templates/pharmacies/general_edit.html

   1 <form name="pharmacy" method="post" action="{$FORM_ACTION}">
   2 <!-- it is important that the hidden form_id field be listed first, when it is called is populates any old information attached with the id, this allows for partial edits
   3                 if it were called last, the settings from the form would be overwritten with the old information-->
   4 <input type="hidden" name="form_id" value="{$pharmacy->id}" />
   5 <table style="font-size:9pt;" width="500px" CELLSPACING="0" CELLPADDING="3">
   6 <tr>
   7         <td width="150px" VALIGN="MIDDLE" >{xl t='Name'}</td>
   8         <td VALIGN="MIDDLE" >
   9                 <input type="text" size="40" name="name" value="{$pharmacy->name}" onKeyDown="PreventIt(event)" />({xl t='Required'})
  10         </td>
  11 </tr>
  12 <tr>
  13         <td VALIGN="MIDDLE" >{xl t='Address'}</td>
  14         <td VALIGN="MIDDLE" >
  15                 <input type="text" size="40" name="address_line1" value="{$pharmacy->address->line1}" onKeyDown="PreventIt(event)" />
  16         </td>
  17 </tr>
  18 <tr>
  19         <td VALIGN="MIDDLE" >{xl t='Address'}</td>
  20         <td VALIGN="MIDDLE" >
  21                 <input type="text" size="40" name="address_line2" value="{$pharmacy->address->line2}" onKeyDown="PreventIt(event)" />
  22         </td>
  23 </tr>
  24 <tr>
  25         <td VALIGN="MIDDLE" >{xl t='City, State Zip'}</td>
  26         <td VALIGN="MIDDLE" >
  27                 <input type="text" size="25" name="city" value="{$pharmacy->address->city}" onKeyDown="PreventIt(event)" /> , <input type="text" size="2" maxlength="2" name="state" value="{$pharmacy->address->state}" onKeyDown="PreventIt(event)" /> <input type="text" size="5" name="zip" value="{$pharmacy->address->zip}" onKeyDown="PreventIt(event)" />
  28         </td>
  29 </tr>
  30 <tr>
  31         <td VALIGN="MIDDLE" >{xl t='Email'}</td>
  32         <td VALIGN="MIDDLE" >
  33                 <input TYPE="TEXT" NAME="email" SIZE="35" VALUE="{$pharmacy->email}" onKeyDown="PreventIt(event)" />
  34         </td>
  35 </tr>
  36 <tr>
  37         <td VALIGN="MIDDLE" >{xl t='Phone'}</td>
  38         <td VALIGN="MIDDLE" >
  39                 <input TYPE="TEXT" NAME="phone" SIZE="12" VALUE="{$pharmacy->get_phone()}" onKeyDown="PreventIt(event)" />
  40         </td>
  41 </tr>
  42 <tr>
  43         <td VALIGN="MIDDLE" >{xl t='Fax'}</td>
  44         <td VALIGN="MIDDLE" >
  45                 <input TYPE="TEXT" NAME="fax" SIZE="12" VALUE="{$pharmacy->get_fax()}" onKeyDown="PreventIt(event)" />
  46         </td>
  47 </tr>
  48
  49 <tr>
  50         <td VALIGN="MIDDLE" >{xl t='Default Method'}</td>
  51         <td VALIGN="MIDDLE" >
  52                 <select name="transmit_method">{html_options options=$pharmacy->transmit_method_array selected=$pharmacy->transmit_method}</select>
  53         </td>
  54 </tr>
  55 <tr><td colspan="2">&nbsp;</td></tr>
  56 <tr>
  57         <td colspan="2"><a href="javascript:submit_pharmacy();" class="css_button"><span>{xl t='Save'}</span></a><a href="controller.php?practice_settings&pharmacy&action=list"  {php} if (!$GLOBALS['concurrent_layout']) echo "target='Main'"; {/php} class="css_button" onclick="top.restoreSession()">
  58 <span>{xl t='Cancel'}</span></a>
  59         </td>
  60 </tr>
  61 </table>
  62 <input type="hidden" name="id" value="{$pharmacy->id}" />
  63 <input type="hidden" name="process" value="{$PROCESS}" />
  64 </form>
  65
  66 {literal}
  67 <script language="javascript">
  68 function submit_pharmacy()
  69 {
  70         if(document.pharmacy.name.value.length>0)
  71         {
  72         top.restoreSession();
  73         document.pharmacy.submit();
  74                 //Z&H Removed redirection
  75         }
  76         else
  77         {
  78         document.pharmacy.name.style.backgroundColor="red";
  79         document.pharmacy.name.focus();
  80         }
  81 }
  82
  83  function Waittoredirect(delaymsec) {
  84          var st = new Date();
  85          var et = null;
  86          do {
  87          et = new Date();
  88          } while ((et - st) < delaymsec);
  89  }
  90 </script>
  91 {/literal}