templates/prescription/general_edit_dutch.html

   1 <html>
   2 <head>
   3 {php}html_header_show();{/php}
   4
   5 {literal}
   6  <style type="text/css" title="mystyles" media="all">
   7 <!--
   8 td {
   9         font-size:8pt;
  10         font-family:helvetica;
  11 }
  12 input {
  13         font-size:8pt;
  14         font-family:helvetica;
  15 }
  16 select {
  17         font-size:8pt;
  18         font-family:helvetica;
  19 }
  20 textarea {
  21         font-size:8pt;
  22         font-family:helvetica;
  23 }
  24 -->
  25 </style>
  26 <script type="text/javascript" src="library/dialog.js"></script>
  27 <script language='JavaScript'>
  28
  29  // This holds all the default drug attributes.
  30 {/literal}
  31  var drugopts = [{$DRUG_ATTRIBUTES}];
  32 {literal}
  33
  34  // Helper to choose an option from its value.
  35  function selchoose(sel, value) {
  36   var o = sel.options;
  37   for (i = 0; i < o.length; ++i) {
  38    o[i].selected = (o[i].value == value);
  39   }
  40  }
  41
  42  // Fill in default values when a drop-down drug is selected.
  43  function drugselected(sel) {
  44   var f = document.forms[0];
  45   var i = f.drug_id.selectedIndex - 1;
  46   if (i >= 0) {
  47    var d = drugopts[i];
  48    f.drug.value = d[0];
  49    selchoose(f.form, d[1]);
  50    f.dosage.value = d[2];
  51    f.size.value = d[3];
  52    selchoose(f.unit, d[4]);
  53    selchoose(f.route, d[5]);
  54    selchoose(f.interval, d[6]);
  55    selchoose(f.substitute, d[7]);
  56    f.quantity.value = d[8];
  57    f.disp_quantity.value = d[8];
  58    selchoose(f.refills, d[9]);
  59    f.per_refill.value = d[10];
  60   }
  61  }
  62
  63  // Invoke the popup to dispense a drug.
  64  function dispense() {
  65   var f = document.forms[0];
  66   dlgopen('interface/drugs/dispense_drug.php' +
  67    {/literal}'?drug_id={$prescription->get_drug_id()}' +{literal}
  68    '&prescription=' + f.id.value +
  69    '&quantity=' + f.disp_quantity.value +
  70    '&fee=' + f.disp_fee.value,
  71    '_blank', 400, 200);
  72  }
  73
  74  function quantityChanged() {
  75   var f = document.forms[0];
  76   f.per_refill.value = f.quantity.value;
  77   if (f.disp_quantity) {
  78    f.disp_quantity.value = f.quantity.value;
  79   }
  80  }
  81
  82 </script>
  83 {/literal}
  84 </head>
  85 <body {$STYLE.BOTTOM_BG_LINE}>
  86 <form name="prescribe" method="post" action="{$FORM_ACTION}" onsubmit="return top.restoreSession()">
  87 <table CELLSPACING="0" CELLPADDING="3">
  88 <tr>
  89   <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Currently Active'}</td>
  90   <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
  91     <input type="checkbox" name="active" value="1"{if $prescription->get_active() > 0} checked{/if} />
  92   </td>
  93 </tr>
  94 <tr>
  95         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Starting Date'}</td>
  96         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
  97                 {html_select_date field_order="DMY" start_year="-10" end_year="+5" time=$prescription->start_date prefix="start_date_"}
  98         </td>
  99 </tr>
 100 <tr>
 101         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Provider'}</td>
 102         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
 103                 {html_options name="provider_id" options=$prescription->provider->utility_provider_array() selected=$prescription->provider->get_id()}
 104                 <input type="hidden" name="patient_id" value="{$prescription->patient->id}" />
 105         </td>
 106 </tr>
 107 <!--
 108 <tr>
 109         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >Patient Name</td>
 110         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >{$prescription->patient->get_name_display()}</td>
 111 </tr>
 112 -->
 113 <tr>
 114         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Drug'}</td>
 115         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
 116                 <input type="input" size="20" name="drug" value="{$prescription->drug}"/>
 117         </td>
 118 </tr>
 119
 120 {if $DRUG_ARRAY_VALUES}
 121 <tr>
 122         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >&nbsp; {xl t='in-house'}</td>
 123         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
 124                 <select name="drug_id" onchange="drugselected(this)">
 125                 {html_options values=$DRUG_ARRAY_VALUES output=$DRUG_ARRAY_OUTPUT}
 126                 </select>
 127         </td>
 128 </tr>
 129 {/if}
 130
 131 <tr>
 132         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Quantity'}</td>
 133         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
 134                 <input TYPE="TEXT" NAME="quantity" SIZE="10" MAXLENGTH="31"
 135                  VALUE="{$prescription->quantity}"
 136                  onchange="quantityChanged()" />
 137         </td>
 138 </tr>
 139 {if $SIMPLIFIED_PRESCRIPTIONS && !$prescription->size}
 140 <tr style='display:none;'>
 141 {else}
 142 <tr>
 143 {/if}
 144         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Medicine Units'}</td>
 145         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
 146                 <input TYPE="TEXT" NAME="size" SIZE="11" MAXLENGTH="10" VALUE="{$prescription->size}"/>
 147                 <select name="unit">{html_options options=$prescription->unit_array selected=$prescription->unit}</select>
 148         </td>
 149 </tr>
 150 <tr>
 151         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Take'}</td>
 152         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
 153 {if $SIMPLIFIED_PRESCRIPTIONS && !$prescription->form && !$prescription->route && !$prescription->interval}
 154                 <input TYPE="text" NAME="dosage" SIZE="30" MAXLENGTH="100" VALUE="{$prescription->dosage}" />
 155                 <input type="hidden" name="form" value="0" />
 156                 <input type="hidden" name="route" value="0" />
 157                 <input type="hidden" name="interval" value="0" />
 158 {else}
 159                 <select name="interval">{html_options options=$prescription->interval_array selected=$prescription->interval}</select>
 160                 <input TYPE="TEXT" NAME="dosage" SIZE="2" MAXLENGTH="10" VALUE="{$prescription->dosage}"/>
 161 {/if}
 162         </td>
 163 </tr>
 164 <tr>
 165         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Refills'}</td>
 166         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
 167                 {html_options name="refills" options=$prescription->refills_array selected=$prescription->refills}
 168 {if $SIMPLIFIED_PRESCRIPTIONS}
 169                 <input TYPE="hidden" ID="per_refill" NAME="per_refill" VALUE="{$prescription->per_refill}" />
 170 {else}
 171                 &nbsp; &nbsp; {xl t='# of tablets:'}
 172                 <input TYPE="TEXT" ID="per_refill" NAME="per_refill" SIZE="2" MAXLENGTH="10" VALUE="{$prescription->per_refill}" />
 173 {/if}
 174         </td>
 175 </tr>
 176 <!--
 177 <tr>
 178         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Substitution'}</td>
 179         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
 180     {html_options name="substitute" options=$prescription->substitute_array selected=$prescription->substitute}
 181         </td>
 182 </tr>
 183 -->
 184 <tr>
 185         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Notes'}</td>
 186         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
 187         <textarea name="note" cols="30" rows="2" wrap="virtual">{$prescription->note}</textarea>
 188         </td>
 189 </tr>
 190 <tr>
 191 {if $WEIGHT_LOSS_CLINIC}
 192   <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" ></td>
 193   <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
 194   </td>
 195 {else}
 196   <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Add to Medication List'}</td>
 197   <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
 198     {html_radios name="medication" options=$prescription->medication_array selected=$prescription->medication}
 199   </td>
 200 {/if}
 201 </tr>
 202 <tr>
 203         <td colspan="3">
 204                 <input type="submit" value="{xl t='Save'}" />
 205                 {if $DRUG_ARRAY_VALUES}
 206                 &nbsp; &nbsp; &nbsp; &nbsp;
 207                 {if $prescription->get_refills() >= $prescription->get_dispensation_count()}
 208                 <input type="submit" name="disp_button" value="{xl t='Save and Dispense'}" />
 209                 <input type="text" name="disp_quantity" size="2" maxlength="10" value="{$DISP_QUANTITY}" />
 210                 units, $
 211                 <input type="text" name="disp_fee" size="5" maxlength="10" value="{$DISP_FEE}" />
 212                 {else}
 213                 {xl t=' prescription has reached its limit of'} {$prescription->get_refills()} {xl t='refills'}.
 214                 {/if}
 215                 {/if}
 216         </td>
 217 </tr>
 218 </table>
 219 <input type="hidden" name="id" value="{$prescription->id}" />
 220 <input type="hidden" name="process" value="{$PROCESS}" />
 221 <script language='JavaScript'>
 222 {$ENDING_JAVASCRIPT}
 223 </script>
 224 </form>
 225 </body>
 226 </html>