interface/new/new.php

   1 <?php
   2 include_once("../globals.php");
   3
   4 // For a layout field return 0=unused, 1=optional, 2=mandatory.
   5 function getLayoutUOR($form_id, $field_id) {
   6   $crow = sqlQuery("SELECT uor FROM layout_options WHERE " .
   7     "form_id = '$form_id' AND field_id = '$field_id' LIMIT 1");
   8   return 0 + $crow['uor'];
   9 }
  10
  11 // Determine if the registration date should be requested.
  12 $regstyle = getLayoutUOR('DEM','regdate') ? "" : " style='display:none'";
  13
  14 $form_pubpid    = $_POST['pubpid'   ] ? trim($_POST['pubpid'   ]) : '';
  15 $form_title     = $_POST['title'    ] ? trim($_POST['title'    ]) : '';
  16 $form_fname     = $_POST['fname'    ] ? trim($_POST['fname'    ]) : '';
  17 $form_mname     = $_POST['mname'    ] ? trim($_POST['mname'    ]) : '';
  18 $form_lname     = $_POST['lname'    ] ? trim($_POST['lname'    ]) : '';
  19 $form_refsource = $_POST['refsource'] ? trim($_POST['refsource']) : '';
  20 $form_sex       = $_POST['sex'      ] ? trim($_POST['sex'      ]) : '';
  21 $form_refsource = $_POST['refsource'] ? trim($_POST['refsource']) : '';
  22 $form_dob       = $_POST['DOB'      ] ? trim($_POST['DOB'      ]) : '';
  23 $form_regdate   = $_POST['regdate'  ] ? trim($_POST['regdate'  ]) : date('Y-m-d');
  24 ?>
  25 <html>
  26
  27 <head>
  28 <?php html_header_show(); ?>
  29 <link rel="stylesheet" href="<?php echo xl($css_header,'e');?>" type="text/css">
  30 <style type="text/css">@import url(../../library/dynarch_calendar.css);</style>
  31
  32 <script type="text/javascript" src="../../library/textformat.js"></script>
  33 <script type="text/javascript" src="../../library/dynarch_calendar.js"></script>
  34 <script type="text/javascript" src="../../library/dynarch_calendar_en.js"></script>
  35 <script type="text/javascript" src="../../library/dynarch_calendar_setup.js"></script>
  36
  37 <script LANGUAGE="JavaScript">
  38
  39  var mypcc = '1';
  40
  41  function validate() {
  42   var f = document.forms[0];
  43 <?php if ($GLOBALS['inhouse_pharmacy']) { ?>
  44   if (f.refsource.selectedIndex <= 0) {
  45    alert('Please select a referral source!');
  46    return false;
  47   }
  48 <?php } ?>
  49 <?php if (getLayoutUOR('DEM','sex') == 2) { ?>
  50   if (f.sex.selectedIndex <= 0) {
  51    alert('Please select a value for sex!');
  52    return false;
  53   }
  54 <?php } ?>
  55 <?php if (getLayoutUOR('DEM','DOB') == 2) { ?>
  56   if (f.DOB.value.length == 0) {
  57    alert('Please select a birth date!');
  58    return false;
  59   }
  60 <?php } ?>
  61   top.restoreSession();
  62   return true;
  63  }
  64
  65 </script>
  66
  67 </head>
  68
  69 <body class="body_top" onload="javascript:document.new_patient.fname.focus();">
  70
  71 <?php if ($GLOBALS['concurrent_layout']) { ?>
  72 <form name='new_patient' method='post' action="new_patient_save.php"
  73  onsubmit='return validate()'>
  74 <span class='title'><?php xl('Add Patient Record','e');?></span>
  75 <?php } else { ?>
  76 <form name='new_patient' method='post' action="new_patient_save.php"
  77  target='_top' onsubmit='return validate()'>
  78 <a class="title" href="../main/main_screen.php" target="_top" onclick="top.restoreSession()">
  79 <?php xl('Add Patient Record','e');?></a>
  80 <?php } ?>
  81
  82 <br><br>
  83
  84 <center>
  85
  86 <?php if ($GLOBALS['omit_employers']) { ?>
  87    <input type='hidden' name='title' value='' />
  88 <?php } ?>
  89
  90 <table border='0'>
  91
  92 <?php if (!$GLOBALS['omit_employers']) { ?>
  93  <tr>
  94   <td>
  95    <span class='bold'><?php xl('Title','e');?>: </span>
  96   </td>
  97   <td>
  98    <select name='title'>
  99 <?php
 100 $ores = sqlStatement("SELECT option_id, title FROM list_options " .
 101   "WHERE list_id = 'titles' ORDER BY seq");
 102 while ($orow = sqlFetchArray($ores)) {
 103   echo "    <option value='" . $orow['option_id'] . "'";
 104   if ($orow['option_id'] == $form_title) echo " selected";
 105   echo ">" . $orow['title'] . "</option>\n";
 106 }
 107 ?>
 108    </select>
 109   </td>
 110  </tr>
 111 <?php } ?>
 112
 113  <tr>
 114   <td>
 115    <span class='bold'><?php xl('First Name','e');?>: </span>
 116   </td>
 117   <td>
 118    <input type='entry' size='15' name='fname' value='<?php echo $form_fname; ?>'>
 119   </td>
 120  </tr>
 121
 122  <tr>
 123   <td>
 124    <span class='bold'><?php xl('Middle Name','e');?>: </span>
 125   </td>
 126   <td>
 127    <input type='entry' size='15' name='mname' value='<?php echo $form_mname; ?>'>
 128   </td>
 129  </tr>
 130
 131  <tr>
 132   <td>
 133    <span class='bold'><?php xl('Last Name','e');?>: </span>
 134   </td>
 135   <td>
 136    <input type='entry' size='15' name='lname' value='<?php echo $form_lname; ?>'>
 137   </td>
 138  </tr>
 139
 140  <tr>
 141   <td>
 142    <span class='bold'><?php xl('Sex','e'); ?>: </span>
 143   </td>
 144   <td>
 145    <select name='sex'>
 146     <option value=''>Unassigned</option>
 147 <?php
 148 $ores = sqlStatement("SELECT option_id, title FROM list_options " .
 149   "WHERE list_id = 'sex' ORDER BY seq");
 150 while ($orow = sqlFetchArray($ores)) {
 151   echo "    <option value='" . $orow['option_id'] . "'";
 152   if ($orow['option_id'] == $form_sex) echo " selected";
 153   echo ">" . $orow['title'] . "</option>\n";
 154 }
 155 ?>
 156    </select>
 157   </td>
 158  </tr>
 159
 160 <?php if ($GLOBALS['inhouse_pharmacy']) { ?>
 161  <tr>
 162   <td>
 163    <span class='bold'><?php xl('Referral Source','e'); ?>: </span>
 164   </td>
 165   <td>
 166    <select name='refsource'>
 167     <option value=''>Unassigned</option>
 168 <?php
 169 $ores = sqlStatement("SELECT option_id, title FROM list_options " .
 170   "WHERE list_id = 'refsource' ORDER BY seq");
 171 while ($orow = sqlFetchArray($ores)) {
 172   echo "    <option value='" . $orow['option_id'] . "'";
 173   if ($orow['option_id'] == $form_refsource) echo " selected";
 174   echo ">" . $orow['title'] . "</option>\n";
 175 }
 176 ?>
 177    </select>
 178   </td>
 179  </tr>
 180 <?php } ?>
 181
 182  <tr>
 183   <td>
 184    <span class='bold'><?php xl('Birth Date','e');?>: </span>
 185   </td>
 186   <td>
 187    <input type='text' size='10' name='DOB' id='DOB'
 188     value='<?php echo $form_dob; ?>'
 189     onkeyup='datekeyup(this,mypcc)' onblur='dateblur(this,mypcc)'
 190     title='yyyy-mm-dd' />
 191    <img src='../pic/show_calendar.gif' align='absbottom' width='24' height='22'
 192     id='img_dob' border='0' alt='[?]' style='cursor:pointer'
 193     title='Click here to choose a date'>
 194    <script LANGUAGE="JavaScript">
 195     Calendar.setup({inputField:"DOB", ifFormat:"%Y-%m-%d", button:"img_dob"});
 196    </script>
 197   </td>
 198  </tr>
 199
 200  <tr<?php echo $regstyle ?>>
 201   <td>
 202    <span class='bold'><?php xl('Registration Date','e');?>: </span>
 203   </td>
 204   <td>
 205    <input type='text' size='10' name='regdate' id='regdate'
 206     value='<?php echo $form_regdate; ?>'
 207     onkeyup='datekeyup(this,mypcc)' onblur='dateblur(this,mypcc)'
 208     title='yyyy-mm-dd' />
 209    <img src='../pic/show_calendar.gif' align='absbottom' width='24' height='22'
 210     id='img_regdate' border='0' alt='[?]' style='cursor:pointer'
 211     title='Click here to choose a date'>
 212    <script LANGUAGE="JavaScript">
 213     Calendar.setup({inputField:"regdate", ifFormat:"%Y-%m-%d", button:"img_regdate"});
 214    </script>
 215   </td>
 216  </tr>
 217
 218  <tr>
 219   <td>
 220    <span class='bold'><?php xl('Patient Number','e');?>: </span>
 221   </td>
 222   <td>
 223    <input type='entry' size='5' name='pubpid' value='<?php echo $form_pubpid; ?>'>
 224    <span class='text'><?php xl('omit to autoassign','e');?> &nbsp; &nbsp; </span>
 225   </td>
 226  </tr>
 227
 228  <tr>
 229   <td colspan='2'>
 230    &nbsp;<br>
 231    <input type='submit' name='form_create' value=<?php xl('Create New Patient','e'); ?> />
 232   </td>
 233   <td>
 234   </td>
 235  </tr>
 236
 237 </table>
 238 </center>
 239 </form>
 240 <script language="Javascript">
 241 <?php
 242 if ($form_pubpid) {
 243   echo "alert('" . xl('This patient ID is already in use!') . "');\n";
 244 }
 245 ?>
 246 </script>
 247
 248 </body>
 249 </html>