sites/default/statement.inc.php

   1 <?php
   2
   3 // Copyright (C) 2005-2006  Rod Roark <rod@sunsetsystems.com>
   4 // Copyright (C) 2016       Raymond Magauran <magauran@medfetch.com>
   5 //
   6 // Windows compatibility mods 2009 Bill Cernansky [mi-squared.com]
   7 //
   8 // This program is free software; you can redistribute it and/or
   9 // modify it under the terms of the GNU General Public License
  10 // as published by the Free Software Foundation; either version 2
  11 // of the License, or (at your option) any later version.
  12 //
  13 // Updated by Medical Information Integration, LLC to support download
  14 //  and multi OS use - tony@mi-squared..com 12-2009
  15
  16 //////////////////////////////////////////////////////////////////////
  17 // This is a template for printing patient statements and collection
  18 // letters.  You must customize it to suit your practice.  If your
  19 // needs are simple then you do not need programming experience to do
  20 // this - just read the comments and make appropriate substitutions.
  21 // All you really need to do is replace the [strings in brackets].
  22 //////////////////////////////////////////////////////////////////////
  23
  24 // The location/name of a temporary file to hold printable statements.
  25 // May want to alter these names to allow multi-site installs out-of-the-box
  26
  27 $STMT_TEMP_FILE = $GLOBALS['temporary_files_dir'] . "/openemr_statements.txt";
  28 $STMT_TEMP_FILE_PDF = $GLOBALS['temporary_files_dir'] . "/openemr_statements.pdf";
  29 $STMT_PRINT_CMD = $GLOBALS['print_command'];
  30
  31 /** There are two options to print a batch of PDF statements:
  32  *  1.  The original statement, a text based statement, using CezPDF
  33  *      Altering this statement is labor intensive, but capable of being altered any way desired...
  34  *
  35  *  2.  Branded Statement, whose core is build from 1., the original statement, using HTML2PDF.
  36  *
  37  *      To customize 2., add your practice location/images/practice_logo.gif
  38  *      In the base/default install this is located at '/openemr/sites/default/images/practice_logo.gif',
  39  *      Adjust directory paths per your installation.
  40  *      Further customize 2. manually in functions report_2() and create_HTML_statement(), below.
  41  *
  42  */
  43 function make_statement($stmt) {
  44   if ($GLOBALS['statement_appearance'] == "1") {
  45     if(is_auth_portal($stmt['pid']) && $_POST['form_portalnotify'])
  46         return osp_create_HTML_statement($stmt);
  47     else
  48                 return create_HTML_statement($stmt);
  49   } else {
  50     return create_statement($stmt);
  51   }
  52 }
  53 /**
  54  * This prints a header for documents.  Keeps the brand uniform...
  55  *  @param string $pid patient_id
  56  *  @param string $direction, options "web" or anything else.  Web provides apache-friendly url links.
  57  *  @return outputs to be displayed however requested
  58  */
  59 function report_header_2($stmt,$direction='',$providerID='1') {
  60   $titleres = getPatientData($stmt['pid'], "fname,lname,DOB");
  61   if ($_SESSION['pc_facility']) {
  62     $sql = "select * from facility where id=?";
  63     $facility = sqlQuery($sql,array($_SESSION['pc_facility']));
  64   } else {
  65     $sql = "SELECT * FROM facility ORDER BY billing_location DESC LIMIT 1";
  66     $facility = sqlQuery($sql);
  67   }
  68   $DOB = oeFormatShortDate($titleres['DOB']);
  69   /******************************************************************/
  70   ob_start();
  71   // Use logo if it exists as 'practice_logo.gif' in the site dir
  72   // old code used the global custom dir which is no longer a valid
  73   ?>
  74   <table style="width:7in;">
  75     <tr>
  76       <td style='width:100px;text-align:top;'>
  77         <?php
  78           $practice_logo = $GLOBALS['OE_SITE_DIR']."/images/practice_logo.gif";
  79           if (file_exists($practice_logo)) {
  80             echo "<img src='$practice_logo' align='left' style='width:125px;margin:0px;'><br />\n";
  81           }
  82         ?>
  83       </td>
  84       <td style='width:40%;'>
  85         <em style="font-weight:bold;font-size:1.4em;"><?php echo text($facility['name']); ?></em><br />
  86         <?php echo text($facility['street']); ?><br />
  87         <?php echo text($facility['city']); ?>, <?php echo text($facility['state']); ?> <?php echo text($facility['postal_code']); ?><br />
  88         <?php echo xlt('Phone').': ' .text($facility['phone']); ?><br />
  89         <?php echo xlt('Fax').': ' .text($facility['fax']); ?><br />
  90         <br clear='all' />
  91       </td>
  92       <td>
  93         <em style="font-weight:bold;font-size:1.4em;"><?php echo text($titleres['fname']) . " " . text($titleres['lname']); ?></em><br />
  94         <b style="font-weight:bold;"><?php echo xlt('Chart Number'); ?>:</b> <?php echo text($stmt['pid']); ?><br />
  95         <b style="font-weight:bold;"><?php echo xlt('Generated on'); ?>:</b> <?php echo oeFormatShortDate(); ?><br />
  96         <b><?php echo xlt('Provider') . ':</b>  '; ?><?php echo text(getProviderName($providerID)); ?> <br />
  97       </td>
  98     </tr>
  99   </table>
 100   <?php
 101   $output = ob_get_contents();
 102   ob_end_clean();
 103   return $output;
 104 }
 105
 106 function create_HTML_statement($stmt) {
 107   if (! $stmt['pid']) return ""; // get out if no data
 108
 109   #minimum_amount_due_to _print
 110   if ($stmt['amount'] <= ($GLOBALS['minimum_amount_to_print']) && $GLOBALS['use_statement_print_exclusion']) return "";
 111
 112   // Facility (service location)
 113   $atres = sqlStatement("select f.name,f.street,f.city,f.state,f.postal_code,f.attn,f.phone from facility f " .
 114     " left join users u on f.id=u.facility_id " .
 115     " left join  billing b on b.provider_id=u.id and b.pid = ? ".
 116     " where  service_location=1",array($stmt['pid']));
 117   $row = sqlFetchArray($atres);
 118   $clinic_name = "{$row['name']}";
 119   $clinic_addr = "{$row['street']}";
 120   $clinic_csz = "{$row['city']}, {$row['state']}, {$row['postal_code']}";
 121   // Contacts
 122   $billing_contact = "{$row['attn']}";
 123   $billing_phone = "{$row['phone']}";
 124   // Billing location
 125   $remit_name = $clinic_name;
 126   $remit_addr = $clinic_addr;
 127   $remit_csz = $clinic_csz;
 128
 129   ob_start();
 130   ?><div style="padding-left:25px;">
 131   <?php
 132   $find_provider = sqlQuery("SELECT * FROM form_encounter " .
 133         "WHERE pid = ? AND encounter = ? " .
 134         "ORDER BY id DESC LIMIT 1", array($stmt['pid'],$stmt['encounter']) );
 135   $providerID = $find_provider['provider_id'];
 136   echo report_header_2($stmt,$direction,$providerID);
 137
 138   // dunning message setup
 139
 140   // insurance has paid something
 141   // $stmt['age'] how old is the invoice
 142   // $stmt['dun_count'] number of statements run
 143   // $stmt['level_closed'] <= 3 insurance 4 = patient
 144
 145   if ($GLOBALS['use_dunning_message']) {
 146     if ($stmt['ins_paid'] != 0 || $stmt['level_closed'] == 4)  {
 147
 148       // do collection messages
 149       switch ($stmt{'age'}) {
 150         case $stmt{'age'} <= $GLOBALS['first_dun_msg_set']:
 151         $dun_message = $GLOBALS['first_dun_msg_text'];
 152         break;
 153         case $stmt{'age'} <= $GLOBALS['second_dun_msg_set']:
 154         $dun_message = $GLOBALS['second_dun_msg_text'];
 155         break;
 156         case $stmt{'age'} <= $GLOBALS['third_dun_msg_set']:
 157         $dun_message = $GLOBALS['third_dun_msg_text'];
 158         break;
 159         case $stmt{'age'} <= $GLOBALS['fourth_dun_msg_set']:
 160         $dun_message = $GLOBALS['fourth_dun_msg_text'];
 161         break;
 162         case $stmt{'age'} >= $GLOBALS['fifth_dun_msg_set']:
 163         $dun_message = $GLOBALS['fifth_dun_msg_text'];
 164         break;
 165       }
 166     }
 167   }
 168   // Text only labels
 169
 170   $label_addressee = xl('ADDRESSEE');
 171   $label_remitto = xl('REMIT TO');
 172   $label_chartnum = xl('Chart Number');
 173   $label_insinfo = xl('Insurance information on file');
 174   $label_totaldue = xl('Total amount due');
 175   $label_payby = xl('If paying by');
 176   $label_cards = xl('VISA/MC/Discovery/HSA');
 177   $label_cardnum = xl('Card');
 178   $label_expiry = xl('Exp');
 179   $label_sign = xl('Signature');
 180   $label_retpay = xl('Please return this bottom part with your payment');
 181   $label_pgbrk = xl('STATEMENT SUMMARY');
 182   $label_visit = xl('Visit Date');
 183   $label_desc = xl('Description');
 184   $label_amt = xl('Amount');
 185
 186   // This is the text for the top part of the page, up to but not
 187   // including the detail lines.  Some examples of variable fields are:
 188   //  %s    = string with no minimum width
 189   //  %9s   = right-justified string of 9 characters padded with spaces
 190   //  %-25s = left-justified string of 25 characters padded with spaces
 191   // Note that "\n" is a line feed (new line) character.
 192   // reformatted to handle i8n by tony
 193
 194   $out  = "<div style='margin-left:60px;margin-top:20px;'><pre>";
 195   $out .= "\n";
 196   $out .= sprintf("_______________________ %s _______________________\n",$label_pgbrk);
 197   $out .= "\n";
 198   $out .= sprintf("%-11s %-46s %s\n",$label_visit,$label_desc,$label_amt);
 199   $out .= "\n";
 200
 201   // This must be set to the number of lines generated above.
 202   //
 203   $count = 6;
 204   $num_ages = 4;
 205   $aging = array();
 206   for ($age_index = 0; $age_index < $num_ages; ++$age_index) {
 207     $aging[$age_index] = 0.00;
 208   }
 209   $todays_time = strtotime(date('Y-m-d'));
 210
 211   // This generates the detail lines.  Again, note that the values must be specified in the order used.
 212   foreach ($stmt['lines'] as $line) {
 213     if ($GLOBALS['use_custom_statement']) {
 214       $description = substr($line['desc'],0,30);
 215     } else {
 216       $description = $line['desc'];
 217     }
 218
 219     $tmp = substr($description, 0, 14);
 220     if ($tmp == 'Procedure 9920' || $tmp == 'Procedure 9921' || $tmp == 'Procedure 9200' || $tmp == 'Procedure 9201')
 221       $description = str_replace("Procedure",xl('Office Visit').":",$description);
 222     //92002-14 are Eye Office Visit Codes
 223
 224     $dos = $line['dos'];
 225     ksort($line['detail']);
 226       # Compute the aging bucket index and accumulate into that bucket.
 227     $age_in_days = (int) (($todays_time - strtotime($dos)) / (60 * 60 * 24));
 228     $age_index = (int) (($age_in_days - 1) / 30);
 229     $age_index = max(0, min($num_ages - 1, $age_index));
 230     $aging[$age_index] += $line['amount'] - $line['paid'];
 231
 232     foreach ($line['detail'] as $dkey => $ddata) {
 233       $ddate = substr($dkey, 0, 10);
 234       if (preg_match('/^(\d\d\d\d)(\d\d)(\d\d)\s*$/', $ddate, $matches)) {
 235         $ddate = $matches[1] . '-' . $matches[2] . '-' . $matches[3];
 236       }
 237       $amount = '';
 238
 239       if ($ddata['pmt']) {
 240         $amount = sprintf("%.2f", 0 - $ddata['pmt']);
 241         $desc = xl('Paid') .' '. oeFormatShortDate($ddate) .': '. $ddata['src'].' '. $ddata['pmt_method'].' '. $ddata['insurance_company'];
 242       } else if ($ddata['rsn']) {
 243         if ($ddata['chg']) {
 244           $amount = sprintf("%.2f", $ddata['chg']);
 245           $desc = xl('Adj') .' '.  oeFormatShortDate($ddate) .': ' . $ddata['rsn'].' '.$ddata['pmt_method'].' '. $ddata['insurance_company'];
 246         } else {
 247           $desc = xl('Note') .' '. oeFormatShortDate($ddate) .': '. $ddata['rsn'].' '.$ddata['pmt_method'].' '. $ddata['insurance_company'];
 248         }
 249       } else if ($ddata['chg'] < 0) {
 250         $amount = sprintf("%.2f", $ddata['chg']);
 251         $desc = xl('Patient Payment');
 252       } else {
 253         $amount = sprintf("%.2f", $ddata['chg']);
 254         $desc = $description;
 255
 256       }
 257
 258       $out .= sprintf("%-10s  %-45s%8s\n", oeFormatShortDate($dos), $desc, $amount);
 259       $dos = '';
 260       ++$count;
 261     }
 262   }
 263
 264   // This generates blank lines until we are at line 20.
 265   //  At line 20 we start middle third.
 266
 267   while ($count++ < 16) $out .= "\n";
 268     # Generate the string of aging text.  This will look like:
 269     # Current xxx.xx / 31-60 x.xx / 61-90 x.xx / Over-90 xxx.xx
 270     # ....+....1....+....2....+....3....+....4....+....5....+....6....+
 271     #
 272   $ageline = xl('Current') .': ' . sprintf("%.2f", $aging[0]);
 273   for ($age_index = 1; $age_index < ($num_ages - 1); ++$age_index) {
 274     $ageline .= ' | ' . ($age_index * 30 + 1) . '-' . ($age_index * 30 + 30) . ':' .
 275                 sprintf(" %.2f", $GLOBALS['gbl_currency_symbol'].''.$aging[$age_index]);
 276   }
 277
 278   // Fixed text labels
 279   $label_ptname = xl('Name');
 280   $label_today = xl('Date');
 281   $label_due = xl('Due');
 282   $label_thanks = xl('Thank you for choosing');
 283   $label_call = xl('Please call if any of the above information is incorrect.');
 284   $label_prompt = xl('We appreciate prompt payment of balances due.');
 285   $label_dept = xl('Billing Department');
 286   $label_bill_phone = (!empty($GLOBALS['billing_phone_number']) ? $GLOBALS['billing_phone_number'] : $billing_phone );
 287   $label_appointments = xl('Future Appointments').':';
 288
 289   // This is the top portion of the page.
 290   $out .= "\n\n\n";
 291   if(strlen($stmt['bill_note']) !=0 && $GLOBALS['statement_bill_note_print']) {
 292     $out .= sprintf("%-46s\n",$stmt['bill_note']);
 293     $count++;
 294   }
 295   if ($GLOBALS['use_dunning_message']) {
 296       $out .= sprintf("%-46s\n",$dun_message);
 297       $count++;
 298   }
 299   $out .= "\n";
 300   $out .= sprintf("%-s: %-25s %-s: %-14s %-s: %8s\n",$label_ptname,$stmt['patient'],
 301   $label_today,oeFormatShortDate($stmt['today']),$label_due,$stmt['amount']);
 302   $out .= sprintf("__________________________________________________________________\n");
 303   $out .= "\n";
 304   $out .= sprintf("%-s\n",$label_call);
 305   $out .= sprintf("%-s\n",$label_prompt);
 306   $out .= "\n";
 307   $out .= sprintf("%-s\n",$billing_contact);
 308   $out .= sprintf("  %-s %-25s\n",$label_dept,$label_bill_phone);
 309   if($GLOBALS['statement_message_to_patient']) {
 310     $out .= "\n";
 311     $statement_message = $GLOBALS['statement_msg_text'];
 312     $out .= sprintf("%-40s\n",$statement_message);
 313     $count++;
 314   }
 315   if($GLOBALS['show_aging_on_custom_statement']) {
 316     # code for ageing
 317     $ageline .= ' | ' . xl('Over') . ' ' . ($age_index * 30) .':'.
 318     sprintf(" %.2f", $aging[$age_index]);
 319     $out .= "\n" . $ageline . "\n\n";
 320     $count++;
 321   }
 322   if($GLOBALS['number_appointments_on_statement']!=0) {
 323     $out .= "\n";
 324     $num_appts = $GLOBALS['number_appointments_on_statement'];
 325     $next_day = mktime(0,0,0,date('m'),date('d')+1,date('Y'));
 326     # add one day to date so it will not get todays appointment
 327     $current_date2 = date('Y-m-d', $next_day);
 328     $events = fetchNextXAppts($current_date2,$stmt['pid'],$num_appts);
 329     $j=0;
 330     $out .= sprintf("%-s\n",$label_appointments);
 331     #loop to add the appointments
 332     for ($x = 1; $x <= $num_appts; $x++) {
 333       $next_appoint_date = oeFormatShortDate($events[$j]['pc_eventDate']);
 334       $next_appoint_time = substr($events[$j]['pc_startTime'],0,5);
 335       if(strlen(umname) != 0 ) {
 336         $next_appoint_provider = $events[$j]['ufname'] . ' ' . $events[$j]['umname'] . ' ' .  $events[$j]['ulname'];
 337       }
 338       else
 339       {
 340         $next_appoint_provider = $events[$j]['ufname'] . ' ' .  $events[$j]['ulname'];
 341       }
 342       if(strlen($next_appoint_time) != 0) {
 343         $label_plsnote[$j] = xlt('Date') . ': ' . text($next_appoint_date) . ' ' . xlt('Time') . ' ' . text($next_appoint_time) . ' ' . xlt('Provider') . ' ' . text($next_appoint_provider);
 344         $out .= sprintf("%-s\n",$label_plsnote[$j]);
 345       }
 346       $j++;
 347       $count++;
 348     }
 349   }
 350   while ($count++ < 29) $out .= "\n";
 351   $out .= sprintf("%-10s %s\n",null,$label_retpay);
 352   $out .= '</pre></div>';
 353   $out .= '<div style="width:7.0in;border-top:1pt dotted black;font-size:12px;margin:0px;"><br /><br />
 354       <table style="width:7in;margin-left:20px;"><tr><td style="width:4.5in;"><br />
 355  ';
 356   $out .= $label_payby.' '.$label_cards;
 357   $out .= "<br /><br />";
 358   $out .= $label_cardnum .': __________________________________  '.$label_expiry.': ___ / _____ <br /><br />';
 359   $out .= $label_sign .'  ____________________________<br />';
 360   $out .="      </td><td style=width:2.0in;vertical-align:middle;'>";
 361           $practice_cards = $GLOBALS['webroot']."/sites/" . $_SESSION['site_id'] . "/images/visa_mc_disc_credit_card_logos_176x35.gif";
 362           if (file_exists($GLOBALS['OE_SITE_DIR']."/images/visa_mc_disc_credit_card_logos_176x35.gif")) {
 363             $out .= "<img src='$practice_cards' style='width:100%;margin:4px auto;'><br /><p>\n".$label_totaldue.": ".$stmt['amount']."</p>";
 364           }
 365
 366   $out .="</td></tr></table>";
 367
 368     $out .= '</div><br />
 369    <pre>';
 370   if($stmt['to'][3]!='')//to avoid double blank lines the if condition is put.
 371   $out .= sprintf("   %-32s\n",$stmt['to'][3]);
 372   $out .= ' </pre>
 373   <div style="width:7in;border-top:1pt solid black;"><br />';
 374   $out .= " <table style='width:6.0in;margin-left:40px;'><tr>";
 375   $out .= '<td style="width:3.0in;"><b>'
 376       .$label_addressee.'</b><br />'
 377       .$stmt['to'][0].'<br />'
 378       .$stmt['to'][1].'<br />'
 379       .$stmt['to'][2].'
 380       </td>
 381       <td style="width:3.0in;"><b>'.$label_remitto.'</b><br />'
 382       .$remit_name.'<br />'
 383       .$remit_addr.'<br />'
 384       .$remit_csz.'
 385       </td>
 386       </tr></table>';
 387
 388   $out .= "      </div></div>";
 389   $out .= "\014
 390   <br /><br />"; // this is a form feed
 391   echo $out;
 392   $output = ob_get_clean();
 393   return $output;
 394 }
 395
 396 // This function builds a printable statement or collection letter from
 397 // an associative array having the following keys:
 398 //
 399 //  today   = statement date yyyy-mm-dd
 400 //  pid     = patient ID
 401 //  patient = patient name
 402 //  amount  = total amount due
 403 //  to      = array of addressee name/address lines
 404 //  lines   = array of lines, each with the following keys:
 405 //    dos     = date of service yyyy-mm-dd
 406 //    desc    = description
 407 //    amount  = charge less adjustments
 408 //    paid    = amount paid
 409 //    notice  = 1 for first notice, 2 for second, etc.
 410 //    detail  = associative array of details
 411 //
 412 // Each detail array is keyed on a string beginning with a date in
 413 // yyyy-mm-dd format, or blanks in the case of the original charge
 414 // items.  Its values are associative arrays like this:
 415 //
 416 //  pmt - payment amount as a positive number, only for payments
 417 //  src - check number or other source, only for payments
 418 //  chg - invoice line item amount amount, only for charges or
 419 //        adjustments (adjustments may be zero)
 420 //  rsn - adjustment reason, only for adjustments
 421 //
 422 // The returned value is a string that can be sent to a printer.
 423 // This example is plain text, but if you are a hotshot programmer
 424 // then you could make a PDF or PostScript or whatever peels your
 425 // banana.  These strings are sent in succession, so append a form
 426 // feed if that is appropriate.
 427 //
 428
 429 // A sample of the text based format follows:
 430
 431 //[Your Clinic Name]             Patient Name          2009-12-29
 432 //[Your Clinic Address]          Chart Number: 1848
 433 //[City, State Zip]              Insurance information on file
 434 //
 435 //
 436 //ADDRESSEE                      REMIT TO
 437 //Patient Name                     [Your Clinic Name]
 438 //patient address                  [Your Clinic Address]
 439 //city, state zipcode              [City, State Zip]
 440 //                                 If paying by VISA/MC/AMEX/Dis
 441 //
 442 //Card_____________________  Exp______ Signature___________________
 443 //                     Return above part with your payment
 444 //-----------------------------------------------------------------
 445 //
 446 //_______________________ STATEMENT SUMMARY _______________________
 447 //
 448 //Visit Date  Description                                    Amount
 449 //
 450 //2009-08-20  Procedure 99345                                198.90
 451 //            Paid 2009-12-15:                               -51.50
 452 //... more details ...
 453 //...
 454 //...
 455 // skipping blanks in example
 456 //
 457 //
 458 //Name: Patient Name              Date: 2009-12-29     Due:   147.40
 459 //_________________________________________________________________
 460 //
 461 //Please call if any of the above information is incorrect
 462 //We appreciate prompt payment of balances due
 463 //
 464 //[Your billing contact name]
 465 //  Billing Department
 466 //  [Your billing dept phone]
 467
 468 function create_statement($stmt) {
 469   if (! $stmt['pid']) return ""; // get out if no data
 470
 471   #minimum_amount_to _print
 472   if ($stmt[amount] <= ($GLOBALS['minimum_amount_to_print']) && $GLOBALS['use_statement_print_exclusion']) return "";
 473
 474   // These are your clinics return address, contact etc.  Edit them.
 475   // TBD: read this from the facility table
 476
 477   // Facility (service location)
 478   $atres = sqlStatement("select f.name,f.street,f.city,f.state,f.postal_code from facility f " .
 479     " left join users u on f.id=u.facility_id " .
 480     " left join  billing b on b.provider_id=u.id and b.pid = '".$stmt['pid']."' " .
 481     " where  service_location=1");
 482   $row = sqlFetchArray($atres);
 483
 484   // Facility (service location)
 485
 486   $clinic_name = "{$row['name']}";
 487   $clinic_addr = "{$row['street']}";
 488   $clinic_csz = "{$row['city']}, {$row['state']}, {$row['postal_code']}";
 489
 490
 491   // Billing location
 492   $remit_name = $clinic_name;
 493   $remit_addr = $clinic_addr;
 494   $remit_csz = $clinic_csz;
 495
 496   // Contacts
 497   $atres = sqlStatement("select f.attn,f.phone from facility f " .
 498     " left join users u on f.id=u.facility_id " .
 499     " left join  billing b on b.provider_id=u.id and b.pid = '".$stmt['pid']."'  " .
 500     " where billing_location=1");
 501   $row = sqlFetchArray($atres);
 502   $billing_contact = "{$row['attn']}";
 503   $billing_phone = "{$row['phone']}";
 504
 505   // dunning message setup
 506
 507   // insurance has paid something
 508   // $stmt['age'] how old is the invoice
 509   // $stmt['dun_count'] number of statements run
 510   // $stmt['level_closed'] <= 3 insurance 4 = patient
 511
 512   if ($GLOBALS['use_dunning_message']) {
 513     if ($stmt['ins_paid'] != 0 || $stmt['level_closed'] == 4)  {
 514
 515       // do collection messages
 516       switch ($stmt{'age'}) {
 517         case $stmt{'age'} <= $GLOBALS['first_dun_msg_set']:
 518         $dun_message = $GLOBALS['first_dun_msg_text'];
 519         break;
 520         case $stmt{'age'} <= $GLOBALS['second_dun_msg_set']:
 521         $dun_message = $GLOBALS['second_dun_msg_text'];
 522         break;
 523         case $stmt{'age'} <= $GLOBALS['third_dun_msg_set']:
 524         $dun_message = $GLOBALS['third_dun_msg_text'];
 525         break;
 526         case $stmt{'age'} <= $GLOBALS['fourth_dun_msg_set']:
 527         $dun_message = $GLOBALS['fourth_dun_msg_text'];
 528         break;
 529         case $stmt{'age'} >= $GLOBALS['fifth_dun_msg_set']:
 530         $dun_message = $GLOBALS['fifth_dun_msg_text'];
 531         break;
 532       }
 533     }
 534   }
 535   // Text only labels
 536
 537   $label_addressee = xl('ADDRESSEE');
 538   $label_remitto = xl('REMIT TO');
 539   $label_chartnum = xl('Chart Number');
 540   $label_insinfo = xl('Insurance information on file');
 541   $label_totaldue = xl('Total amount due');
 542   $label_payby = xl('If paying by');
 543   $label_cards = xl('VISA/MC/Discovery/HSA');
 544   $label_cardnum = xl('Card');
 545   $label_expiry = xl('Exp');
 546   $label_sign = xl('Signature');
 547   $label_retpay = xl('Return above part with your payment');
 548   $label_pgbrk = xl('STATEMENT SUMMARY');
 549   $label_visit = xl('Visit Date');
 550   $label_desc = xl('Description');
 551   $label_amt = xl('Amount');
 552
 553   // This is the text for the top part of the page, up to but not
 554   // including the detail lines.  Some examples of variable fields are:
 555   //  %s    = string with no minimum width
 556   //  %9s   = right-justified string of 9 characters padded with spaces
 557   //  %-25s = left-justified string of 25 characters padded with spaces
 558   // Note that "\n" is a line feed (new line) character.
 559   // reformatted to handle i8n by tony
 560   $out = "\n\n";
 561   $providerNAME = getProviderName($stmt['providerID']);
 562   $out .= sprintf("%-30s %s %-s\n",$clinic_name,$stmt['patient'],$stmt['today']);
 563   $out .= sprintf("%-30s %s: %-s\n",$providerNAME,$label_chartnum,$stmt['pid']);
 564   $out .= sprintf("%-30s %s\n",$clinic_addr,$label_insinfo);
 565   $out .= sprintf("%-30s %-s: %-s\n",$clinic_csz,$label_totaldue,$stmt['amount']);
 566   $out .= "\n";
 567   $out .= sprintf("       %-30s %-s\n",$label_addressee,$label_remitto);
 568   $out .= sprintf("       %-30s %s\n",$stmt['to'][0],$remit_name);
 569   $out .= sprintf("       %-30s %s\n",$stmt['to'][1],$remit_addr);
 570   $out .= sprintf("       %-30s %s\n",$stmt['to'][2],$remit_csz);
 571
 572   if($stmt['to'][3]!='')//to avoid double blank lines the if condition is put.
 573   $out .= sprintf("   %-32s\n",$stmt['to'][3]);
 574   $out .= sprintf("_________________________________________________________________\n");
 575   $out .= "\n";
 576   $out .= sprintf("%-32s\n",$label_payby.' '.$label_cards);
 577   $out .= "\n";
 578   $out .= sprintf("%s_____________________  %s______ %s___________________%s\n\n",
 579     $label_cardnum,$label_expiry,$label_sign);
 580   $out .= sprintf("-----------------------------------------------------------------\n");
 581   $out .= sprintf("%-20s %s\n",null,$label_retpay);
 582   $out .= "\n";
 583   $out .= sprintf("_______________________ %s _______________________\n",$label_pgbrk);
 584   $out .= "\n";
 585   $out .= sprintf("%-11s %-46s %s\n",$label_visit,$label_desc,$label_amt);
 586   $out .= "\n";
 587
 588   // This must be set to the number of lines generated above.
 589   //
 590   $count = 25;
 591   $num_ages = 4;
 592   $aging = array();
 593   for ($age_index = 0; $age_index < $num_ages; ++$age_index) {
 594     $aging[$age_index] = 0.00;
 595   }
 596   $todays_time = strtotime(date('Y-m-d'));
 597
 598   // This generates the detail lines.  Again, note that the values must
 599   // be specified in the order used.
 600   //
 601
 602
 603   foreach ($stmt['lines'] as $line) {
 604     if ($GLOBALS['use_custom_statement']) {
 605       $description = substr($line['desc'],0,30);
 606
 607     }
 608     else {
 609       $description = $line['desc'];
 610
 611     }
 612
 613     $tmp = substr($description, 0, 14);
 614     if ($tmp == 'Procedure 9920' || $tmp == 'Procedure 9921' || $tmp == 'Procedure 9200' || $tmp == 'Procedure 9201')
 615       $description = str_replace("Procedure",xl('Office Visit').":",$description);
 616     //92002-14 are Eye Office Visit Codes
 617
 618     $dos = $line['dos'];
 619     ksort($line['detail']);
 620       # Compute the aging bucket index and accumulate into that bucket.
 621       #
 622     $age_in_days = (int) (($todays_time - strtotime($dos)) / (60 * 60 * 24));
 623     $age_index = (int) (($age_in_days - 1) / 30);
 624     $age_index = max(0, min($num_ages - 1, $age_index));
 625     $aging[$age_index] += $line['amount'] - $line['paid'];
 626
 627     foreach ($line['detail'] as $dkey => $ddata) {
 628       $ddate = substr($dkey, 0, 10);
 629       if (preg_match('/^(\d\d\d\d)(\d\d)(\d\d)\s*$/', $ddate, $matches)) {
 630         $ddate = $matches[1] . '-' . $matches[2] . '-' . $matches[3];
 631       }
 632       $amount = '';
 633
 634       if ($ddata['pmt']) {
 635         $amount = sprintf("%.2f", 0 - $ddata['pmt']);
 636         $desc = xl('Paid') .' '. oeFormatShortDate($ddate) .': '. $ddata['src'].' '. $ddata['pmt_method'].' '. $ddata['insurance_company'];
 637       } else if ($ddata['rsn']) {
 638         if ($ddata['chg']) {
 639           $amount = sprintf("%.2f", $ddata['chg']);
 640           $desc = xl('Adj') .' '.  oeFormatShortDate($ddate) .': ' . $ddata['rsn'].' '.$ddata['pmt_method'].' '. $ddata['insurance_company'];
 641         } else {
 642           $desc = xl('Note') .' '. oeFormatShortDate($ddate) .': '. $ddata['rsn'].' '.$ddata['pmt_method'].' '. $ddata['insurance_company'];
 643         }
 644       } else if ($ddata['chg'] < 0) {
 645         $amount = sprintf("%.2f", $ddata['chg']);
 646         $desc = xl('Patient Payment');
 647       } else {
 648         $amount = sprintf("%.2f", $ddata['chg']);
 649         $desc = $description;
 650
 651       }
 652
 653       $out .= sprintf("%-10s  %-45s%8s\n", oeFormatShortDate($dos), $desc, $amount);
 654       $dos = '';
 655       ++$count;
 656     }
 657   }
 658
 659   // This generates blank lines until we are at line 42.
 660   //
 661   while ($count++ < 42) $out .= "\n";
 662     # Generate the string of aging text.  This will look like:
 663     # Current xxx.xx / 31-60 x.xx / 61-90 x.xx / Over-90 xxx.xx
 664     # ....+....1....+....2....+....3....+....4....+....5....+....6....+
 665     #
 666   $ageline = xl('Current') .' ' . sprintf("%.2f", $aging[0]);
 667   for ($age_index = 1; $age_index < ($num_ages - 1); ++$age_index) {
 668     $ageline .= ' / ' . ($age_index * 30 + 1) . '-' . ($age_index * 30 + 30) .
 669     sprintf(" %.2f", $aging[$age_index]);
 670   }
 671
 672   // Fixed text labels
 673   $label_ptname = xl('Name');
 674   $label_today = xl('Date');
 675   $label_due = xl('Amount Due');
 676   $label_thanks = xl('Thank you for choosing');
 677   $label_call = xl('Please call if any of the above information is incorrect.');
 678   $label_prompt = xl('We appreciate prompt payment of balances due.');
 679   $label_dept = xl('Billing Department');
 680   $label_bill_phone = (!empty($GLOBALS['billing_phone_number']) ? $GLOBALS['billing_phone_number'] : $billing_phone );
 681   $label_appointments = xl('Future Appointments').':';
 682
 683   // This is the bottom portion of the page.
 684   $out .= "\n";
 685   if(strlen($stmt['bill_note']) !=0 && $GLOBALS['statement_bill_note_print']) {
 686     $out .= sprintf("%-46s\n",$stmt['bill_note']);
 687   }
 688   if ($GLOBALS['use_dunning_message']) {
 689       $out .= sprintf("%-46s\n",$dun_message);
 690   }
 691   $out .= "\n";
 692   $out .= sprintf("%-s: %-25s %-s: %-14s %-s: %8s\n",$label_ptname,$stmt['patient'],
 693   $label_today,oeFormatShortDate($stmt['today']),$label_due,$stmt['amount']);
 694   $out .= sprintf("__________________________________________________________________\n");
 695   $out .= "\n";
 696   $out .= sprintf("%-s\n",$label_call);
 697   $out .= sprintf("%-s\n",$label_prompt);
 698   $out .= "\n";
 699   $out .= sprintf("%-s\n",$billing_contact);
 700   $out .= sprintf("  %-s %-25s\n",$label_dept,$label_bill_phone);
 701   if($GLOBALS['statement_message_to_patient']) {
 702     $out .= "\n";
 703     $statement_message = $GLOBALS['statement_msg_text'];
 704     $out .= sprintf("%-40s\n",$statement_message);
 705   }
 706   if($GLOBALS['show_aging_on_custom_statement']) {
 707     # code for ageing
 708     $ageline .= ' / ' . xl('Over') . '-' . ($age_index * 30) .
 709     sprintf(" %.2f", $aging[$age_index]);
 710     $out .= "\n" . $ageline . "\n\n";
 711
 712   }
 713   if($GLOBALS['number_appointments_on_statement']!=0) {
 714     $out .= "\n";
 715     $num_appts = $GLOBALS['number_appointments_on_statement'];
 716     $next_day = mktime(0,0,0,date('m'),date('d')+1,date('Y'));
 717     # add one day to date so it will not get todays appointment
 718     $current_date2 = date('Y-m-d', $next_day);
 719     $events = fetchNextXAppts($current_date2,$stmt['pid'],$num_appts);
 720     $j=0;
 721     $out .= sprintf("%-s\n",$label_appointments);
 722     #loop to add the appointments
 723     for ($x = 1; $x <= $num_appts; $x++) {
 724       $next_appoint_date = oeFormatShortDate($events[$j]['pc_eventDate']);
 725       $next_appoint_time = substr($events[$j]['pc_startTime'],0,5);
 726       if(strlen(umname) != 0 ) {
 727         $next_appoint_provider = $events[$j]['ufname'] . ' ' . $events[$j]['umname'] . ' ' .  $events[$j]['ulname'];
 728       }
 729       else
 730       {
 731         $next_appoint_provider = $events[$j]['ufname'] . ' ' .  $events[$j]['ulname'];
 732       }
 733       if(strlen($next_appoint_time) != 0) {
 734         $label_plsnote[$j] = xlt('Date') . ': ' . text($next_appoint_date) . ' ' . xlt('Time') . ' ' . text($next_appoint_time) . ' ' . xlt('Provider') . ' ' . text($next_appoint_provider);
 735         $out .= sprintf("%-s\n",$label_plsnote[$j]);
 736       }
 737       $j++;
 738     }
 739   }
 740   $out .= "\014"; // this is a form feed
 741
 742   return $out;
 743 }
 744
 745 function osp_create_HTML_statement($stmt) {
 746         if (! $stmt['pid']) return ""; // get out if no data
 747
 748         #minimum_amount_due_to _print
 749         if ($stmt['amount'] <= ($GLOBALS['minimum_amount_to_print']) && $GLOBALS['use_statement_print_exclusion']) return "";
 750
 751         // Facility (service location)
 752         $atres = sqlStatement("select f.name,f.street,f.city,f.state,f.postal_code,f.attn,f.phone from facility f " .
 753                         " left join users u on f.id=u.facility_id " .
 754                         " left join  billing b on b.provider_id=u.id and b.pid = ? ".
 755                         " where  service_location=1",array($stmt['pid']));
 756         $row = sqlFetchArray($atres);
 757         $clinic_name = "{$row['name']}";
 758         $clinic_addr = "{$row['street']}";
 759         $clinic_csz = "{$row['city']}, {$row['state']}, {$row['postal_code']}";
 760         // Contacts
 761         $billing_contact = "{$row['attn']}";
 762         $billing_phone = "{$row['phone']}";
 763         // Billing location
 764         $remit_name = $clinic_name;
 765         $remit_addr = $clinic_addr;
 766         $remit_csz = $clinic_csz;
 767
 768         ob_start();
 769         ?><div style="padding-left:25px;">
 770   <?php
 771   $find_provider = sqlQuery("SELECT * FROM form_encounter " .
 772         "WHERE pid = ? AND encounter = ? " .
 773         "ORDER BY id DESC LIMIT 1", array($stmt['pid'],$stmt['encounter']) );
 774   $providerID = $find_provider['provider_id'];
 775   echo report_header_2($stmt,$direction,$providerID);
 776
 777   // dunning message setup
 778
 779   // insurance has paid something
 780   // $stmt['age'] how old is the invoice
 781   // $stmt['dun_count'] number of statements run
 782   // $stmt['level_closed'] <= 3 insurance 4 = patient
 783
 784   if ($GLOBALS['use_dunning_message']) {
 785     if ($stmt['ins_paid'] != 0 || $stmt['level_closed'] == 4)  {
 786
 787       // do collection messages
 788       switch ($stmt{'age'}) {
 789         case $stmt{'age'} <= $GLOBALS['first_dun_msg_set']:
 790         $dun_message = $GLOBALS['first_dun_msg_text'];
 791         break;
 792         case $stmt{'age'} <= $GLOBALS['second_dun_msg_set']:
 793         $dun_message = $GLOBALS['second_dun_msg_text'];
 794         break;
 795         case $stmt{'age'} <= $GLOBALS['third_dun_msg_set']:
 796         $dun_message = $GLOBALS['third_dun_msg_text'];
 797         break;
 798         case $stmt{'age'} <= $GLOBALS['fourth_dun_msg_set']:
 799         $dun_message = $GLOBALS['fourth_dun_msg_text'];
 800         break;
 801         case $stmt{'age'} >= $GLOBALS['fifth_dun_msg_set']:
 802         $dun_message = $GLOBALS['fifth_dun_msg_text'];
 803         break;
 804       }
 805     }
 806   }
 807   // Text only labels
 808
 809   $label_addressee = xl('ADDRESSEE');
 810   $label_remitto = xl('REMIT TO');
 811   $label_chartnum = xl('Chart Number');
 812   $label_insinfo = xl('Insurance information on file');
 813   $label_totaldue = xl('Total amount due');
 814   $label_payby = xl('If paying by');
 815   $label_cards = xl('VISA/MC/Discovery/HSA');
 816   $label_cardnum = xl('Card');
 817   $label_expiry = xl('Exp');
 818   $label_sign = xl('Signature');
 819   $label_retpay = xl('Please fill in credit information and send for review.');
 820   $label_pgbrk = xl('STATEMENT SUMMARY');
 821   $label_visit = xl('Visit Date');
 822   $label_desc = xl('Description');
 823   $label_amt = xl('Amount');
 824
 825   // This is the text for the top part of the page, up to but not
 826   // including the detail lines.  Some examples of variable fields are:
 827   //  %s    = string with no minimum width
 828   //  %9s   = right-justified string of 9 characters padded with spaces
 829   //  %-25s = left-justified string of 25 characters padded with spaces
 830   // Note that "\n" is a line feed (new line) character.
 831   // reformatted to handle i8n by tony
 832
 833   $out  = "<div style='margin-left:60px;margin-top:0px;'>";
 834   $out .= "\n";
 835   $out .= sprintf("_______________________ %s _______________________\n",$label_pgbrk);
 836   $out .= "\n";
 837   $out .= sprintf("%-11s %-46s %s\n",$label_visit,$label_desc,$label_amt);
 838   $out .= "\n";
 839
 840   // This must be set to the number of lines generated above.
 841   //
 842   $count = 6;
 843   $num_ages = 4;
 844   $aging = array();
 845   for ($age_index = 0; $age_index < $num_ages; ++$age_index) {
 846     $aging[$age_index] = 0.00;
 847   }
 848   $todays_time = strtotime(date('Y-m-d'));
 849
 850   // This generates the detail lines.  Again, note that the values must be specified in the order used.
 851   foreach ($stmt['lines'] as $line) {
 852     if ($GLOBALS['use_custom_statement']) {
 853       $description = substr($line['desc'],0,30);
 854     } else {
 855       $description = $line['desc'];
 856     }
 857
 858     $tmp = substr($description, 0, 14);
 859     if ($tmp == 'Procedure 9920' || $tmp == 'Procedure 9921' || $tmp == 'Procedure 9200' || $tmp == 'Procedure 9201')
 860       $description = str_replace("Procedure",xl('Office Visit').":",$description);
 861     //92002-14 are Eye Office Visit Codes
 862
 863     $dos = $line['dos'];
 864     ksort($line['detail']);
 865       # Compute the aging bucket index and accumulate into that bucket.
 866     $age_in_days = (int) (($todays_time - strtotime($dos)) / (60 * 60 * 24));
 867     $age_index = (int) (($age_in_days - 1) / 30);
 868     $age_index = max(0, min($num_ages - 1, $age_index));
 869     $aging[$age_index] += $line['amount'] - $line['paid'];
 870
 871     foreach ($line['detail'] as $dkey => $ddata) {
 872       $ddate = substr($dkey, 0, 10);
 873       if (preg_match('/^(\d\d\d\d)(\d\d)(\d\d)\s*$/', $ddate, $matches)) {
 874         $ddate = $matches[1] . '-' . $matches[2] . '-' . $matches[3];
 875       }
 876       $amount = '';
 877
 878       if ($ddata['pmt']) {
 879         $amount = sprintf("%.2f", 0 - $ddata['pmt']);
 880         $desc = xl('Paid') .' '. oeFormatShortDate($ddate) .': '. $ddata['src'].' '. $ddata['pmt_method'].' '. $ddata['insurance_company'];
 881       } else if ($ddata['rsn']) {
 882         if ($ddata['chg']) {
 883           $amount = sprintf("%.2f", $ddata['chg']);
 884           $desc = xl('Adj') .' '.  oeFormatShortDate($ddate) .': ' . $ddata['rsn'].' '.$ddata['pmt_method'].' '. $ddata['insurance_company'];
 885         } else {
 886           $desc = xl('Note') .' '. oeFormatShortDate($ddate) .': '. $ddata['rsn'].' '.$ddata['pmt_method'].' '. $ddata['insurance_company'];
 887         }
 888       } else if ($ddata['chg'] < 0) {
 889         $amount = sprintf("%.2f", $ddata['chg']);
 890         $desc = xl('Patient Payment');
 891       } else {
 892         $amount = sprintf("%.2f", $ddata['chg']);
 893         $desc = $description;
 894
 895       }
 896
 897       $out .= sprintf("%-10s  %-45s%8s\n", oeFormatShortDate($dos), $desc, $amount);
 898       $dos = '';
 899       ++$count;
 900     }
 901   }
 902
 903   // This generates blank lines until we are at line 20.
 904   //  At line 20 we start middle third.
 905
 906   //while ($count++ < 16) $out .= "\n";
 907     # Generate the string of aging text.  This will look like:
 908     # Current xxx.xx / 31-60 x.xx / 61-90 x.xx / Over-90 xxx.xx
 909     # ....+....1....+....2....+....3....+....4....+....5....+....6....+
 910     #
 911   $ageline = xl('Current') .': ' . sprintf("%.2f", $aging[0]);
 912   for ($age_index = 1; $age_index < ($num_ages - 1); ++$age_index) {
 913     $ageline .= ' | ' . ($age_index * 30 + 1) . '-' . ($age_index * 30 + 30) . ':' .
 914                 sprintf(" %.2f", $GLOBALS['gbl_currency_symbol'].''.$aging[$age_index]);
 915   }
 916
 917   // Fixed text labels
 918   $label_ptname = xl('Name');
 919   $label_today = xl('Date');
 920   $label_due = xl('Due');
 921   $label_thanks = xl('Thank you for choosing');
 922   $label_call = xl('Please call or message if any of the above information is incorrect.');
 923   $label_prompt = xl('We appreciate prompt payment of balances due.');
 924   $label_dept = xl('Billing Department');
 925   $label_bill_phone = (!empty($GLOBALS['billing_phone_number']) ? $GLOBALS['billing_phone_number'] : $billing_phone );
 926   $label_appointments = xl('Future Appointments').':';
 927
 928   // This is the top portion of the page.
 929   $out .= "\n";
 930   if(strlen($stmt['bill_note']) !=0 && $GLOBALS['statement_bill_note_print']) {
 931     $out .= sprintf("%-46s\n",$stmt['bill_note']);
 932     $count++;
 933   }
 934   if ($GLOBALS['use_dunning_message']) {
 935       $out .= sprintf("%-46s\n",$dun_message);
 936       $count++;
 937   }
 938   $out .= "\n";
 939   $out .= sprintf("%-s: %-25s %-s: %-14s %-s: %8s\n",$label_ptname,$stmt['patient'],
 940   $label_today,oeFormatShortDate($stmt['today']),$label_due,$stmt['amount']);
 941   $out .= sprintf("__________________________________________________________________\n");
 942   $out .= "\n";
 943   $out .= sprintf("%-s\n",$label_call);
 944   $out .= sprintf("%-s\n",$label_prompt);
 945   $out .= "\n";
 946   $out .= sprintf("%-s\n",$billing_contact);
 947   $out .= sprintf("  %-s %-25s\n",$label_dept,$label_bill_phone);
 948   if($GLOBALS['statement_message_to_patient']) {
 949     $out .= "\n";
 950     $statement_message = $GLOBALS['statement_msg_text'];
 951     $out .= sprintf("%-40s\n",$statement_message);
 952     $count++;
 953   }
 954   if($GLOBALS['show_aging_on_custom_statement']) {
 955     # code for ageing
 956     $ageline .= ' | ' . xl('Over') . ' ' . ($age_index * 30) .':'.
 957     sprintf(" %.2f", $aging[$age_index]);
 958     $out .= "\n" . $ageline . "\n\n";
 959     $count++;
 960   }
 961   if($GLOBALS['number_appointments_on_statement']!=0) {
 962     $out .= "\n";
 963     $num_appts = $GLOBALS['number_appointments_on_statement'];
 964     $next_day = mktime(0,0,0,date('m'),date('d')+1,date('Y'));
 965     # add one day to date so it will not get todays appointment
 966     $current_date2 = date('Y-m-d', $next_day);
 967     $events = fetchNextXAppts($current_date2,$stmt['pid'],$num_appts);
 968     $j=0;
 969     $out .= sprintf("%-s\n",$label_appointments);
 970     #loop to add the appointments
 971     for ($x = 1; $x <= $num_appts; $x++) {
 972       $next_appoint_date = oeFormatShortDate($events[$j]['pc_eventDate']);
 973       $next_appoint_time = substr($events[$j]['pc_startTime'],0,5);
 974       if(strlen(umname) != 0 ) {
 975         $next_appoint_provider = $events[$j]['ufname'] . ' ' . $events[$j]['umname'] . ' ' .  $events[$j]['ulname'];
 976       }
 977       else
 978       {
 979         $next_appoint_provider = $events[$j]['ufname'] . ' ' .  $events[$j]['ulname'];
 980       }
 981       if(strlen($next_appoint_time) != 0) {
 982         $label_plsnote[$j] = xlt('Date') . ': ' . text($next_appoint_date) . ' ' . xlt('Time') . ' ' . text($next_appoint_time) . ' ' . xlt('Provider') . ' ' . text($next_appoint_provider);
 983         $out .= sprintf("%-s\n",$label_plsnote[$j]);
 984       }
 985       $j++;
 986       $count++;
 987     }
 988   }
 989  // while ($count++ < 29) $out .= "\n";
 990   $out .= sprintf("%-10s %s\n",null,$label_retpay);
 991   $out .= '</pre></div>';
 992   $out .= '<div style="width:7.0in;border-top:1pt dotted black;font-size:12px;margin:0px;"><br /><br />
 993       <table style="width:8in;margin-left:20px;"><tr><td style="width:4.5in;"><br />
 994  ';
 995   $out .= $label_payby.' '.$label_cards;
 996   $out .= "<br /><br />";
 997   $out .= $label_cardnum .': {TextInput}  '.$label_expiry.': {smTextInput} / {smTextInput} <br /><br />';
 998   $out .= $label_sign .'  {PatientSignature}<br />';
 999   $out .="      </td><td style=width:2.0in;vertical-align:middle;'>";
1000           $practice_cards = $GLOBALS['webroot']."/sites/" . $_SESSION['site_id'] . "/images/visa_mc_disc_credit_card_logos_176x35.gif";
1001           if (file_exists($GLOBALS['OE_SITE_DIR']."/images/visa_mc_disc_credit_card_logos_176x35.gif")) {
1002             //$out .= "<img onclick='getPayment()' src='$practice_cards' style='width:100%;margin:4px auto;'><br /><p>\n".$label_totaldue.": ".$stmt['amount']."</p>";
1003             $out .= "<br /><p>".$label_totaldue.": ".$stmt['amount']."</p>";
1004           }
1005
1006   $out .="</td></tr></table>";
1007
1008     $out .= '</div><br />';
1009   if($stmt['to'][3]!='')//to avoid double blank lines the if condition is put.
1010   $out .= sprintf("   %-32s\n",$stmt['to'][3]);
1011   $out .= ' </pre>
1012   <div style="width:8in;border-top:1pt solid black;"><br />';
1013   $out .= " <table style='width:6.0in;margin-left:40px;'><tr>";
1014   $out .= '<td style="width:3.0in;"><b>'
1015       .$label_addressee.'</b><br />'
1016       .$stmt['to'][0].'<br />'
1017       .$stmt['to'][1].'<br />'
1018       .$stmt['to'][2].'
1019       </td>
1020       <td style="width:3.0in;"><b>'.$label_remitto.'</b><br />'
1021       .$remit_name.'<br />'
1022       .$remit_addr.'<br />'
1023       .$remit_csz.'
1024       </td>
1025       </tr></table>';
1026
1027   $out .= "      </div></div>";
1028   $out .= "\014
1029   <br /><br />"; // this is a form feed
1030   echo $out;
1031   $output = ob_get_clean();
1032   return $output;
1033 }
1034
1035 ?>