interface/patient_file/encounter/other.php

   1 <?php
   2 include_once("../../globals.php");
   3 include_once("$srcdir/sql.inc");
   4
   5 //the number of rows to display before resetting and starting a new column:
   6 $N=10
   7 ?>
   8
   9 <html>
  10 <head>
  11 <?php html_header_show();?>
  12
  13 <link rel="stylesheet" href="<?php echo $css_header;?>" type="text/css">
  14 </head>
  15 <body class="body_bottom">
  16
  17 <table border=0 cellspacing=0 cellpadding=0 height=100%>
  18 <tr>
  19
  20 <td valign=top>
  21
  22 <dl>
  23
  24 <form method='post' name='other_form' action="diagnosis.php?mode=add&type=OTHER"
  25  target='Diagnosis' onsubmit='return top.restoreSession()'>
  26 <script type="text/javascript">
  27 function clearform(atrib){
  28 document.other_form.text.value=document.other_form.textH.value;
  29 document.other_form.code.value=document.other_form.codeH.value;
  30 document.other_form.fee.value=document.other_form.feeH.value*document.other_form.noofunits.value;
  31 document.other_form.units.value=document.other_form.noofunits.value;
  32 document.other_form.textH.value='';
  33 document.other_form.codeH.value='';
  34 document.other_form.feeH.value='';
  35 document.other_form.noofunits.value='1';
  36 }
  37 function isNumberKey(evt)
  38       {var charCode = (evt.which) ? evt.which : event.keyCode
  39          if (charCode > 31 && (charCode < 48 || charCode > 57))
  40          {
  41          alert("<?php xl('Units must be a number','e'); ?>");
  42          return false;
  43          }
  44 return true;  }
  45 </script>
  46 <dt><span class=title><?php xl('Other','e'); ?></span></dt>
  47
  48 <br>
  49 <table>
  50 <tr>
  51 <td class="text"><?php xl('code','e'); ?></td>
  52 <td class="text"><?php xl('description','e'); ?></td>
  53 <td class="text">&nbsp;&nbsp;&nbsp;<?php xl('fee','e'); ?></td>
  54 <td class="text"><?php xl('units','e'); ?></td>
  55 <td></td>
  56 </tr>
  57 <tr>
  58 <input type=hidden name=code>
  59 <input type=hidden name=text>
  60 <input type=hidden name=fee>
  61 <input type=hidden name=units>
  62   <td class="text"><input type=entry name=codeH size=4>&nbsp;&nbsp;</td>
  63   <td class="text"><input type=entry name=textH size=13 value="">&nbsp;&nbsp;</td>
  64   <td class="text"><?php xl('$','e'); ?> </span><input type=entry name=feeH size=5></td>
  65   <td> <input type=text name="noofunits" onkeypress="return isNumberKey(event)" size=3 value=1></td>
  66   <td>&nbsp;<a class='text' onclick="clearform('clear')" href="javascript:top.restoreSession();document.other_form.submit();">
  67    <?php xl('Save','e'); ?> </a>
  68   </td>
  69 </tr>
  70 </table>
  71 </form>
  72
  73 </dl>
  74
  75 </td>
  76 </tr>
  77 </table>
  78
  79 </body>
  80 </html>