interface/usergroup/facilities.php

   1 <?php
   2 require_once("../globals.php");
   3 require_once("../../library/acl.inc");
   4 require_once("$srcdir/sql.inc");
   5 require_once("$srcdir/formdata.inc.php");
   6
   7 $alertmsg = '';
   8
   9 if (isset($_POST["mode"]) && $_POST["mode"] == "facility") {
  10   sqlStatement("INSERT INTO facility SET " .
  11   "name = '"         . trim(formData('facility'    )) . "', " .
  12   "phone = '"        . trim(formData('phone'       )) . "', " .
  13   "fax = '"          . trim(formData('fax'         )) . "', " .
  14   "street = '"       . trim(formData('street'      )) . "', " .
  15   "city = '"         . trim(formData('city'        )) . "', " .
  16   "state = '"        . trim(formData('state'       )) . "', " .
  17   "postal_code = '"  . trim(formData('postal_code' )) . "', " .
  18   "country_code = '" . trim(formData('country_code')) . "', " .
  19   "federal_ein = '"  . trim(formData('federal_ein' )) . "', " .
  20   "facility_npi = '" . trim(formData('facility_npi')) . "'");
  21 }
  22 ?>
  23 <html>
  24 <head>
  25
  26 <link rel="stylesheet" href="<?php echo $css_header;?>" type="text/css">
  27
  28 </head>
  29 <body class="body_top">
  30
  31 <span class="title"><?php xl('Facility Administration','e'); ?></span>
  32
  33 <br><br>
  34
  35 <table width=100%>
  36 <tr>
  37
  38 <td valign=top>
  39
  40 <form name='facility' method='post' action="facilities.php"
  41  onsubmit='return top.restoreSession()'>
  42 <input type=hidden name=mode value="facility">
  43 <span class="bold"><?php xl('New Facility Information','e'); ?>: </span>
  44 </td><td>
  45
  46 <table border=0 cellpadding=0 cellspacing=0>
  47 <tr>
  48 <td><span class="text"><?php xl('Name','e'); ?>: </span></td><td><input type=entry name=facility size=20 value=""></td>
  49 <td><span class="text"><?php xl('Phone','e'); ?>: </span></td><td><input type=entry name=phone size=20 value=""></td>
  50 </tr>
  51 <tr>
  52 <td>&nbsp;</td><td>&nbsp;</td>
  53 <td><span class="text"><?php xl('Fax','e'); ?>: </span></td><td><input type=entry name=fax size=20 value=""></td>
  54 </tr>
  55 <tr>
  56 <td><span class="text"><?php xl('Address','e'); ?>: </span></td><td><input type=entry size=20 name=street value=""></td>
  57 <td><span class="text"><?php xl('City','e'); ?>: </span></td><td><input type=entry size=20 name=city value=""></td>
  58 </tr>
  59 <tr>
  60 <td><span class="text"><?php xl('State','e'); ?>: </span></td><td><input type=entry size=20 name=state value=""></td>
  61 <td><span class="text"><?php xl('Zip Code','e'); ?>: </span></td><td><input type=entry size=20 name=postal_code value=""></td>
  62 </tr>
  63 <tr>
  64 <td height="22"><span class="text"><?php xl('Country','e'); ?>: </span></td>
  65 <td><input type=entry size=20 name=country_code value=""></td>
  66 <td><span class="text"><?php xl('Federal EIN','e'); ?>: </span></td><td><input type=entry size=20 name=federal_ein value=""></td>
  67 </tr>
  68 <tr>
  69 <td>&nbsp;</td><td>&nbsp;</td>
  70
  71 <td><span class="text"><?php ($GLOBALS['simplified_demographics'] ? xl('Facility Code','e') : xl('Facility NPI','e')); ?>:
  72 </span></td><td><input type=entry size=20 name=facility_npi value=""></td>
  73
  74 </tr>
  75 <tr>
  76 <td>&nbsp;</td><td>&nbsp;</td>
  77 <td>&nbsp;</td><td><input type="submit" value=<?php xl('Add Facility','e'); ?>></td>
  78 </tr>
  79 </table>
  80 </form>
  81 <br>
  82 </tr>
  83 <tr>
  84 <td valign=top>
  85
  86 <span class="bold"><?php xl('Edit Facilities','e'); ?>: </span>
  87 </td><td valign=top>
  88 <?php
  89 $fres = 0;
  90 $fres = sqlStatement("select * from facility order by name");
  91 if ($fres) {
  92   $result2 = array();
  93   for ($iter3 = 0;$frow = sqlFetchArray($fres);$iter3++)
  94     $result2[$iter3] = $frow;
  95   foreach($result2 as $iter3) {
  96 ?>
  97 <span class="text"><?php echo $iter3{name};?></span>
  98 <a href="facility_admin.php?fid=<?php echo $iter3{id};?>" class="link_submit"
  99  onclick="top.restoreSession()">(<?php xl('Edit','e'); ?>)</a><br>
 100 <?php
 101   }
 102 }
 103 ?>
 104
 105 </td>
 106 </tr>
 107 </table>
 108
 109 <script language="JavaScript">
 110 <?php
 111   if ($alertmsg = trim($alertmsg)) {
 112     echo "alert('$alertmsg');\n";
 113   }
 114 ?>
 115 </script>
 116
 117 </body>
 118 </html>