templates/prescription/general_edit.html

   1 <html>
   2 <head>
   3 {literal}
   4  <style type="text/css" title="mystyles" media="all">
   5 <!--
   6 td {
   7         font-size:8pt;
   8         font-family:helvetica;
   9 }
  10 input {
  11         font-size:8pt;
  12         font-family:helvetica;
  13 }
  14 select {
  15         font-size:8pt;
  16         font-family:helvetica;
  17 }
  18 textarea {
  19         font-size:8pt;
  20         font-family:helvetica;
  21 }
  22 -->
  23 </style>
  24 <script type="text/javascript" src="library/dialog.js"></script>
  25 <script language='JavaScript'>
  26
  27  // This holds all the default drug attributes.
  28 {/literal}
  29  var drugopts = [{$DRUG_ATTRIBUTES}];
  30 {literal}
  31
  32  // Helper to choose an option from its value.
  33  function selchoose(sel, value) {
  34   var o = sel.options;
  35   for (i = 0; i < o.length; ++i) {
  36    o[i].selected = (o[i].value == value);
  37   }
  38  }
  39
  40  // Fill in default values when a drop-down drug is selected.
  41  function drugselected(sel) {
  42   var f = document.forms[0];
  43   var i = f.drug_id.selectedIndex - 1;
  44   if (i >= 0) {
  45    var d = drugopts[i];
  46    f.drug.value = d[0];
  47    selchoose(f.form, d[1]);
  48    f.dosage.value = d[2];
  49    f.size.value = d[3];
  50    selchoose(f.unit, d[4]);
  51    selchoose(f.route, d[5]);
  52    selchoose(f.interval, d[6]);
  53    selchoose(f.substitute, d[7]);
  54    f.quantity.value = d[8];
  55    f.disp_quantity.value = d[8];
  56    selchoose(f.refills, d[9]);
  57    f.per_refill.value = d[10];
  58   }
  59  }
  60
  61  // Invoke the popup to dispense a drug.
  62  function dispense() {
  63   var f = document.forms[0];
  64   dlgopen('interface/drugs/dispense_drug.php' +
  65    '?drug_id=' + f.drug_id.value +
  66    '&prescription=' + f.id.value +
  67    '&quantity=' + f.disp_quantity.value +
  68    '&fee=' + f.disp_fee.value,
  69    '_blank', 400, 200);
  70  }
  71
  72 </script>
  73 {/literal}
  74 </head>
  75 <body {$STYLE.BOTTOM_BG_LINE}>
  76 <form name="prescribe" method="post" action="{$FORM_ACTION}">
  77 <table CELLSPACING="0" CELLPADDING="3">
  78 <tr>
  79         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >Starting Date</td>
  80         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
  81                 {html_select_date start_year="-10" end_year="+5" time=$prescription->start_date prefix="start_date_"}
  82         </td>
  83 </tr>
  84 <tr>
  85         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >Provider</td>
  86         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
  87                 {html_options name="provider_id" options=$prescription->provider->utility_provider_array() selected=$prescription->provider->get_id()}
  88                 <input type="hidden" name="patient_id" value="{$prescription->patient->id}" />
  89         </td>
  90 </tr>
  91 <!--
  92 <tr>
  93         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >Patient Name</td>
  94         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >{$prescription->patient->get_name_display()}</td>
  95 </tr>
  96 -->
  97 <tr>
  98         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >Drug</td>
  99         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
 100                 <input type="input" size="20" name="drug" value="{$prescription->drug}"/><input class="button" type="BUTTON" onClick="drugPopup=window.open('controller.php?prescription&lookup', 'drugPopup', 'width=400,height=50,menubar=no,titlebar=no,left = 825,top = 400'); drugPopup.opener=self; return true;" value="Drug Lookup"/>
 101         </td>
 102 </tr>
 103
 104 {if $DRUG_ARRAY_VALUES}
 105 <tr>
 106         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >&nbsp; in-house</td>
 107         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
 108                 <select name="drug_id" onchange="drugselected(this)">
 109                 {html_options values=$DRUG_ARRAY_VALUES output=$DRUG_ARRAY_OUTPUT selected=$prescription->get_drug_id()}
 110                 </select>
 111         </td>
 112 </tr>
 113 {/if}
 114
 115 <tr>
 116         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >Quantity</td>
 117         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
 118                 <input TYPE="TEXT" NAME="quantity" SIZE="10" MAXLENGTH="10" VALUE="{$prescription->quantity}" onchange="document.getElementById('per_refill').value=this.value"/>
 119         </td>
 120 </tr>
 121 <tr>
 122         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >Medicine Units</td>
 123         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
 124                 <input TYPE="TEXT" NAME="size" SIZE="11" MAXLENGTH="10" VALUE="{$prescription->size}"/>
 125                 <select name="unit">{html_options options=$prescription->unit_array selected=$prescription->unit}</select>
 126         </td>
 127 </tr>
 128 <tr>
 129         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >Take</td>
 130         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
 131 {if $SIMPLIFIED_PRESCRIPTIONS && !$prescription->form && !$prescription->route && !$prescription->interval}
 132                 <input TYPE="text" NAME="dosage" SIZE="30" MAXLENGTH="100" VALUE="{$prescription->dosage}" />
 133                 <input type="hidden" name="form" value="0" />
 134                 <input type="hidden" name="route" value="0" />
 135                 <input type="hidden" name="interval" value="0" />
 136 {else}
 137                 <input TYPE="TEXT" NAME="dosage" SIZE="2" MAXLENGTH="10" VALUE="{$prescription->dosage}"/> in
 138                 <select name="form">{html_options options=$prescription->form_array selected=$prescription->form}</select>
 139                 <select name="route">{html_options options=$prescription->route_array selected=$prescription->route}</select>
 140                 <select name="interval">{html_options options=$prescription->interval_array selected=$prescription->interval}</select>
 141 {/if}
 142         </td>
 143 </tr>
 144 <tr>
 145         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >Refills</td>
 146         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
 147                 {html_options name="refills" options=$prescription->refills_array selected=$prescription->refills}
 148                 &nbsp; &nbsp; # of tablets:
 149                 <input TYPE="TEXT" ID="per_refill" NAME="per_refill" SIZE="2" MAXLENGTH="10" VALUE="{$prescription->per_refill}"/></td>
 150 </tr>
 151 <tr>
 152         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >Substitution</td>
 153         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
 154         {html_options name="substitute" options=$prescription->substitute_array selected=$prescription->substitute}
 155         </td>
 156 </tr>
 157 <tr>
 158         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >Notes</td>
 159         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
 160         <textarea name="note" cols="30" rows="2" wrap="virtual">{$prescription->note}</textarea>
 161         </td>
 162 </tr>
 163 {if !$WEIGHT_LOSS_CLINIC}
 164 <tr>
 165         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >Add to Medication List</td>
 166         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >
 167         {html_radios name="medication" options=$prescription->medication_array selected=$prescription->medication}
 168         </td>
 169 </tr>
 170 {/if}
 171 <tr>
 172         <td colspan="3">
 173                 <input type="submit" value="Prescribe" />
 174                 {if $DRUG_ARRAY_VALUES}
 175                 &nbsp; &nbsp; &nbsp; &nbsp;
 176                 {if $prescription->get_refills() >= $prescription->get_dispensation_count()}
 177                 <input type="submit" name="disp_button" value="Prescribe and Dispense" />
 178                 <input type="text" name="disp_quantity" size="2" maxlength="10" value="{$DISP_QUANTITY}" />
 179                 units, $
 180                 <input type="text" name="disp_fee" size="5" maxlength="10" value="{$DISP_FEE}" />
 181                 {else}
 182                 This prescription has reached its limit of {$prescription->get_refills()} refills.
 183                 {/if}
 184                 {/if}
 185         </td>
 186 </tr>
 187 </table>
 188 <input type="hidden" name="id" value="{$prescription->id}" />
 189 <input type="hidden" name="process" value="{$PROCESS}" />
 190 <script language='JavaScript'>
 191 {$ENDING_JAVASCRIPT}
 192 </script>
 193 </form>
 194 </body>
 195 </html>