1 <!-- Work
/School Note Form created by Nikolai Vitsyn
: 2004/02/13 and update
2005/03/30
2 Copyright (C
) Open Source Medical Software
4 This program is free software
; you can redistribute it
and/or
5 modify it under the terms of the GNU General
Public License
6 as published by the Free Software Foundation
; either version
2
7 of the License
, or (at your option
) any later version
.
9 This program is distributed in the hope that it will be useful
,
10 but WITHOUT ANY WARRANTY
; without even the implied warranty of
11 MERCHANTABILITY
or FITNESS
FOR A PARTICULAR PURPOSE
. See the
12 GNU General
Public License
for more details
.
14 You should have received a copy of the GNU General
Public License
15 along with this program
; if not
, write to the Free Software
16 Foundation
, Inc
., 59 Temple Place
- Suite
330, Boston
, MA
02111-1307, USA
. -->
20 $fake_register_globals=false;
21 $sanitize_all_escapes=true;
23 include_once("../../globals.php");
24 include_once("$srcdir/api.inc");
25 formHeader("Form: note");
26 $returnurl = $GLOBALS['concurrent_layout'] ?
'encounter_top.php' : 'patient_encounter.php';
27 $provider_results = sqlQuery("select fname, lname from users where username=?",array($_SESSION{"authUser"}));
28 /* name of this form */
33 <?php
html_header_show();?
>
35 <!-- supporting javascript code
-->
36 <script type
="text/javascript" src
="<?php echo $GLOBALS['webroot'] ?>/library/js/jquery.js"></script
>
37 <script type
="text/javascript" src
="<?php echo $GLOBALS['webroot'] ?>/library/textformat.js"></script
>
39 <!-- pop up calendar
-->
40 <style type
="text/css">@import
url(<?php
echo $GLOBALS['webroot'] ?
>/library
/dynarch_calendar
.css
);</style
>
41 <script type
="text/javascript" src
="<?php echo $GLOBALS['webroot'] ?>/library/dynarch_calendar.js"></script
>
42 <?php
include_once("{$GLOBALS['srcdir']}/dynarch_calendar_en.inc.php"); ?
>
43 <script type
="text/javascript" src
="<?php echo $GLOBALS['webroot'] ?>/library/dynarch_calendar_setup.js"></script
>
45 <link rel
="stylesheet" href
="<?php echo $css_header;?>" type
="text/css">
47 <script language
="JavaScript">
48 // required for textbox date verification
49 var mypcc
= '<?php echo $GLOBALS['phone_country_code
'] ?>';
54 <body
class="body_top">
55 <?php
echo date("F d, Y", time()); ?
>
57 <form method
=post action
="<?php echo $rootdir."/forms
/".$form_name."/save
.php?mode
=new";?>" name
="my_form" id
="my_form">
58 <span
class="title"><?php
echo xlt('Work/School Note'); ?
></span
><br
></br
>
60 <div style
="margin: 10px;">
61 <input type
="button" class="save" value
=" <?php echo xla('Save'); ?> ">  
;
62 <input type
="button" class="dontsave" value
="<?php echo xla('Don\'t Save'); ?>">  
;
65 <select name
="note_type">
66 <option value
="WORK NOTE"><?php
echo xlt('WORK NOTE'); ?
></option
>
67 <option value
="SCHOOL NOTE"><?php
echo xlt('SCHOOL NOTE'); ?
></option
>
70 <b
><?php
echo xlt('MESSAGE:'); ?
></b
>
72 <textarea name
="message" id
="message" rows
="7" cols
="47"></textarea
>
76 // commented out below private field, because no field in database, and causes error.
79 <input type
="checkbox" name
="private" id
="private"><label
for="private">This note is
private</label
>
84 <b
><?php
echo xlt('Signature:'); ?
></b
>
89 <?php
echo xlt('Doctor:'); ?
>
90 <input type
="text" name
="doctor" id
="doctor" value
="<?php echo attr($provider_results["fname
"]).' '.attr($provider_results["lname
"]); ?>">
94 <span
class="text"><?php
echo xlt('Date'); ?
></span
>
95 <input type
='text' size
='10' name
='date_of_signature' id
='date_of_signature'
96 value
='<?php echo date('Y
-m
-d
', time()); ?>'
97 title
='<?php echo xla('yyyy
-mm
-dd
'); ?>'
98 onkeyup
='datekeyup(this,mypcc)' onblur
='dateblur(this,mypcc)' />
99 <img src
='../../pic/show_calendar.gif' align
='absbottom' width
='24' height
='22'
100 id
='img_date_of_signature' border
='0' alt
='[?]' style
='cursor:pointer;cursor:hand'
101 title
='<?php echo xla('Click here to choose a date
'); ?>'>
106 <div style
="margin: 10px;">
107 <input type
="button" class="save" value
=" <?php echo xla('Save'); ?> ">  
;
108 <input type
="button" class="dontsave" value
="<?php echo xla('Don\'t Save'); ?>">  
;
115 <script language
="javascript">
116 /* required for popup calendar */
117 Calendar
.setup({inputField
:"date_of_signature", ifFormat
:"%Y-%m-%d", button
:"img_date_of_signature"});
119 // jQuery stuff to make the page a little easier to use
121 $
(document
).ready(function(){
122 $
(".save").click(function() { top
.restoreSession(); $
('#my_form').submit(); });
123 $
(".dontsave").click(function() { location
.href
='<?php echo "$rootdir/patient_file/encounter/$returnurl";?>'; });
124 //$("#printform").click(function() { PrintForm(); });