interface/billing/sl_eob_patient_note.php

   1 <?
   2   // Copyright (C) 2005 Rod Roark <rod@sunsetsystems.com>
   3   //
   4   // 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 2
   7   // of the License, or (at your option) any later version.
   8
   9   // This allows entry and editing of a "billing note" for the patient.
  10
  11   include_once("../globals.php");
  12   include_once("../../library/patient.inc");
  13   include_once("../../library/forms.inc");
  14
  15   $info_msg = "";
  16 ?>
  17 <html>
  18 <head>
  19 <link rel=stylesheet href="<?echo $css_header;?>" type="text/css">
  20 <title>EOB Posting - Patient Note</title>
  21 </head>
  22 <body>
  23 <?
  24   $patient_id = $_GET['patient_id'];
  25   if (! $patient_id) die("You cannot access this page directly.");
  26
  27   if ($_POST['form_save']) {
  28     $thevalue = trim($_POST['form_note']);
  29     $thename = $thevalue ? "Billing" : "";
  30
  31     sqlStatement("UPDATE patient_data SET " .
  32       "genericname2 = '$thename', " .
  33       "genericval2 = '$thevalue' " .
  34       "WHERE pid = '$patient_id'");
  35
  36     echo "<script language='JavaScript'>\n";
  37     if ($info_msg) echo " alert('$info_msg');\n";
  38     echo " window.close();\n";
  39     echo "</script></body></html>\n";
  40     exit();
  41   }
  42
  43   $row = sqlQuery("select fname, lname, genericname2, genericval2 " .
  44     "from patient_data where pid = '$patient_id' limit 1");
  45 ?>
  46 <center>
  47
  48 <h2>Billing Note for <? echo $row['fname'] . " " . $row['lname'] ?></h2>
  49 <p>&nbsp;</p>
  50
  51 <form method='post' action='sl_eob_patient_note.php?patient_id=<? echo $patient_id ?>'>
  52
  53 <p>
  54 <input type='text' name='form_note' size='60' maxlength='255'
  55  value='<? echo addslashes($row['genericval2']) ?>' />
  56 </p>
  57
  58 <p>&nbsp;</p>
  59 <input type='submit' name='form_save' value='Save'>
  60 &nbsp;
  61 <input type='button' value='Cancel' onclick='window.close()'>
  62
  63 </form>
  64 </center>
  65
  66 </body>
  67 </html>