contrib/forms/plist/new.php

   1 <?php
   2 include_once("../../globals.php");
   3 include_once("$srcdir/api.inc");
   4 include_once("$srcdir/forms.inc");
   5 include_once("$srcdir/calendar.inc");
   6 include_once("$srcdir/lists.inc");
   7 $frmn = 'form_plist';
   8 $ftitle = 'Problem list';
   9 $old = sqlStatement("select form_id, formdir from forms where (form_name='${ftitle}') and (pid=$pid) order by date desc limit 1");
  10 if ($old) {
  11   $dt = sqlFetchArray($old);
  12   $fid = $dt{'form_id'};
  13   if ($fid && ($fid != 0) && ($fid != '')){
  14   $fdir = $dt{'formdir'};
  15   unset($dt);
  16   $dt = formFetch($frmn, $fid);
  17   $newid = formSubmit($frmn, array_slice($dt,7), $id, $userauthorized);
  18   addForm($encounter, $ftitle, $newid, $fdir, $pid, $userauthorized);
  19   $id = $newid;
  20   formJump("${rootdir}/patient_file/encounter/view_form.php?formname=${fdir}&id=${newid}");
  21   exit;
  22 }
  23 }
  24 ?>
  25 <!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN"
  26 "http://www.w3.org/TR/html4/loose.dtd">
  27
  28 <html>
  29 <head>
  30 <link rel=stylesheet href="<?echo $css_header;?>" type="text/css">
  31 <link rel=stylesheet href="../../acog.css" type="text/css">
  32 <script language="JavaScript" src="../../acog.js" type="text/JavaScript"></script>
  33 <script language="JavaScript" type="text/JavaScript">
  34   window.onload = initialize;
  35 </script>
  36 </head>
  37 <?
  38    $fres=sqlStatement("select * from patient_data where pid=".$_SESSION["pid"]);
  39    if ($fres){
  40      $patient = sqlFetchArray($fres);
  41    }
  42    $history = getHistoryData($_SESSION["pid"]);
  43 ?>
  44 <body <?echo $top_bg_line;?> >
  45
  46 <form action="<?echo $rootdir;?>/forms/plist/save.php?mode=new" method="post" enctype="multipart/form-data" name="my_form">
  47 <? include("../../acog_menu.inc"); ?>
  48   <table width="70%"  border="0" cellspacing="0" cellpadding="4">
  49   <tr>
  50     <td width="120" align="left" valign="bottom" class="srvCaption">Patient name:</td>
  51     <td align="left" valign="bottom"><input name="pname" type="text" class="fullin" id="pname" value="<? echo $patient{'fname'}.' '.$patient{'mname'}.' '.$patient{'lname'}; ?>"></td>
  52   </tr>
  53   <tr>
  54     <td width="120" align="left" valign="bottom" class="srvCaption">Birth date: </td>
  55     <td align="left" valign="bottom"><input name="pbdate" type="text" class="fullin" id="pbdate" value="<?  echo $patient{'DOB'};  ?>"></td>
  56   </tr>
  57   <tr>
  58     <td width="120" align="left" valign="bottom" class="srvCaption">ID No:</td>
  59     <td align="left" valign="bottom"><input name="pl_pid" type="text" class="fullin" id="pl_pid" value="<? echo $patient{'id'};  ?>" readonly="true"></td>
  60   </tr>
  61   <tr>
  62     <td width="120" align="left" valign="bottom" class="srvCaption">Date</td>
  63     <td align="left" valign="bottom"><input name="pl_date" type="text" class="fullin" id="pl_date" value="<? echo date('Y-m-d'); ?>"></td>
  64   </tr>
  65 </table>
  66 <div class="srvChapter">Problem list <a href="#" onMouseOver="toolTip('The Problem List captures problems, allergies, family history, and current medication use.')" onMouseOut="toolTip();"><img src="../../pic/mark_q.png" width="13" height="13" border="0"></a></div>
  67 <div style="border: solid 2px black; background-color:#FFFFFF;">
  68   <table width="100%"  border="0" cellspacing="0" cellpadding="2">
  69     <tr>
  70       <td width="50%" class="ficaption3" id="bordR">High risk:</td>
  71       <td width="50%" class="ficaption3">Family history:</td>
  72     </tr>
  73     <tr>
  74       <td class="fibody2" id="bordR"><textarea name="pl_high_risk" rows="6" wrap="VIRTUAL" class="fullin2" id="pl_high_risk"><? echo $obj{'pl_high_risk'} ?></textarea></td>
  75       <td class="fibody2"><textarea name="pl_family_history" rows="6" wrap="VIRTUAL" class="fullin2" id="pl_family_history"><?
  76           ($history['history_mother'] != '')?$tmp[] = "Mother: ".$history['history_mother']:'';
  77           ($history['history_father'] != '')?$tmp[] = "Father: ".$history['history_father']:'';
  78           ($history['history_siblings'] != '')?$tmp[] = "Siblings: ".$history['history_siblings']:'';
  79           ($history['history_spouse'] != '')?$tmp[] = "Spouse: ".$history['history_spouse']:'';
  80           ($history['history_offspring'] != '')?$tmp[] = "Offspring: ".$history['history_offspring']:'';
  81           echo join(', ', $tmp);
  82           ?></textarea></td>
  83     </tr>
  84     <tr>
  85       <td class="ficaption3" id="bordR">Drug/Latex/Transfusion/Allergic reactions: </td>
  86       <td class="ficaption3">Current medications:</td>
  87     </tr>
  88     <tr>
  89       <td class="fibody3" id="bordR"><textarea name="pl_reactions" rows="6" wrap="VIRTUAL" class="fullin2" id="pl_reactions"><?
  90 $allergies = ''; $checked = 'checked';
  91 if ($result = getListByType($pid, "allergy", "id,title,comments,activity,date", 1, "all", 0)){
  92         foreach ($result as $iter) {
  93           $al_tmp[] = $iter{"title"}.' ('.$iter{"comments"}.') ';
  94           $checked = '';
  95         }
  96         $allergies = join(',', $al_tmp);
  97 }
  98 echo $allergies;
  99 ?></textarea></td>
 100       <td class="fibody3"><textarea name="pl_medications" rows="6" wrap="VIRTUAL" class="fullin2" id="pl_medications"><?
 101 if ($result = getListByType($pid, "medication", "id,title,comments,activity,date", 1, "all", 0)){
 102         foreach ($result as $iter) {
 103           $tmp_med[] = $iter{"title"}.' ('.$iter{"comments"}.') ';
 104         }
 105 echo join(', ', $tmp_med);
 106 }
 107 ?></textarea></td>
 108     </tr>
 109   </table>
 110 </div>
 111 <p>&nbsp;</p>
 112 <div style="border: solid 2px black; background-color:#FFFFFF;">
 113   <table width="100%"  border="0" cellspacing="0" cellpadding="2">
 114     <tr>
 115       <td width="20" align="left" valign="bottom" class="ficaption2" id="bordR">No</td>
 116       <td width="120" align="center" valign="bottom" class="ficaption2" id="bordR">Entry date </td>
 117       <td align="center" valign="bottom" class="ficaption2" id="bordR">Problem/Resolution</td>
 118       <td width="120" align="center" valign="bottom" class="ficaption2" id="bordR">Onset age and date </td>
 119       <td width="120" align="center" valign="bottom" class="ficaption2">Resolution date </td>
 120     </tr>
 121 <?
 122 $pli = 1;
 123
 124 while ($pli < 26){
 125 //print $obj["pl_problem_$pli"];
 126 list($pl_ed, $pl_problem, $pl_onset, $pl_rd) = explode('|~', $obj["pl_problem_${pli}"]);
 127 print <<<EOL
 128     <tr>
 129       <td align="left" valign="bottom" class="fibody2" id="bordR">${pli}.</td>
 130       <td align="left" valign="bottom" class="fibody2" id="bordR"><input name="pl_ed_${pli}" type="text" class="fullin2" value="${pl_ed}"></td>
 131       <td align="left" valign="bottom" class="fibody2" id="bordR"><input name="pl_problem_${pli}" type="text" class="fullin2" value="${pl_problem}"></td>
 132       <td align="left" valign="bottom" class="fibody2" id="bordR"><input name="pl_onset_${pli}" type="text" class="fullin2" value="${pl_onset}"></td>
 133       <td align="left" valign="bottom" class="fibody2"><input name="pl_rd_${pli}" type="text" class="fullin2" value="${pl_rd}"></td>
 134     </tr>
 135 EOL;
 136 $pli++;
 137 }
 138 ?>
 139   </table>
 140 </div>
 141 <table width="100%" border="0">
 142   <tr>
 143     <td align="left" width="100"> <a href="javascript:document.my_form.submit();" class="link_submit">[Save Data]</a> </td>
 144     <td align="right"> <a href="<?echo "$rootdir/patient_file/encounter/patient_encounter.php";?>" class="link_submit">[Don't Save]</a> </td>
 145   </tr>
 146 </table>
 147 </form>
 148 <?php
 149 formFooter();
 150 ?>
 151 </body>
 152 </html>