interface/new/new.php

   1 <?php
   2 /**
   3 *
   4 * LICENSE: This program is free software; you can redistribute it and/or
   5 * modify it under the terms of the GNU General Public License
   6 * as published by the Free Software Foundation; either version 3
   7 * of the License, or (at your option) any later version.
   8 * This program is distributed in the hope that it will be useful,
   9 * but WITHOUT ANY WARRANTY; without even the implied warranty of
  10 * MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE.  See the
  11 * GNU General Public License for more details.
  12 * You should have received a copy of the GNU General Public License
  13 * along with this program.  If not, see <http://opensource.org/licenses/gpl-license.php>.
  14 *
  15 * @package   OpenEMR
  16 * @author    Brady Miller <brady.g.miller@gmail.com>
  17 * @link      http://www.open-emr.org
  18 */
  19
  20 include_once("../globals.php");
  21
  22 if ($GLOBALS['full_new_patient_form']) {
  23     require("new_comprehensive.php");
  24     exit;
  25 }
  26
  27 // For a layout field return 0=unused, 1=optional, 2=mandatory.
  28 function getLayoutUOR($form_id, $field_id)
  29 {
  30     $crow = sqlQuery("SELECT uor FROM layout_options WHERE " .
  31     "form_id = '$form_id' AND field_id = '$field_id' LIMIT 1");
  32     return 0 + $crow['uor'];
  33 }
  34
  35 // Determine if the registration date should be requested.
  36 $regstyle = getLayoutUOR('DEM', 'regdate') ? "" : " style='display:none'";
  37
  38 $form_pubpid    = $_POST['pubpid'   ] ? trim($_POST['pubpid'   ]) : '';
  39 $form_title     = $_POST['title'    ] ? trim($_POST['title'    ]) : '';
  40 $form_fname     = $_POST['fname'    ] ? trim($_POST['fname'    ]) : '';
  41 $form_mname     = $_POST['mname'    ] ? trim($_POST['mname'    ]) : '';
  42 $form_lname     = $_POST['lname'    ] ? trim($_POST['lname'    ]) : '';
  43 $form_refsource = $_POST['refsource'] ? trim($_POST['refsource']) : '';
  44 $form_sex       = $_POST['sex'      ] ? trim($_POST['sex'      ]) : '';
  45 $form_refsource = $_POST['refsource'] ? trim($_POST['refsource']) : '';
  46 $form_dob       = $_POST['DOB'      ] ? trim($_POST['DOB'      ]) : '';
  47 $form_regdate   = $_POST['regdate'  ] ? trim($_POST['regdate'  ]) : date('Y-m-d');
  48 ?>
  49 <html>
  50
  51 <head>
  52 <?php html_header_show(); ?>
  53 <link rel="stylesheet" href="<?php echo xl($css_header, 'e');?>" type="text/css">
  54 <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery-datetimepicker-2-5-4/build/jquery.datetimepicker.min.css">
  55
  56 <script type="text/javascript" src="../../library/textformat.js?v=<?php echo $v_js_includes; ?>"></script>
  57 <script type="text/javascript" src="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery-min-3-1-1/index.js"></script>
  58 <script type="text/javascript" src="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery-datetimepicker-2-5-4/build/jquery.datetimepicker.full.min.js"></script>
  59
  60 <?php include_once("{$GLOBALS['srcdir']}/options.js.php"); ?>
  61
  62 <script LANGUAGE="JavaScript">
  63
  64  var mypcc = '1';
  65
  66  function validate() {
  67   var f = document.forms[0];
  68 <?php if ($GLOBALS['inhouse_pharmacy']) { ?>
  69   if (f.refsource.selectedIndex <= 0) {
  70    alert('Please select a referral source!');
  71    return false;
  72   }
  73 <?php } ?>
  74 <?php if (getLayoutUOR('DEM', 'sex') == 2) { ?>
  75   if (f.sex.selectedIndex <= 0) {
  76    alert('Please select a value for sex!');
  77    return false;
  78   }
  79 <?php } ?>
  80 <?php if (getLayoutUOR('DEM', 'DOB') == 2) { ?>
  81   if (f.DOB.value.length == 0) {
  82    alert('Please select a birth date!');
  83    return false;
  84   }
  85 <?php } ?>
  86   top.restoreSession();
  87   return true;
  88  }
  89
  90 $(document).ready(function(){
  91     $('.datepicker').datetimepicker({
  92         <?php $datetimepicker_timepicker = false; ?>
  93         <?php $datetimepicker_showseconds = false; ?>
  94         <?php $datetimepicker_formatInput = false; ?>
  95         <?php require($GLOBALS['srcdir'] . '/js/xl/jquery-datetimepicker-2-5-4.js.php'); ?>
  96         <?php // can add any additional javascript settings to datetimepicker here; need to prepend first setting with a comma ?>
  97     });
  98     $('.datetimepicker').datetimepicker({
  99         <?php $datetimepicker_timepicker = true; ?>
 100         <?php $datetimepicker_showseconds = false; ?>
 101         <?php $datetimepicker_formatInput = false; ?>
 102         <?php require($GLOBALS['srcdir'] . '/js/xl/jquery-datetimepicker-2-5-4.js.php'); ?>
 103         <?php // can add any additional javascript settings to datetimepicker here; need to prepend first setting with a comma ?>
 104     });
 105 });
 106
 107 </script>
 108
 109 </head>
 110
 111 <body class="body_top" onload="javascript:document.new_patient.fname.focus();">
 112
 113 <form name='new_patient' method='post' action="new_patient_save.php"
 114  onsubmit='return validate()'>
 115 <span class='title'><?php xl('Add Patient Record', 'e');?></span>
 116
 117 <br><br>
 118
 119 <center>
 120
 121 <?php if ($GLOBALS['omit_employers']) { ?>
 122    <input type='hidden' name='title' value='' />
 123 <?php } ?>
 124
 125 <table border='0'>
 126
 127 <?php if (!$GLOBALS['omit_employers']) { ?>
 128  <tr>
 129   <td>
 130    <span class='bold'><?php xl('Title', 'e');?>: </span>
 131   </td>
 132   <td>
 133    <select name='title'>
 134 <?php
 135 $ores = sqlStatement("SELECT option_id, title FROM list_options " .
 136   "WHERE list_id = 'titles' AND activity = 1 ORDER BY seq");
 137 while ($orow = sqlFetchArray($ores)) {
 138     echo "    <option value='" . $orow['option_id'] . "'";
 139     if ($orow['option_id'] == $form_title) {
 140         echo " selected";
 141     }
 142
 143     echo ">" . $orow['title'] . "</option>\n";
 144 }
 145 ?>
 146    </select>
 147   </td>
 148  </tr>
 149 <?php } ?>
 150
 151  <tr>
 152   <td>
 153    <span class='bold'><?php xl('First Name', 'e');?>: </span>
 154   </td>
 155   <td>
 156    <input type='entry' size='15' name='fname' value='<?php echo $form_fname; ?>'>
 157   </td>
 158  </tr>
 159
 160  <tr>
 161   <td>
 162    <span class='bold'><?php xl('Middle Name', 'e');?>: </span>
 163   </td>
 164   <td>
 165    <input type='entry' size='15' name='mname' value='<?php echo $form_mname; ?>'>
 166   </td>
 167  </tr>
 168
 169  <tr>
 170   <td>
 171    <span class='bold'><?php xl('Last Name', 'e');?>: </span>
 172   </td>
 173   <td>
 174    <input type='entry' size='15' name='lname' value='<?php echo $form_lname; ?>'>
 175   </td>
 176  </tr>
 177
 178  <tr>
 179   <td>
 180    <span class='bold'><?php xl('Sex', 'e'); ?>: </span>
 181   </td>
 182   <td>
 183    <select name='sex'>
 184     <option value=''>Unassigned</option>
 185 <?php
 186 $ores = sqlStatement("SELECT option_id, title FROM list_options " .
 187   "WHERE list_id = 'sex' AND activity = 1 ORDER BY seq");
 188 while ($orow = sqlFetchArray($ores)) {
 189     echo "    <option value='" . $orow['option_id'] . "'";
 190     if ($orow['option_id'] == $form_sex) {
 191         echo " selected";
 192     }
 193
 194     echo ">" . $orow['title'] . "</option>\n";
 195 }
 196 ?>
 197    </select>
 198   </td>
 199  </tr>
 200
 201 <?php if ($GLOBALS['inhouse_pharmacy']) { ?>
 202  <tr>
 203   <td>
 204    <span class='bold'><?php xl('Referral Source', 'e'); ?>: </span>
 205   </td>
 206   <td>
 207    <select name='refsource'>
 208     <option value=''>Unassigned</option>
 209 <?php
 210 $ores = sqlStatement("SELECT option_id, title FROM list_options " .
 211   "WHERE list_id = 'refsource' AND activity = 1 ORDER BY seq");
 212 while ($orow = sqlFetchArray($ores)) {
 213     echo "    <option value='" . $orow['option_id'] . "'";
 214     if ($orow['option_id'] == $form_refsource) {
 215         echo " selected";
 216     }
 217
 218     echo ">" . $orow['title'] . "</option>\n";
 219 }
 220 ?>
 221    </select>
 222   </td>
 223  </tr>
 224 <?php } ?>
 225
 226  <tr>
 227   <td>
 228    <span class='bold'><?php xl('Birth Date', 'e');?>: </span>
 229   </td>
 230   <td>
 231    <input type='text' size='10' class='datepicker' name='DOB' id='DOB'
 232     value='<?php echo $form_dob; ?>'
 233     title='yyyy-mm-dd' />
 234   </td>
 235  </tr>
 236
 237  <tr<?php echo $regstyle ?>>
 238   <td>
 239    <span class='bold'><?php xl('Registration Date', 'e');?>: </span>
 240   </td>
 241   <td>
 242    <input type='text' size='10' class='datepicker' name='regdate' id='regdate'
 243     value='<?php echo $form_regdate; ?>'
 244     title='yyyy-mm-dd' />
 245   </td>
 246  </tr>
 247
 248  <tr>
 249   <td>
 250    <span class='bold'><?php xl('Patient Number', 'e');?>: </span>
 251   </td>
 252   <td>
 253    <input type='entry' size='5' name='pubpid' value='<?php echo $form_pubpid; ?>'>
 254    <span class='text'><?php xl('omit to autoassign', 'e');?> &nbsp; &nbsp; </span>
 255   </td>
 256  </tr>
 257
 258  <tr>
 259   <td colspan='2'>
 260    &nbsp;<br>
 261    <input type='submit' name='form_create' value=<?php xl('Create New Patient', 'e'); ?> />
 262   </td>
 263   <td>
 264   </td>
 265  </tr>
 266
 267 </table>
 268 </center>
 269 </form>
 270 <script language="Javascript">
 271 <?php
 272 if ($form_pubpid) {
 273     echo "alert('" . xl('This patient ID is already in use!') . "');\n";
 274 }
 275 ?>
 276 </script>
 277
 278 </body>
 279 </html>