interface/forms/CAMOS/print.php

   1 <?php
   2 include_once("../../globals.php");
   3 include_once("../../../library/api.inc");
   4 formHeader("Form: CAMOS");
   5 $returnurl = $GLOBALS['concurrent_layout'] ? 'encounter_top.php' : 'patient_encounter.php';
   6 ?>
   7 <html><head>
   8 <link rel=stylesheet href="<?echo $css_header;?>" type="text/css">
   9 </head>
  10 <body <?echo $top_bg_line;?> topmargin=0 rightmargin=0 leftmargin=2 bottommargin=0 marginwidth=2 marginheight=0>
  11 <form method=post action="<?echo $rootdir;?>/forms/CAMOS/save.php?mode=new" name="my_form"
  12  onsubmit="return top.restoreSession()">
  13 <h1><php xl ('CAMOS','e'); ?> </h1>
  14 <hr>
  15 <input type="submit" name="submit form" value="<?php xl('submit form','e'); ?>" />
  16 <?php
  17 echo "<a href='".$GLOBALS['webroot'] .
  18   "/interface/patient_file/encounter/$returnurl' onclick='top.restoreSession()'>[" .
  19   xl('do not save') . "]</a>";
  20 ?>
  21 <table></table><h3><php xl ('Computer Aided Medical Ordering System','e'); ?></h3>
  22 <table><tr><td><php xl ('category','e'); ?></td> <td><input type="text" name="category"  /></td></tr>
  23 <tr><td><php xl ('subcategory','e'); ?></td> <td><input type="text" name="subcategory"  /></td></tr>
  24 <tr><td><php xl ('item','e'); ?></td> <td><input type="text" name="item"  /></td></tr>
  25 <tr><td><php xl ('content','e'); ?></td> <td><input type="text" name="content"  /></td></tr>
  26 </table><input type="submit" name="submit form" value="submit form" />
  27 <?php
  28 echo "<a href='" . $GLOBALS['webroot'] .
  29   "/interface/patient_file/encounter/$returnurl' onclick='top.restoreSession()'>[" .
  30   xl('do not save') ."]</a>";
  31 ?>
  32
  33 </form>
  34 <?php
  35 formFooter();
  36 ?>