some contributed fixes for the acog forms
[openemr.git] / contrib / forms / plist / new.php
blob88a4bd3352551e451f6b35884da63d90e65939e7
1 <?php
2 include_once("../../globals.php");
3 include_once("$srcdir/api.inc");
4 include_once("$srcdir/forms.inc");
5 include_once("$srcdir/calendar.inc");
6 include_once("$srcdir/lists.inc");
7 $frmn = 'form_plist';
8 $ftitle = 'Problem list';
9 $old = sqlStatement("select form_id, formdir from forms where (form_name='${ftitle}') and (pid=$pid) order by date desc limit 1");
10 if ($old) {
11 $dt = sqlFetchArray($old);
12 $fid = $dt{'form_id'};
13 if ($fid && ($fid != 0) && ($fid != '')){
14 $fdir = $dt{'formdir'};
15 unset($dt);
16 $dt = formFetch($frmn, $fid);
17 $newid = formSubmit($frmn, array_slice($dt,7), $id, $userauthorized);
18 addForm($encounter, $ftitle, $newid, $fdir, $pid, $userauthorized);
19 $id = $newid;
20 formJump("${rootdir}/patient_file/encounter/view_form.php?formname=${fdir}&id=${newid}");
21 exit;
25 <!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN"
26 "http://www.w3.org/TR/html4/loose.dtd">
28 <html>
29 <head>
30 <link rel=stylesheet href="<?echo $css_header;?>" type="text/css">
31 <link rel=stylesheet href="../../acog.css" type="text/css">
32 <script language="JavaScript" src="../../acog.js" type="text/JavaScript"></script>
33 <script language="JavaScript" type="text/JavaScript">
34 window.onload = initialize;
35 </script>
36 </head>
37 <?
38 $fres=sqlStatement("select * from patient_data where pid=".$_SESSION["pid"]);
39 if ($fres){
40 $patient = sqlFetchArray($fres);
42 $history = getHistoryData($_SESSION["pid"]);
44 <body <?echo $top_bg_line;?> >
46 <form action="<?echo $rootdir;?>/forms/plist/save.php?mode=new" method="post" enctype="multipart/form-data" name="my_form">
47 <? include("../../acog_menu.inc"); ?>
48 <table width="70%" border="0" cellspacing="0" cellpadding="4">
49 <tr>
50 <td width="120" align="left" valign="bottom" class="srvCaption">Patient name:</td>
51 <td align="left" valign="bottom"><input name="pname" type="text" class="fullin" id="pname" value="<? echo $patient{'fname'}.' '.$patient{'mname'}.' '.$patient{'lname'}; ?>"></td>
52 </tr>
53 <tr>
54 <td width="120" align="left" valign="bottom" class="srvCaption">Birth date: </td>
55 <td align="left" valign="bottom"><input name="pbdate" type="text" class="fullin" id="pbdate" value="<? echo $patient{'DOB'}; ?>"></td>
56 </tr>
57 <tr>
58 <td width="120" align="left" valign="bottom" class="srvCaption">ID No:</td>
59 <td align="left" valign="bottom"><input name="pl_pid" type="text" class="fullin" id="pl_pid" value="<? echo $patient{'id'}; ?>" readonly="true"></td>
60 </tr>
61 <tr>
62 <td width="120" align="left" valign="bottom" class="srvCaption">Date</td>
63 <td align="left" valign="bottom"><input name="pl_date" type="text" class="fullin" id="pl_date" value="<? echo date('Y-m-d'); ?>"></td>
64 </tr>
65 </table>
66 <div class="srvChapter">Problem list <a href="#" onMouseOver="toolTip('The Problem List captures problems, allergies, family history, and current medication use.')" onMouseOut="toolTip();"><img src="../../pic/mark_q.png" width="13" height="13" border="0"></a></div>
67 <div style="border: solid 2px black; background-color:#FFFFFF;">
68 <table width="100%" border="0" cellspacing="0" cellpadding="2">
69 <tr>
70 <td width="50%" class="ficaption3" id="bordR">High risk:</td>
71 <td width="50%" class="ficaption3">Family history:</td>
72 </tr>
73 <tr>
74 <td class="fibody2" id="bordR"><textarea name="pl_high_risk" rows="6" wrap="VIRTUAL" class="fullin2" id="pl_high_risk"><? echo $obj{'pl_high_risk'} ?></textarea></td>
75 <td class="fibody2"><textarea name="pl_family_history" rows="6" wrap="VIRTUAL" class="fullin2" id="pl_family_history"><?
76 // ($history['history_mother'] != '' ) ? $tmp[] = "Mother: " . $history['history_mother'] : '';
77 // ($history['history_father'] != '' ) ? $tmp[] = "Father: " . $history['history_father'] : '';
78 // ($history['history_siblings'] != '' ) ? $tmp[] = "Siblings: " . $history['history_siblings'] : '';
79 // ($history['history_spouse'] != '' ) ? $tmp[] = "Spouse: " . $history['history_spouse'] : '';
80 // ($history['history_offspring'] != '') ? $tmp[] = "Offspring: " . $history['history_offspring'] : '';
81 // echo join(', ', $tmp);
82 $tmp = array();
83 if ($history['history_mother' ] != '') $tmp[] = "Mother: " . $history['history_mother' ];
84 if ($history['history_father' ] != '') $tmp[] = "Father: " . $history['history_father' ];
85 if ($history['history_siblings' ] != '') $tmp[] = "Siblings: " . $history['history_siblings' ];
86 if ($history['history_spouse' ] != '') $tmp[] = "Spouse: " . $history['history_spouse' ];
87 if ($history['history_offspring'] != '') $tmp[] = "Offspring: " . $history['history_offspring'];
88 if (count($tmp)) echo join(', ', $tmp);
89 ?></textarea></td>
90 </tr>
91 <tr>
92 <td class="ficaption3" id="bordR">Drug/Latex/Transfusion/Allergic reactions: </td>
93 <td class="ficaption3">Current medications:</td>
94 </tr>
95 <tr>
96 <td class="fibody3" id="bordR"><textarea name="pl_reactions" rows="6" wrap="VIRTUAL" class="fullin2" id="pl_reactions"><?
97 $allergies = ''; $checked = 'checked';
98 if ($result = getListByType($pid, "allergy", "id,title,comments,activity,date", 1, "all", 0)){
99 foreach ($result as $iter) {
100 $al_tmp[] = $iter{"title"}.' ('.$iter{"comments"}.') ';
101 $checked = '';
103 $allergies = join(',', $al_tmp);
105 echo $allergies;
106 ?></textarea></td>
107 <td class="fibody3"><textarea name="pl_medications" rows="6" wrap="VIRTUAL" class="fullin2" id="pl_medications"><?
108 if ($result = getListByType($pid, "medication", "id,title,comments,activity,date", 1, "all", 0)){
109 foreach ($result as $iter) {
110 $tmp_med[] = $iter{"title"}.' ('.$iter{"comments"}.') ';
112 echo join(', ', $tmp_med);
114 ?></textarea></td>
115 </tr>
116 </table>
117 </div>
118 <p>&nbsp;</p>
119 <div style="border: solid 2px black; background-color:#FFFFFF;">
120 <table width="100%" border="0" cellspacing="0" cellpadding="2">
121 <tr>
122 <td width="20" align="left" valign="bottom" class="ficaption2" id="bordR">No</td>
123 <td width="120" align="center" valign="bottom" class="ficaption2" id="bordR">Entry date </td>
124 <td align="center" valign="bottom" class="ficaption2" id="bordR">Problem/Resolution</td>
125 <td width="120" align="center" valign="bottom" class="ficaption2" id="bordR">Onset age and date </td>
126 <td width="120" align="center" valign="bottom" class="ficaption2">Resolution date </td>
127 </tr>
129 $pli = 1;
131 while ($pli < 26){
132 //print $obj["pl_problem_$pli"];
133 list($pl_ed, $pl_problem, $pl_onset, $pl_rd) = explode('|~', $obj["pl_problem_${pli}"]);
134 print <<<EOL
135 <tr>
136 <td align="left" valign="bottom" class="fibody2" id="bordR">${pli}.</td>
137 <td align="left" valign="bottom" class="fibody2" id="bordR"><input name="pl_ed_${pli}" type="text" class="fullin2" value="${pl_ed}"></td>
138 <td align="left" valign="bottom" class="fibody2" id="bordR"><input name="pl_problem_${pli}" type="text" class="fullin2" value="${pl_problem}"></td>
139 <td align="left" valign="bottom" class="fibody2" id="bordR"><input name="pl_onset_${pli}" type="text" class="fullin2" value="${pl_onset}"></td>
140 <td align="left" valign="bottom" class="fibody2"><input name="pl_rd_${pli}" type="text" class="fullin2" value="${pl_rd}"></td>
141 </tr>
142 EOL;
143 $pli++;
146 </table>
147 </div>
148 <table width="100%" border="0">
149 <tr>
150 <td align="left" width="100"> <a href="javascript:document.my_form.submit();" class="link_submit">[Save Data]</a> </td>
151 <td align="right"> <a href="<?php echo $GLOBALS['form_exit_url']; ?>" class="link_submit">[Don't Save]</a> </td>
152 </tr>
153 </table>
154 </form>
155 <?php
156 formFooter();
158 </body>
159 </html>