interface/new/new.php

   1 <?php
   2
   3 /**
   4  * new.php
   5  *
   6  * @package   OpenEMR
   7  * @link      http://www.open-emr.org
   8  * @author    Brady Miller <brady.g.miller@gmail.com>
   9  * @copyright Copyright (c) 2018 Brady Miller <brady.g.miller@gmail.com>
  10  * @license   https://github.com/openemr/openemr/blob/master/LICENSE GNU General Public License 3
  11  */
  12
  13 require_once("../globals.php");
  14
  15 use OpenEMR\Common\Csrf\CsrfUtils;
  16 use OpenEMR\Core\Header;
  17
  18 if ($GLOBALS['full_new_patient_form']) {
  19     require("new_comprehensive.php");
  20     exit;
  21 }
  22
  23 // For a layout field return 0=unused, 1=optional, 2=mandatory.
  24 function getLayoutUOR($form_id, $field_id)
  25 {
  26     $crow = sqlQuery("SELECT uor FROM layout_options WHERE " .
  27     "form_id = ? AND field_id = ? LIMIT 1", array($form_id, $field_id));
  28     return 0 + $crow['uor'];
  29 }
  30
  31 // Determine if the registration date should be requested.
  32 $regstyle = getLayoutUOR('DEM', 'regdate') ? "" : " style='display:none'";
  33
  34 $form_pubpid    = $_POST['pubpid'   ] ? trim($_POST['pubpid'   ]) : '';
  35 $form_title     = $_POST['title'    ] ? trim($_POST['title'    ]) : '';
  36 $form_fname     = $_POST['fname'    ] ? trim($_POST['fname'    ]) : '';
  37 $form_mname     = $_POST['mname'    ] ? trim($_POST['mname'    ]) : '';
  38 $form_lname     = $_POST['lname'    ] ? trim($_POST['lname'    ]) : '';
  39 $form_refsource = $_POST['refsource'] ? trim($_POST['refsource']) : '';
  40 $form_sex       = $_POST['sex'      ] ? trim($_POST['sex'      ]) : '';
  41 $form_refsource = $_POST['refsource'] ? trim($_POST['refsource']) : '';
  42 $form_dob       = $_POST['DOB'      ] ? trim($_POST['DOB'      ]) : '';
  43 $form_regdate   = $_POST['regdate'  ] ? trim($_POST['regdate'  ]) : date('Y-m-d');
  44 ?>
  45 <html>
  46
  47 <head>
  48
  49 <?php
  50     Header::setupHeader('datetime-picker');
  51     include_once($GLOBALS['srcdir'] . "/options.js.php");
  52 ?>
  53
  54 <script>
  55
  56  function validate() {
  57   var f = document.forms[0];
  58 <?php if ($GLOBALS['inhouse_pharmacy']) { ?>
  59   if (f.refsource.selectedIndex <= 0) {
  60    alert('Please select a referral source!');
  61    return false;
  62   }
  63 <?php } ?>
  64 <?php if (getLayoutUOR('DEM', 'sex') == 2) { ?>
  65   if (f.sex.selectedIndex <= 0) {
  66    alert('Please select a value for sex!');
  67    return false;
  68   }
  69 <?php } ?>
  70 <?php if (getLayoutUOR('DEM', 'DOB') == 2) { ?>
  71   if (f.DOB.value.length == 0) {
  72    alert('Please select a birth date!');
  73    return false;
  74   }
  75 <?php } ?>
  76   top.restoreSession();
  77   return true;
  78  }
  79
  80 $(function () {
  81     $('.datepicker').datetimepicker({
  82         <?php $datetimepicker_timepicker = false; ?>
  83         <?php $datetimepicker_showseconds = false; ?>
  84         <?php $datetimepicker_formatInput = true; ?>
  85         <?php require($GLOBALS['srcdir'] . '/js/xl/jquery-datetimepicker-2-5-4.js.php'); ?>
  86         <?php // can add any additional javascript settings to datetimepicker here; need to prepend first setting with a comma ?>
  87     });
  88     $('.datetimepicker').datetimepicker({
  89         <?php $datetimepicker_timepicker = true; ?>
  90         <?php $datetimepicker_showseconds = false; ?>
  91         <?php $datetimepicker_formatInput = true; ?>
  92         <?php require($GLOBALS['srcdir'] . '/js/xl/jquery-datetimepicker-2-5-4.js.php'); ?>
  93         <?php // can add any additional javascript settings to datetimepicker here; need to prepend first setting with a comma ?>
  94     });
  95 });
  96
  97 </script>
  98
  99 </head>
 100
 101 <body class="body_top" onload="javascript:document.new_patient.fname.focus();">
 102
 103 <form name='new_patient' method='post' action="new_patient_save.php"
 104  onsubmit='return validate()'>
 105 <input type="hidden" name="csrf_token_form" value="<?php echo attr(CsrfUtils::collectCsrfToken()); ?>" />
 106
 107 <span class='title'><?php echo xlt('Add Patient Record'); ?></span>
 108
 109 <br /><br />
 110
 111 <center>
 112
 113 <?php if ($GLOBALS['omit_employers']) { ?>
 114    <input type='hidden' name='title' value='' />
 115 <?php } ?>
 116
 117 <table class="border-0">
 118
 119 <?php if (!$GLOBALS['omit_employers']) { ?>
 120  <tr>
 121   <td>
 122    <span class='font-weight-bold'><?php echo xlt('Title'); ?>:</span>
 123   </td>
 124   <td>
 125    <select name='title'>
 126     <?php
 127     $ores = sqlStatement("SELECT option_id, title FROM list_options " .
 128     "WHERE list_id = 'titles' AND activity = 1 ORDER BY seq");
 129     while ($orow = sqlFetchArray($ores)) {
 130         echo "    <option value='" . attr($orow['option_id']) . "'";
 131         if ($orow['option_id'] == $form_title) {
 132             echo " selected";
 133         }
 134
 135         echo ">" . text($orow['title']) . "</option>\n";
 136     }
 137     ?>
 138    </select>
 139   </td>
 140  </tr>
 141 <?php } ?>
 142
 143  <tr>
 144   <td>
 145    <span class='font-weight-bold'><?php echo xlt('First Name'); ?>: </span>
 146   </td>
 147   <td>
 148    <input type='entry' size='15' name='fname' value='<?php echo attr($form_fname); ?>' />
 149   </td>
 150  </tr>
 151
 152  <tr>
 153   <td>
 154    <span class='font-weight-bold'><?php echo xlt('Middle Name'); ?>: </span>
 155   </td>
 156   <td>
 157    <input type='entry' size='15' name='mname' value='<?php echo attr($form_mname); ?>' />
 158   </td>
 159  </tr>
 160
 161  <tr>
 162   <td>
 163    <span class='font-weight-bold'><?php echo xlt('Last Name'); ?>: </span>
 164   </td>
 165   <td>
 166    <input type='entry' size='15' name='lname' value='<?php echo attr($form_lname); ?>' />
 167   </td>
 168  </tr>
 169
 170  <tr>
 171   <td>
 172    <span class='font-weight-bold'><?php echo xlt('Sex'); ?>: </span>
 173   </td>
 174   <td>
 175    <select name='sex'>
 176     <option value=''>Unassigned</option>
 177 <?php
 178 $ores = sqlStatement("SELECT option_id, title FROM list_options " .
 179   "WHERE list_id = 'sex' AND activity = 1 ORDER BY seq");
 180 while ($orow = sqlFetchArray($ores)) {
 181     echo "    <option value='" . attr($orow['option_id']) . "'";
 182     if ($orow['option_id'] == $form_sex) {
 183         echo " selected";
 184     }
 185
 186     echo ">" . text($orow['title']) . "</option>\n";
 187 }
 188 ?>
 189    </select>
 190   </td>
 191  </tr>
 192
 193 <?php if ($GLOBALS['inhouse_pharmacy']) { ?>
 194  <tr>
 195   <td>
 196    <span class='font-weight-bold'><?php echo xlt('Referral Source'); ?>: </span>
 197   </td>
 198   <td>
 199    <select name='refsource'>
 200     <option value=''><?php echo xlt("Unassigned"); ?></option>
 201     <?php
 202     $ores = sqlStatement("SELECT option_id, title FROM list_options " .
 203     "WHERE list_id = 'refsource' AND activity = 1 ORDER BY seq");
 204     while ($orow = sqlFetchArray($ores)) {
 205         echo "    <option value='" . attr($orow['option_id']) . "'";
 206         if ($orow['option_id'] == $form_refsource) {
 207             echo " selected";
 208         }
 209
 210         echo ">" . text($orow['title']) . "</option>\n";
 211     }
 212     ?>
 213    </select>
 214   </td>
 215  </tr>
 216 <?php } ?>
 217
 218  <tr>
 219   <td>
 220    <span class='font-weight-bold'><?php echo xlt('Birth Date'); ?>:</span>
 221   </td>
 222   <td>
 223    <input type='text' size='10' class='datepicker' name='DOB' id='DOB'
 224     value='<?php echo attr($form_dob); ?>' />
 225   </td>
 226  </tr>
 227
 228  <tr<?php echo $regstyle ?>>
 229   <td>
 230    <span class='font-weight-bold'><?php echo xlt('Registration Date'); ?>: </span>
 231   </td>
 232   <td>
 233    <input type='text' size='10' class='datepicker' name='regdate' id='regdate'
 234     value='<?php echo attr($form_regdate); ?>' />
 235   </td>
 236  </tr>
 237
 238  <tr>
 239   <td>
 240    <span class='font-weight-bold'><?php echo xlt('Patient Number'); ?>: </span>
 241   </td>
 242   <td>
 243    <input type='entry' size='5' name='pubpid' value='<?php echo attr($form_pubpid); ?>' />
 244    <span class='text'><?php echo xlt('omit to autoassign'); ?> &nbsp; &nbsp; </span>
 245   </td>
 246  </tr>
 247
 248  <tr>
 249   <td colspan='2'>
 250    &nbsp;<br />
 251    <input type='submit' name='form_create' value='<?php echo xla('Create New Patient'); ?>' />
 252   </td>
 253   <td>
 254   </td>
 255  </tr>
 256
 257 </table>
 258 </center>
 259 </form>
 260 <script>
 261 <?php
 262 if ($form_pubpid) {
 263     echo "alert(" . xlj('This patient ID is already in use!') . ");\n";
 264 }
 265 ?>
 266 </script>
 267
 268 </body>
 269 </html>