day = date_array[0];
  79
  80     // Attention! Javascript consider months in the range 0 - 11
  81     var month = date_array[1] - 1;
  82     var year = date_array[2];
  83
  84     // This instruction will create a date object
  85     source_date = new Date(year,month,day);
  86
  87     if(year != source_date.getFullYear()) {
  88          alert('Year is not valid!');
  89          return false;
  90     }
  91
  92     if(month != source_date.getMonth()) {
  93          alert('Month is not valid!');
  94          return false;
  95     }
  96
  97     if(day != source_date.getDate()) {
  98          alert('Day is not valid!');
  99          return false;
 100     }
 101 } else {
 102     alert('Date format is not valid! The format should be: YYYY-MM-DD');
 103     return false;
 104 }
 105
 106   return true;
 107 }
 108
 109
 110 /*
 111  * FORM VALIDATION CLIENT SIDE
 112  */
 113 function validate() {
 114     valid = true;
 115
 116 fname = document.new_patient.fname.value;
 117 lname = document.new_patient.lname.value;
 118 voorletters = document.new_patient.dbc_voorletters.value;
 119 geboort =  document.new_patient.dbc_geboort.value;
 120 straat =  document.new_patient.dbc_straat.value;
 121 nummer = document.new_patient.dbc_nummer.value;
 122 plaats = document.new_patient.dbc_plaats.value;
 123 postal = document.new_patient.dbc_postal.value;
 124 insurance = document.new_patient.dbc_insurance.value;
 125 policy = document.new_patient.dbc_policy.value;
 126 insdatum = document.new_patient.dbc_insdatum.value;
 127
 128 if ( fname == "" ) {
 129     alert ( "Please fill in the 'Voornaam' box." ); valid = false;
 130 }
 131
 132 if ( lname == "" ) {
 133     alert ( "Please fill in the 'Achternaam' box." ); valid = false;
 134 }
 135
 136 if ( voorletters == "" ) {
 137     alert ( "Please fill in the 'Voorletters' box." ); valid = false;
 138 }
 139
 140 if ( geboort == "" && !checkdate(geboort) ) {
 141     alert ( "Please fill in the 'Geboort' box." ); valid = false;
 142     document.new_patient.dbc_geboort.value = '';
 143 }
 144
 145 if ( straat == "" ) {
 146     alert ( "Please fill in the 'Straat' box." ); valid = false;
 147 }
 148
 149 if ( nummer == "" ) {
 150     alert ( "Please fill in the 'Nummer' box." ); valid = false;
 151 }
 152
 153 if ( plaats == "" ) {
 154     alert ( "Please fill in the 'Plaats' box." ); valid = false;
 155 }
 156
 157 if ( postal == "" ) {
 158     alert ( "Please fill in the 'Postcode' box." ); valid = false;
 159 }
 160
 161 if ( insurance != 0 ) {
 162     if ( policy == "" || insdatum == "") {
 163         alert ( "Please fill all the insurance details." ); valid = false;
 164     }
 165 }
 166
 167     return valid;
 168 }
 169
 170 </script>
 171
 172 </head>
 173
 174 <body class="body_top" onload="javascript:document.new_patient.fname.focus();">
 175
 176 <?php if ($GLOBALS['concurrent_layout']) { ?>
 177 <form name='new_patient' method='post' action="new_patient_save.php"
 178  onsubmit='return validate()'>
 179 <span class='title'>Nieuwe Patiënt</span>
 180 <?php } else { ?>
 181 <form name='new_patient' method='post' action="new_patient_save.php"
 182  target='_top' onsubmit='return validate()'>
 183 <a class="title" href="../main/main_screen.php" target="_top" onclick="top.restoreSession()">
 184 Nieuwe Patiënt</a>
 185 <?php } ?>
 186
 187 <br><br>
 188
 189 <div class="tblcontainer">
 190 <table class="tbllist">
 191     <tr>
 192         <td><span class='bold'>Voornaam / Voorvoegsel / Achternaam</span></td>
 193         <td><input type='text' size='15' name='fname' /></td>
 194         <td align="right"><input type='text' size='7' name='dbc_prefix' /></td>
 195         <td><input type='text' size='15' name='lname' /></td>
 196     </tr>
 197     <tr>
 198         <td><span class='bold'>Voorletters:</span></td>
 199         <td><input type='text' size='5' name='dbc_voorletters' /></td>
 200         <td><span class='bold'>Geslacht:</span></td>
 201         <td><?php dropdown_sex($rsex, 'dbc_sex');?></td>
 202     </tr>
 203     <tr style="background-color: #79B0BE">
 204         <td><span class='bold'>Voorvoegsel /Achternaam partner:</span></td>
 205         <td><input type='text' size='7' name='dbc_prefix_partner' /></td>
 206         <td><input type='text' size='15' name='dbc_lastname_partner' /></td>
 207         <td></td>
 208     </tr>
 209     <tr>
 210         <td><span class='bold'>Geboortedatum:</span></td>
 211         <td><input type='text' size='10' maxlenght='10' name='dbc_geboort' id='dbc_geboort'/></td>
 212         <td></td>
 213         <td></td>
 214     </tr>
 215 </table>
 216
 217 <br />
 218 <table class="tbllist">
 219     <tr><td colspan="5">Adres</td></tr>
 220     <tr>
 221         <td><span class='bold'>Straat</span></td>
 222         <td><input type="text" id="dbc_straat" name="dbc_straat" size="30" /></td>
 223         <td><span class='bold'>Huisnummer/Toevoeging</span></td>
 224         <td><input type="text" id="dbc_nummer" name="dbc_nummer" size="5" /></td>
 225         <td><input type="text" id="dbc_toevoe" name="dbc_toevoe" size="5" /></td>
 226     </tr>
 227     <tr>
 228         <td><span class='bold'>Land</span></td>
 229         <td>
 230             <?php if ( !$r["country_code"] ) $r["country_code"] = 150;
 231             dropdown_countries($r["country_code"], 'dbc_land'); ?>
 232         </td>
 233         <td><span class='bold'>Plaats/Postcode</span></td>
 234         <td><input type="text" id="dbc_plaats" name="dbc_plaats" size="20" /></td>
 235         <td><input type="text" id="df_postal" name="dbc_postal" size="6" maxlength="6" /></td>
 236     </tr>
 237
 238 </table>
 239
 240 <br />
 241 <table class="tbllist">
 242     <tr><td colspan="3">Insurance</td></tr>
 243     <tr>
 244         <td><span class='bold'>Zorgverzekeraar</span></td>
 245         <td colspan="2"><?=dropdown_insurance(0, 'dbc_insurance');?></td>
 246     </tr>
 247     <tr>
 248         <td><span class='bold'>Polisnummer</span></td>
 249         <td><input type="text" size="16" name="dbc_policy" id="dbc_policy" /></td>
 250         <td>
 251             <span class='bold'>Startdatum</span>
 252             <input type="text" size="10" name="dbc_insdatum" id="dbc_insdatum" />
 253         </td>
 254     </tr>
 255
 256
 257     <tr>
 258         <td colspan='2'>&nbsp;<br>
 259         <input type='submit' name='form_create' value=<?php xl('Create New Patient','e'); ?> /></td>
 260         <td></td>
 261     </tr>
 262 </table>
 263 </div>
 264
 265 <!-- needed in saving function -->
 266 <input type="hidden" name="regdate" id="regdate" value="<?php date('Y-m-d')?>" />
 267 <input type="hidden" name="mname" id="mname" value="" />
 268 <input type="hidden" name="db_id" id="db_id" value="" />
 269 <input type="hidden" name="title" id="title" value="" />
 270
 271 </form>
 272
 273 </body>
 274 </html>