interface/forms/eye_mag/a_issue.php

   1 <?php
   2 /**
   3  * This file presents the PMSFH control panel.
   4  * It uses ajax/javascript to add, delete or edit an issue.
   5  *
   6  * Originally culled from /interface/patient_file/summary and adapted...
   7  *
   8  * Copyright (C) 2005-2011 Rod Roark <rod@sunsetsystems.com>
   9  * Copyright (C) 2015-6 Ray Magauran <magauran@MedFetch.com>
  10  *
  11  * This program is free software; you can redistribute it and/or
  12  * modify it under the terms of the GNU General Public License
  13  * as published by the Free Software Foundation; either version 2
  14  * of the License, or (at your option) any later version.
  15  *
  16  * @package OpenEMR
  17  * @author  Rod Roark <rod@sunsetsystems.com>
  18  * @author Ray Magauran <magauran@MedFetch.com>
  19  * @link    http://www.open-emr.org
  20  */
  21
  22 //SANITIZE ALL ESCAPES
  23 $sanitize_all_escapes=true;
  24 //STOP FAKE REGISTER GLOBALS
  25 $fake_register_globals=false;
  26 $form_folder= "eye_mag";
  27 require_once('../../globals.php');
  28 require_once($GLOBALS['srcdir'].'/lists.inc');
  29 require_once($GLOBALS['srcdir'].'/patient.inc');
  30 require_once($GLOBALS['srcdir'].'/acl.inc');
  31 require_once($GLOBALS['srcdir'].'/sql.inc');
  32 require_once($GLOBALS['srcdir'].'/options.inc.php');
  33 require_once($GLOBALS['fileroot'].'/custom/code_types.inc.php');
  34 require_once($GLOBALS['srcdir'].'/csv_like_join.php');
  35 require_once($GLOBALS['srcdir'].'/htmlspecialchars.inc.php');
  36 require_once($GLOBALS['srcdir'].'/formdata.inc.php');
  37 require_once($GLOBALS['srcdir'].'/log.inc');
  38 require_once("../../forms/".$form_folder."/php/".$form_folder."_functions.php");
  39
  40 $pid = 0 + (empty($_REQUEST['pid']) ? $pid : $_REQUEST['pid']);
  41 $info_msg = "";
  42
  43 // A nonempty thisenc means we are to link the issue to the encounter.
  44 // ie. we are going to use this as a billing issue?
  45 // The Coding Engine does not look at encounters and issue linkage, yet.  It could and perhaps should.
  46 $encounter = 0 + (empty($_REQUEST['encounter']) ? $_SESSION['encounter'] : $_REQUEST['encounter']);
  47
  48 $issue = $_REQUEST['issue'];
  49 $deletion = $_REQUEST['deletion'];
  50 $form_save = $_REQUEST['form_save'];
  51 if (!$pid) $pid = $_SESSION['pid'];
  52 $form_id = $_REQUEST['form_id'];
  53 $form_type = $_REQUEST['form_type'];
  54 $uniqueID = $_REQUEST['uniqueID'];
  55
  56 if ($issue && !acl_check('patients','med','','write') ) die(xlt("Edit is not authorized!"));
  57 if ( !acl_check('patients','med','',array('write','addonly') )) die(xlt("Add is not authorized!"));
  58 $PMSFH = build_PMSFH($pid);
  59 $patient = getPatientData($pid, "*");
  60 $providerID   = findProvider($pid,$encounter);
  61 if (!$_SESSION['providerID'] && $providerID)  ($_SESSION['providerID'] = $providerID);
  62
  63 $irow = array();
  64 if ($issue) {
  65   $irow = sqlQuery("SELECT * FROM lists WHERE id = ?",array($issue));
  66 } else if ($thistype) {
  67   $irow['type'] = $thistype;
  68   $irow['subtype'] = $subtype;
  69 }
  70 if (!empty($irow['type'])) {
  71   foreach ($ISSUE_TYPES as $key => $value) {
  72     if ($key == $irow['type']) break;
  73     ++$type_index;
  74   }
  75 }
  76 $given="ROSGENERAL,ROSHEENT,ROSCV,ROSPULM,ROSGI,ROSGU,ROSDERM,ROSNEURO,ROSPSYCH,ROSMUSCULO,ROSIMMUNO,ROSENDOCRINE";
  77 $query="SELECT $given from form_eye_mag where id=? and pid=?";
  78 $rres = sqlQuery($query,array($form_id,$pid));
  79 foreach (explode(',',$given) as $item) {
  80     $$item = $rres[$item];
  81 }
  82
  83 ?><html>
  84 <head>
  85 <title><?php echo xlt('Add New Issue'); ?></title>
  86 <script language="JavaScript">
  87                 <?php       require_once("$srcdir/restoreSession.php");  ?>
  88 </script>
  89 <script type="text/javascript" src="<?php echo $GLOBALS['webroot']; ?>/interface/main/tabs/js/include_opener.js"></script>
  90
  91 <meta name="viewport" content="width=device-width, initial-scale=1" />
  92 <style type="text/css">@import url(<?php echo $GLOBALS['webroot']; ?>/library/dynarch_calendar.css);</style>
  93 <script type="text/javascript" src="<?php echo $GLOBALS['webroot']; ?>/library/dynarch_calendar.js"></script>
  94 <?php require_once($GLOBALS['srcdir'].'/dynarch_calendar_en.inc.php'); ?>
  95 <script type="text/javascript" src="<?php echo $GLOBALS['webroot']; ?>/library/dynarch_calendar_setup.js"></script>
  96
  97 <script type="text/javascript" src="<?php echo $GLOBALS['webroot']; ?>/library/textformat.js"></script>
  98 <script type="text/javascript" src="<?php echo $GLOBALS['webroot']; ?>/library/dialog.js"></script>
  99
 100 <script language="JavaScript">
 101  var mypcc = '<?php echo $GLOBALS['phone_country_code'] ?>';
 102  var aitypes = new Array(); // issue type attributes
 103  var aopts   = new Array(); // Option objects
 104     <?php
 105     //This builds the litle quick pick list in this section.
 106     // If the provider has more 2 items already defined in the last month, they are collated
 107     // and ranked by frequency, sort alphabetically and <=10 are listed.
 108     // If not, we use the defaults from list_options/
 109   $i='0';
 110
 111   foreach ($PMSFH[0] as $key => $value) {
 112     echo " aopts['" . attr($key) . "'] = [];\n";
 113     $local ='1';
 114     echo " aitypes['" . attr($key). "'] = '0';\n";
 115     if ($key =="PMH") { // "0" = medical_problem_issue_list leave out Dental "4"
 116       $qry = sqlStatement("SELECT title, title as option_id, diagnosis as codes, count(title) AS freq  FROM `lists` WHERE `type` LIKE ? and
 117         subtype = '' and pid in (select pid from form_encounter where provider_id =?
 118         and date BETWEEN NOW() - INTERVAL 30 DAY AND NOW()) GROUP BY title order by freq desc limit 10", array("medical_problem",$_SESSION['providerID']));
 119
 120       if (sqlNumRows($qry) < '4') { //if they are just starting out, use the list_options for all
 121         $qry = sqlStatement("SELECT * FROM list_options WHERE list_id = ? and subtype not like 'eye'",array("medical_problem_issue_list"));
 122       }
 123     } elseif ($key =="Medication") {
 124       $qry = sqlStatement("SELECT title, title as option_id, diagnosis as codes, count(title) AS freq  FROM `lists` WHERE `type` LIKE ? and
 125         subtype = '' and pid in (select pid from form_encounter where provider_id =?
 126         and date BETWEEN NOW() - INTERVAL 30 DAY AND NOW()) GROUP BY title order by freq desc limit 10", array("medication",$_SESSION['providerID']));
 127       if (sqlNumRows($qry) < '4') { //if they are just starting out, use the list_options for all
 128         $qry = sqlStatement("SELECT * FROM list_options WHERE list_id = ? and subtype not like 'eye'",array("medication_issue_list"));
 129       }
 130     } elseif ($key =="Surgery") {
 131       $qry = sqlStatement("SELECT title, title as option_id, diagnosis as codes, count(title) AS freq  FROM `lists` WHERE `type` LIKE ? and
 132         subtype = '' and pid in (select pid from form_encounter where provider_id =?
 133         and date BETWEEN NOW() - INTERVAL 30 DAY AND NOW()) GROUP BY title order by freq desc limit 10", array("surgery",$_SESSION['providerID']));
 134       if (sqlNumRows($qry) < '4') { //if they are just starting out, use the list_options for all
 135         $qry = sqlStatement("SELECT * FROM list_options WHERE list_id = ? and subtype not like 'eye'",array("surgery_issue_list"));
 136       }
 137     } elseif ($key =="Allergy") {
 138       $qry = sqlStatement("SELECT title, title as option_id, diagnosis as codes, count(title) AS freq  FROM `lists` WHERE `type` LIKE ? and
 139         subtype = '' and pid in (select pid from form_encounter where provider_id =?
 140         and date BETWEEN NOW() - INTERVAL 30 DAY AND NOW()) GROUP BY title order by freq desc limit 10", array("allergy",$_SESSION['providerID']));
 141       if (sqlNumRows($qry) < '4') { //if they are just starting out, use the list_options for all
 142         $qry = sqlStatement("SELECT * FROM list_options WHERE list_id = ? and subtype not like 'eye'",array("allergy_issue_list"));
 143       }
 144     } elseif ($key == "POH") { // POH medical group
 145       $query = "SELECT title, title as option_id, diagnosis as codes, count(title) AS freq  FROM `lists` WHERE `type` LIKE 'medical_problem' and subtype = 'eye' and pid in (select pid from form_encounter where provider_id =? and date BETWEEN NOW() - INTERVAL 30 DAY AND NOW()) GROUP BY title order by freq desc limit 10";
 146       $qry = sqlStatement($query,array($_SESSION['providerID']));
 147       if (sqlNumRows($qry) < '4') { //if they are just starting out, use the list_options for all
 148         $qry = sqlStatement("SELECT * FROM list_options WHERE list_id = 'medical_problem_issue_list' and subtype = 'eye'");
 149       }
 150     } elseif ($key == "POS") { // POS surgery group
 151       $query = "SELECT title, title as option_id, diagnosis as codes, count(title) AS freq  FROM `lists` WHERE `type` LIKE 'surgery' and subtype = 'eye' and pid in (select pid from form_encounter where provider_id =? and date BETWEEN NOW() - INTERVAL 30 DAY AND NOW()) GROUP BY title order by freq desc limit 10";
 152       $qry = sqlStatement($query,array($_SESSION['providerID']));
 153       if (sqlNumRows($qry) < '4') { //if they are just starting out, use the list_options for all
 154         $qry = sqlStatement("SELECT * FROM list_options WHERE list_id = 'surgery_issue_list' and subtype = 'eye'");
 155       }
 156     } elseif ($key == "FH") {
 157       $local = "";
 158       $qry = "";
 159     } elseif ($key == "SOCH") {
 160       $local = "";
 161       $qry = "";
 162     } elseif ($key == "ROS") {
 163       $local = "";
 164       $qry = "";
 165     }
 166     if ($local =="1") { // leave FH/SocHx/ROS for later - done below separately
 167       while($res = sqlFetchArray($qry)){ //Should we take the top 10 and display alphabetically?
 168         echo " aopts['" .attr($key). "'][aopts['" .attr($key). "'].length] = new Option('".attr(trim($res['option_id']))."', '".attr(xl_list_label(trim($res['title'])))."', false, false);\n";
 169         if ($res['codes']) {
 170           echo " aopts['" .attr($key). "'][aopts['" .attr($key). "'].length-1].setAttribute('data-code','".attr(trim($res['codes']))."');\n";
 171         }
 172       }
 173     }
 174     ++$i;
 175   }
 176
 177 ?>
 178
 179 <?php require($GLOBALS['srcdir'] . "/restoreSession.php"); ?>
 180
 181 function newtype(index) {
 182   var f = document.forms[0];
 183   var theopts = f.form_titles.options;
 184   theopts.length = 0;
 185   if (aopts[index]) {
 186     var i = 0;
 187     for (i = 0; i < aopts[index].length; ++i) {
 188       theopts[i] = aopts[index][i];
 189     }
 190   }
 191
 192    f.form_type.value = index;
 193    f.form_occur.options[0].selected = true;
 194
 195   document.getElementById('row_quick_picks'     ).style.display = i ? '' : 'none'; //select list of things
 196   document.getElementById('row_title'           ).style.display = '';
 197   document.getElementById('row_diagnosis'       ).style.display = 'none';
 198   document.getElementById('row_begindate'       ).style.display = 'none';
 199   document.getElementById('row_enddate'         ).style.display = 'none';
 200   document.getElementById('row_reaction'        ).style.display = 'none';
 201   document.getElementById('row_referredby'      ).style.display = 'none';
 202   document.getElementById('row_classification'  ).style.display = 'none';
 203   document.getElementById('row_occurrence'      ).style.display = 'none';
 204   document.getElementById('row_comments'        ).style.display = 'none';
 205   document.getElementById('row_outcome'         ).style.display = 'none';
 206   document.getElementById('row_destination'     ).style.display = 'none';
 207   document.getElementById('row_social'          ).style.display = 'none';
 208   document.getElementById('row_FH'              ).style.display = 'none';
 209   document.getElementById('row_ROS'             ).style.display = 'none';
 210   document.getElementById('row_PLACEHOLDER'     ).style.display = 'none';
 211   document.getElementById('cancel_button'       ).style.display = 'none';
 212   document.getElementById('row_eye_med'         ).style.display = 'none';
 213
 214
 215   if (index == 'PMH') {
 216     document.getElementById('title_diagnosis'   ).textContent ="<?php echo xlt('PMH Dx').":"; ?>";
 217     document.getElementById('row_diagnosis'     ).style.display = '';
 218     document.getElementById('row_begindate'     ).style.display = '';
 219     document.getElementById('row_enddate'       ).style.display = '';
 220     document.getElementById('row_occurrence'    ).style.display = '';
 221     f.form_occur.options[2].selected = true;
 222     document.getElementById('row_comments'      ).style.display = '';
 223
 224   } else if (index == 'Allergy') {
 225     document.getElementById('title_diagnosis'   ).textContent ="<?php echo xlt('Allergic to').":"; ?>";
 226     document.getElementById('row_reaction'      ).style.display = '';
 227     document.getElementById('row_begindate'     ).style.display = '';
 228     document.getElementById('row_comments'      ).style.display = '';
 229
 230   } else if (index == 'Medication') {
 231     document.getElementById('title_diagnosis'   ).textContent ="<?php echo xlt('Medication').":"; ?>";
 232     document.getElementById('row_begindate'     ).style.display = '';
 233     document.getElementById('row_enddate'       ).style.display = '';
 234     document.getElementById('row_comments'      ).style.display = '';
 235     document.getElementById('row_eye_med'       ).style.display = '';
 236
 237     //change Onset to started
 238     //change resolved to Completed
 239     document.getElementById('onset'             ).textContent = "<?php echo xlt('Start').':'; ?>";
 240     document.getElementById('resolved'          ).textContent = "<?php echo xlt('Finish').':'; ?>";
 241
 242   } else if ((index == 'Surgery')||(index =='POS')) {
 243     document.getElementById('title_diagnosis'   ).textContent ="<?php echo xlt('Procedure').':'; ?>";
 244     document.getElementById('row_diagnosis'     ).style.display = '';
 245
 246     document.getElementById('row_begindate'     ).style.display = '';
 247     document.getElementById('row_referredby'    ).style.display = '';
 248     document.getElementById('form_referredby'   ).title="<?php echo xla('Name of the Surgeon'); ?>";
 249     document.getElementById('by_whom'           ).textContent = "<?php echo xlt('Surgeon').':'; ?>";
 250     document.getElementById('onset'             ).textContent = "<?php echo xlt('Date').':'; ?>";
 251     document.getElementById('row_outcome'       ).style.display = '';
 252     document.getElementById('row_comments'      ).style.display = '';
 253
 254   } else if (index == 4) { //Dental so skip it
 255   } else if (index == 'POH') {
 256     document.getElementById('title_diagnosis'   ).textContent ="<?php echo xlt('Eye Dx{{eye diagnosis}}').":"; ?>";
 257     document.getElementById('row_diagnosis'     ).style.display = '';
 258     document.getElementById('row_begindate'     ).style.display = '';
 259     document.getElementById('row_referredby'    ).style.display = '';
 260     document.getElementById('by_whom'           ).textContent ="<?php echo xlt('Collaborator').":"; ?>";
 261     document.getElementById('form_referredby'   ).title="<?php echo xla('Co-managing/referring provider'); ?>";
 262     document.getElementById('onset'             ).textContent = "<?php echo xlt('Date').":"; ?>";
 263     document.getElementById('row_comments'      ).style.display = '';
 264
 265   } else if (index == 'FH') {
 266     document.getElementById('row_title'         ).style.display = 'none';
 267     document.getElementById('row_FH'            ).style.display = '';
 268
 269   } else if (index == 'SOCH') {
 270     document.getElementById('row_title'         ).style.display = 'none';
 271     document.getElementById('row_social'        ).style.display = '';
 272     document.getElementById('cancel_button'       ).style.display = '';
 273
 274   } else if (index == 'ROS') {
 275     document.getElementById('row_title'         ).style.display = 'none';
 276     document.getElementById('row_ROS'           ).style.display = '';
 277
 278   } else {
 279     document.getElementById('title_diagnosis'   ).textContent ="<?php echo xlt('Eye Dx{{eye diagnosis}}').":"; ?>";
 280     document.getElementById('row_diagnosis'     ).style.display = '';
 281     document.getElementById('row_begindate'     ).style.display = '';
 282     document.getElementById('row_referredby'    ).style.display = '';
 283     document.getElementById('form_referredby'   ).title="<?php echo xla('Referring provider'); ?>";
 284     document.getElementById('by_whom'           ).textContent ="<?php echo xlt('Collaborator').":"; ?>";
 285     document.getElementById('onset'             ).textContent = "<?php echo xlt('Date').":"; ?>";
 286     document.getElementById('row_comments'      ).style.display = '';
 287     document.getElementById('row_PLACEHOLDER'   ).style.display = '';
 288   }
 289   return false;
 290 }
 291  // If a clickoption title is selected, copy it to the title field.
 292  // We also want to copy any other fields present in obj.PMSFH_options
 293  // We need to build this object first.  The base install options will need ICD-10 codes attached
 294  // to make this work.
 295  // f.form_title.diagnosis = f.form_titles.options[f.form_titles.selectedIndex].text;
 296 function set_text() {
 297   var f = document.forms[0];
 298   f.form_title.value = f.form_titles.options[f.form_titles.selectedIndex].text;
 299   f.form_diagnosis.value = f.form_titles.options[f.form_titles.selectedIndex].getAttribute('data-code');
 300   f.form_titles.selectedIndex = -1;
 301 }
 302
 303 function refreshIssue() {  parent.refresh_page(); }
 304 function submit_this_form() {
 305     var url = "../../forms/eye_mag/save.php?PMSFH_save=1&mode=update&form_save=1";
 306     var formData = $("form#theform").serialize();
 307     var f = document.forms[0];
 308     top.restoreSession();
 309     $.ajax({
 310            type   : 'POST',   // define the type of HTTP verb we want to use (POST for our form)
 311            url    : url,      // the url where we want to POST
 312            data   : formData  // our data object
 313         }).done(function(result){
 314           f.form_title.value = '';
 315           f.form_diagnosis.value = '';
 316           f.form_begin.value ='';
 317           f.form_end.value ='';
 318           f.form_referredby.value ='';
 319           f.form_reaction.value ='';
 320           f.form_classification.value ='';
 321           f.form_comments.value ='';
 322           f.form_outcome.value ='';
 323           f.form_destination.value ='';
 324           f.issue.value ='';
 325           parent.populate_form(result);
 326         });
 327 }
 328 // Process click on Delete link.
 329 function deleteme() {
 330   var url = "../../forms/eye_mag/save.php?PMSFH_save=1&mode=update&form_save=1";
 331   var f = document.forms[0];
 332   top.restoreSession();
 333   $.ajax({
 334            type    : 'POST',
 335            data    : {
 336                         pid    : <?php echo attr($pid); ?>,
 337                         issue  : f.issue.value,
 338                         deletion : '1',
 339                         PMSFH  : '1'
 340                       },
 341             url    : url
 342            }).done(function (result){
 343             // CLEAR THE FORM TOO...
 344             f.form_title.value = '';
 345             f.form_diagnosis.value = '';
 346             f.form_begin.value ='';
 347             f.form_end.value ='';
 348             f.form_referredby.value ='';
 349             f.form_reaction.value ='';
 350             f.form_classification.value ='';
 351             f.form_comments.value ='';
 352             f.form_occur.options[0].selected = true;
 353             f.form_outcome.value ='';
 354             f.form_destination.value ='';
 355             f.issue.value ='';
 356             parent.populate_form(result);
 357            });}
 358
 359 function imdeleted() { closeme(); }
 360 function clearme() {
 361   negate_radio('radio_tobacco');
 362   var f = document.forms[0];
 363
 364  // f.radio_tobacco.value = '';
 365   f.form_diagnosis.value = '';
 366   f.form_begin.value ='';
 367   f.form_end.value ='';
 368   f.form_referredby.value ='';
 369   f.form_reaction.value ='';
 370   f.form_classification.value ='';
 371   f.form_comments.value ='';
 372   f.form_outcome.value ='';
 373   f.form_destination.value ='';
 374   f.issue.value ='';
 375 }
 376  // Called when the Active checkbox is clicked.  For consistency we
 377  // use the existence of an end date to indicate inactivity, even
 378  // though the simple verion of the form does not show an end date.
 379 function resolvedClicked(cb) {
 380   var f = document.forms[0];
 381   if (!cb.checked) {
 382    f.form_end.value = '';
 383    f.delete_button.classList.remove("nodisplay");
 384   } else {
 385    var today = new Date();
 386    f.form_end.value = '' + (today.getYear() + 1900) + '-' +
 387     (today.getMonth() + 1) + '-' + today.getDate();
 388     f.delete_button.classList.add("nodisplay");
 389   }}
 390
 391 // Called when resolved outcome is chosen and the end date is entered.
 392 function outcomeClicked(cb) {
 393   var f = document.forms[0];
 394   if (cb.value == '1'){
 395    var today = new Date();
 396    f.form_end.value = '' + (today.getYear() + 1900) + '-' +
 397     ("0" + (today.getMonth() + 1)).slice(-2) + '-' + ("0" + today.getDate()).slice(-2);
 398    f.form_end.focus();
 399   }}
 400 // This is for callback by the find-code popup.
 401 // Appends to or erases the current list of diagnoses.
 402 function set_related(codetype, code, selector, codedesc) {
 403  var f = document.forms[0];
 404  var s = f.form_diagnosis.value;
 405  var title = f.form_title.value;
 406  if (code) {
 407   if (s.length > 0) s += ';';
 408   s += codetype + ':' + code;
 409  } else {
 410   s = '';
 411  }
 412  f.form_diagnosis.value = s;
 413  if(title == '') f.form_title.value = codedesc;
 414 }
 415
 416 // This invokes the find-code popup.
 417 function sel_diagnosis() {
 418   var f = document.forms[0];
 419   term = f.form_title.value;
 420   <?php
 421   if(($irow['type'] == 'PMH') ||($irow['type'] == 'POH'))
 422   {
 423     ?>
 424   dlgopen('../../patient_file/encounter/find_code_popup.php?codetype=<?php echo attr(collect_codetypes("medical_problem","csv")) ?>&search_term='+term, '_blank', 500, 400);
 425     <?php
 426   }
 427   else{
 428     ?>
 429   dlgopen('../../patient_file/encounter/find_code_popup.php?codetype=<?php echo attr(collect_codetypes("diagnosis","csv")) ?>&search_term='+term, '_blank', 500, 400);
 430     <?php
 431   }
 432   ?>
 433   f.form_save.focus();
 434 }
 435
 436 // Check for errors when the form is submitted.
 437 function validate() {
 438   var f = document.forms[0];
 439   if(f.form_begin.value > f.form_end.value && (f.form_end.value)) {
 440     alert("<?php echo addslashes(xl('Please Enter End Date greater than Begin Date!')); ?>");
 441     return false;
 442   }
 443   if (f.form_type.value != 'ROS' && f.form_type.value != 'FH' && f.form_type.value !='SOCH') {
 444     if (! f.form_title.value) {
 445       alert("<?php echo addslashes(xl('Please enter a title!')); ?>");
 446       return false;
 447     }
 448   }
 449  return true;
 450 }
 451
 452 // Supports customizable forms (currently just for IPPF).
 453 function divclick(cb, divid) {
 454  var divstyle = document.getElementById(divid).style;
 455  if (cb.checked) {
 456   divstyle.display = 'block';
 457  } else {
 458   divstyle.display = 'none';
 459  }
 460  return true;}
 461 //function for selecting the smoking status in drop down list based on the selection in radio button.
 462 function smoking_statusClicked(cb) {
 463   if (cb.value == 'currenttobacco')
 464   {
 465   document.getElementById('form_tobacco').selectedIndex = 1;
 466   }
 467   else if (cb.value == 'nevertobacco')
 468   {
 469   document.getElementById('form_tobacco').selectedIndex = 4;
 470   }
 471   else if (cb.value == 'quittobacco')
 472   {
 473   document.getElementById('form_tobacco').selectedIndex = 3;
 474   }
 475   else if (cb.value == 'not_applicabletobacco')
 476   {
 477   document.getElementById('form_tobacco').selectedIndex = 6;
 478   }
 479   radioChange(document.getElementById('form_tobacco').value);   }
 480 //function for selecting the smoking status in radio button based on the selection of drop down list.
 481 function radioChange(rbutton){
 482     if (rbutton == 1 || rbutton == 2 || rbutton == 15 || rbutton == 16)
 483      {
 484      document.getElementById('radio_tobacco[current]').checked = true;
 485      }
 486      else if (rbutton == 3)
 487      {
 488      document.getElementById('radio_tobacco[quit]').checked = true;
 489      }
 490      else if (rbutton == 4)
 491      {
 492      document.getElementById('radio_tobacco[never]').checked = true;
 493      }
 494      else if (rbutton == 5 || rbutton == 9)
 495      {
 496      document.getElementById('radio_tobacco[not_applicable]').checked = true;
 497      }
 498      else if (rbutton == '')
 499      {
 500      var radList = document.getElementsByName('radio_tobacco');
 501      for (var i = 0; i < radList.length; i++) {
 502      if(radList[i].checked) radList[i].checked = false;
 503      }
 504      }
 505      //Added on 5-jun-2k14 (regarding 'Smoking Status - display SNOMED code description')
 506      if(rbutton!=""){
 507          if(code_options_js[rbutton]!="")
 508             $("#smoke_code").html(" ( "+code_options_js[rbutton]+" )");
 509          else
 510              $("#smoke_code").html("");
 511      }
 512      else
 513         $("#smoke_code").html("");
 514   }
 515
 516 function setSelectBoxByText(eid, etxt) {
 517     var eid = document.getElementById(eid);
 518     for (var i = 0; i < eid.options.length; ++i) {
 519         if (eid.options[i].text === etxt)
 520             eid.options[i].selected = true;
 521     }
 522 }
 523 function clear_option(section) {
 524   //click the field, erase the Negative radio and input Y
 525   var f = document.forms[0];
 526   var name = 'radio_'+section.name;
 527   var radio = document.getElementById(name);
 528     radio.checked = false;
 529   if (section.value==''){
 530     section.value="Y";
 531     section.select();
 532   }}
 533 function negate_radio(section) {
 534   if (section.checked ==true){
 535     var rfield = section.name.match(/radio_(.*)/);
 536     document.getElementById(rfield[1]).value='';
 537   } }
 538   //Added on 5-jun-2k14 (regarding 'Smoking Status - display SNOMED code description')
 539  var code_options_js = Array();
 540
 541  <?php
 542  $smoke_codes = getSmokeCodes();
 543
 544  foreach ($smoke_codes as $val => $code) {
 545             echo "code_options_js"."['" . attr($val) . "']='" . attr($code) . "';\n";
 546       }
 547  ?>
 548
 549 </script>
 550 <!-- Add Font stuff for the look and feel.  -->
 551
 552     <link rel="stylesheet" href="../../forms/<?php echo $form_folder; ?>/css/style.css" type="text/css">
 553     <link rel="stylesheet" href="<?php echo $GLOBALS['css_header']; ?>" type="text/css">
 554     <link rel="stylesheet" href="<?php echo $css_header;?>" type="text/css">
 555
 556     <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative'] ?>/jquery-ui-1-11-4/themes/excite-bike/jquery-ui.css">
 557     <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative'] ?>/pure-0-5-0/pure-min.css">
 558     <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative'] ?>/bootstrap-3-3-4/dist/css/bootstrap.min.css">
 559     <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative'] ?>/qtip2-2-2-1/jquery.qtip.min.css" />
 560     <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative'] ?>/font-awesome-4-6-3/css/font-awesome.min.css">
 561     <style>
 562   td, select, textarea, input  {
 563  font-family: Fontawesome, Arial, Helvetica, sans-serif;
 564  font-size: 8pt;
 565  }
 566
 567  input[type="text"],textarea{
 568     text-align:left;
 569     background-color: cornsilk !important;
 570     text-align: left;
 571     display: inline-block;
 572     border: 1px solid #CCC !important;
 573     box-shadow: 0px 1px 3px #DDD inset !important;
 574     border-radius: 4px;
 575     margin:3px 3px 3px 5px;
 576     box-sizing: border-box;
 577     width:100%;
 578    }
 579
 580   div.section {
 581    border: solid;
 582    border-width: 1px;
 583    border-color: #0000ff;
 584    margin: 0 0 0 10pt;
 585    padding: 5pt;
 586   }
 587   .ROS_class input[type="text"] {
 588     width:100px;
 589   }
 590   .label {
 591     color:black;
 592   }
 593   .issues {
 594     font-size:0.8em;
 595   }
 596  select {
 597     text-align:left;
 598     background-color: cornsilk !important;
 599     text-align: left;
 600     border: 1px solid #CCC !important;
 601     box-shadow: 0px 1px 3px #DDD inset !important;
 602     border-radius: 4px;
 603     margin:1px 3px 1px 5px;
 604     box-sizing: border-box;
 605  }
 606
 607 </style>
 608
 609     <link rel="shortcut icon" href="<?php echo $GLOBALS['webroot']; ?>/sites/default/favicon.ico" />
 610 <script src="<?php echo $GLOBALS['assets_static_relative'] ?>/jquery-min-1-11-1/index.js"></script>
 611 <script src="<?php echo $GLOBALS['assets_static_relative'] ?>/bootstrap-3-3-4/dist/js/bootstrap.min.js"></script>
 612 <script src="<?php echo $GLOBALS['assets_static_relative'] ?>/jquery-ui-1-11-4/jquery-ui.min.js"></script>
 613 <script type="text/javascript" src="<?php echo $GLOBALS['webroot']; ?>/interface/forms/<?php echo $form_folder; ?>/js/eye_base.php?enc=<?php echo attr($encounter); ?>&providerID=<?php echo attr($providerID); ?>"></script>
 614
 615
 616
 617 </head>
 618 <body>
 619   <div id="page" style="text-align: justify; text-justify: newspaper;">
 620     <form method='POST' name='theform' id='theform'
 621     action='a_issue.php?pid=<?php echo attr($pid); ?>&encounter=<?php echo attr($encounter); ?>'
 622      onsubmit='return validate();'
 623      >
 624      <input type="hidden" name="form_id" id="form_id" value = "<?php echo attr($form_id); ?>">
 625      <input type="hidden" name="issue" id="issue" value = "<?php echo attr($issue); ?>">
 626      <input type="hidden" name="uniqueID" id="uniqueID" value = "<?php echo attr($uniqueID); ?>">
 627      <div class="issues">
 628         <?php
 629         $output ='';
 630         global $counter_header;
 631         $count_header='0';
 632         $output= array();
 633         foreach ($PMSFH[0] as $key => $value) {
 634           $checked = '';
 635           if ($key == "POH") {  $checked = " checked='checked' "; }
 636           $key_short_title = $key;
 637           if ($key == "Medication") {$key_short_title = "Meds"; $title = "Medications"; }
 638           if ($key == "Problem") {$key_short_title = "PMH"; $title = "Past Medical History"; }
 639           if ($key == "Surgery") {$key_short_title = "Surg"; $title = "Surgery History"; }
 640           if ($key == "SOCH") {$key_short_title = "Soc"; $title = "Social History"; }
 641           $HELLO[attr($key)] = '<input type="radio" name="form_type" id="PMSFH_'.attr($key).'" value="'.attr($key).'" '.$checked.' onclick="top.restoreSession();newtype(\''.attr($key).'\');" /><span>'.
 642                           '<label class="input-helper input-helper--checkbox" for="PMSFH_'.attr($key).'" title="'.xla($title).'">' . xlt($key_short_title) . '</label></span>&nbsp;';
 643         }
 644         //put them in the desired display order
 645         echo $HELLO['POH'].$HELLO['POS'].$HELLO['PMH'].$HELLO['Medication'].$HELLO['Surgery'].$HELLO['Allergy'].$HELLO['FH'].$HELLO['SOCH'].$HELLO['ROS'];
 646         ?>
 647       </div>
 648     <div class="borderShadow" style="text-align:left;margin-top:7px;width:95%;">
 649       <table  border='0' width='95%'>
 650         <tr id='row_quick_picks'>
 651           <td valign='top' nowrap>&nbsp;</td>
 652           <td valign='top'  colspan="2">
 653             <select name='form_titles' size='5' onchange='top.restoreSession();set_text();'>
 654             </select>
 655           </td>
 656           <td>
 657         </tr>
 658         <tr id="row_title">
 659           <td valign='top' class="right" id='title_diagnosis' nowrap style="font-weight:bold;vertical-align:middle;"><?php echo xlt('Title'); ?>:</td>
 660           <td  colspan="3">
 661             <input type='text' size='40' name='form_title' id='form_title' value='<?php echo attr($irow['title']) ?>' />
 662           </td>
 663         </tr>
 664         <tr id="row_diagnosis">
 665           <td valign='top' class="right" nowrap style="font-weight:bold;vertical-align:middle;"><b><?php echo xlt('Code'); ?>:</b></td>
 666           <td colspan="3">
 667             <input type='text' size='50' name='form_diagnosis' id='form_diagnosis'
 668               value='<?php echo attr($irow['diagnosis']) ?>' onclick='top.restoreSession();sel_diagnosis();'
 669               title='<?php echo xla('Click to select or change diagnoses'); ?>' />
 670           </td>
 671         </tr>
 672         <tr id='row_begindate'>
 673           <td nowrap class="right"><b id="onset"><?php echo xlt('Onset'); ?>:</b></td>
 674           <td>
 675            <input type='text' size='10' name='form_begin' id='form_begin'
 676             value='<?php echo attr($irow['begdate']) ?>'¸
 677             style="width: 80px;"
 678             onkeyup='datekeyup(this,mypcc)' onblur='dateblur(this,mypcc)'
 679             title='<?php echo xla('yyyy-mm-dd date of onset, surgery or start of medication'); ?>' />
 680            <img src='<?php echo $GLOBALS['webroot']; ?>/interface/pic/show_calendar.gif' align='absbottom' width='15' height='15'
 681             id='img_begin' border='0' alt='[?]' style='cursor:pointer'
 682             title='<?php echo xla('Click here to choose a date'); ?>' />
 683           </td>
 684           <td id='row_enddate' nowrap><input type='checkbox' name='form_active' id='form_active' value='1' <?php echo attr($irow['enddate']) ? "checked" : ""; ?>
 685             onclick='top.restoreSession();resolvedClicked(this);'
 686             title='<?php echo xla('Indicates if this issue is currently active'); ?>' />
 687             <b id="resolved"><?php echo xlt('Resolved'); ?>:</b>&nbsp;<input type='text' size='10' name='form_end' id='form_end'
 688             style="width: 80px;"
 689             value='<?php echo attr($irow['enddate']) ?>'
 690             onkeyup='datekeyup(this,mypcc)' onblur='dateblur(this,mypcc)'
 691             title='<?php echo xla('yyyy-mm-dd date of recovery or end of medication'); ?>' />
 692            <img src='<?php echo $GLOBALS['webroot']; ?>/interface/pic/show_calendar.gif' align='absbottom' width='15' height='15'
 693             id='img_end' border='0' alt='[?]' style='cursor:pointer'
 694             title='<?php echo xla('Click here to choose a date'); ?>' />
 695           </td>
 696          </tr>
 697
 698          <tr id='row_occurrence'>
 699           <td valign='top'  class="right" nowrap><b><?php echo xlt('Course'); ?>:</b></td>
 700           <td colspan="3">
 701            <?php
 702             // Modified 6/2009 by BM to incorporate the occurrence items into the list_options listings
 703             generate_form_field(array('data_type'=>1,'field_id'=>'occur','list_id'=>'occurrence','empty_title'=>'SKIP'), $irow['occurrence']);
 704            ?><a href="<?php echo $GLOBALS['webroot']; ?>/interface/super/edit_list.php?list_id=occurrence" target="RTop"
 705               title="<?php echo xla('Click here to Edit the Course/Occurrence List'); ?>" style="color:black;"><i class="fa fa-pencil fa-fw"></i></a>
 706           </td>
 707          </tr>
 708
 709          <tr id='row_classification'>
 710           <td valign='top'  class="right" nowrap><b><?php echo xlt('Classification'); ?>:</b></td>
 711           <td colspan="3">
 712            <select name='form_classification' id='form_classification'>
 713               <?php
 714              foreach ($ISSUE_CLASSIFICATIONS as $key => $value) {
 715               echo "   <option value='".attr($key)."'";
 716               if ($key == $irow['classification']) echo " selected";
 717               echo ">".text($value)."\n";
 718              }
 719               ?>
 720            </select>
 721           </td>
 722         </tr>
 723         <tr id='row_reaction'>
 724            <td valign='top'  class="right" nowrap><b><?php echo xlt('Reaction'); ?>:</b></td>
 725            <td  colspan="3">
 726             <input type='text' size='40' name='form_reaction' id='form_reaction' value='<?php echo attr($irow['reaction']) ?>'
 727              title='<?php echo xla('Allergy Reaction'); ?>' />
 728            </td>
 729         </tr>
 730         <tr id='row_referredby'>
 731           <td class="right" nowrap><b id="by_whom"><?php echo xlt('Referred by'); ?>:</b></td>
 732           <td  colspan="3">
 733             <input type='text' size='40' name='form_referredby' id='form_referredby' value='<?php echo attr($irow['referredby']) ?>'
 734             title='<?php echo xla('Referring physician and practice'); ?>' />
 735           </td>
 736         </tr>
 737         <tr id='row_eye_med'>
 738           <td class="right" nowrap><b id="by_whom"><?php echo xlt('Eye Med'); ?>:</b></td>
 739           <td  colspan="3"><?php echo $irow['subtype']; ?>
 740             <input type='checkbox' name='form_eye_subtype' id='form_eye_subtype' value='1'
 741             <?php if ($irow['subtype'] =='eye') echo "checked"; ?> style="margin:3px 3px 3px 5px;"
 742             title='<?php echo xla('Indicates if this issue is an ophthalmic-specific medication'); ?>' />
 743           </td>
 744         </tr>
 745
 746         <tr id='row_comments'>
 747           <td valign='top' class="right" nowrap><b><?php echo xlt('Comments'); ?>:</b></td>
 748           <td colspan="3">
 749            <textarea name='form_comments' id='form_comments' cols='40' wrap='virtual'><?php echo text($irow['comments']) ?></textarea>
 750           </td>
 751         </tr>
 752         <tr id="row_outcome">
 753           <td valign='top'  class="right" nowrap><b><?php echo xlt('Outcome'); ?>:</b></td>
 754           <td>
 755            <?php
 756             echo generate_select_list('form_outcome', 'outcome', $irow['outcome'], '', '', '', 'outcomeClicked(this);');
 757            ?>
 758           </td>
 759         </tr>
 760         <tr id="row_destination">
 761           <td valign='top'  class="right" nowrap><b><?php echo xlt('Destination'); ?>:</b></td>
 762           <td colspan="3">
 763           <?php if (true) { ?>
 764            <input type='text' size='40' name='form_destination' value='<?php echo attr($irow['destination']) ?>'
 765             title='GP, Secondary care specialist, etc.' />
 766           <?php } else { // leave this here for now, please -- Rod ?>
 767            <?php echo rbinput('form_destination', '1', 'GP'                 , 'destination') ?>&nbsp;
 768            <?php echo rbinput('form_destination', '2', 'Secondary care spec', 'destination') ?>&nbsp;
 769            <?php echo rbinput('form_destination', '3', 'GP via physio'      , 'destination') ?>&nbsp;
 770            <?php echo rbinput('form_destination', '4', 'GP via podiatry'    , 'destination') ?>
 771           <?php } ?>
 772           </td>
 773         </tr>
 774       </table>
 775       <table id="row_social" width="100%">
 776             <?php
 777               $given ="*";
 778               $dateStart=$_POST['dateState'];
 779               $dateEnd=$_POST['dateEnd'];
 780               if ($dateStart && $dateEnd) {
 781                     $result1 = sqlQuery("select $given from history_data where pid = ? and date >= ? and date <= ? order by date DESC limit 0,1", array($pid,$dateStart,$dateEnd) );
 782                 }
 783                 else if ($dateStart && !$dateEnd) {
 784                     $result1 = sqlQuery("select $given from history_data where pid = ? and date >= ? order by date DESC limit 0,1", array($pid,$dateStart) );
 785                 }
 786                 else if (!$dateStart && $dateEnd) {
 787                     $result1 = sqlQuery("select $given from history_data where pid = ? and date <= ? order by date DESC limit 0,1", array($pid,$dateEnd) );
 788                 }
 789                 else {
 790                     $result1 = sqlQuery("select $given from history_data where pid=? order by date DESC limit 0,1", array($pid) );
 791                 }
 792
 793                 $group_fields_query = sqlStatement("SELECT * FROM layout_options " .
 794                 "WHERE form_id = 'HIS' AND group_name = '4Lifestyle' AND uor > 0 " .
 795                 "ORDER BY seq");
 796               while ($group_fields = sqlFetchArray($group_fields_query)) {
 797                   $titlecols  = $group_fields['titlecols'];
 798                   $datacols   = $group_fields['datacols'];
 799                   $data_type  = $group_fields['data_type'];
 800                   $field_id   = $group_fields['field_id'];
 801                   $list_id    = $group_fields['list_id'];
 802                   $currvalue  = '';
 803               if (isset($result1[$field_id])) $currvalue = $result1[$field_id];
 804               if ($data_type == 28 || $data_type == 32) {
 805                   $tmp = explode('|', $currvalue);
 806                   switch(count($tmp)) {
 807                     case "4": {
 808                       $result2[$field_id]['resnote'] = $tmp[0];
 809                       $result2[$field_id]['restype'] = $tmp[1];
 810                       $result2[$field_id]['resdate'] = $tmp[2];
 811                       $result2[$field_id]['reslist'] = $tmp[3];
 812                     } break;
 813                     case "3": {
 814                       $result2[$field_id]['resnote'] = $tmp[0];
 815                       $result2[$field_id]['restype'] = $tmp[1];
 816                       $result2[$field_id]['resdate'] = $tmp[2];
 817                     } break;
 818                     case "2": {
 819                       $result2[$field_id]['resnote'] = $tmp[0];
 820                       $result2[$field_id]['restype'] = $tmp[1];
 821                       $result2[$field_id]['resdate'] = "";
 822                     } break;
 823                     case "1": {
 824                       $result2[$field_id]['resnote'] = $tmp[0];
 825                       $result2[$field_id]['resdate'] = $result2[$field_id]['restype'] = "";
 826                     } break;
 827                     default: {
 828                       $result2[$field_id]['restype'] = $result2[$field_id]['resdate'] = $result2[$field_id]['resnote'] = "";
 829                     } break;
 830                   }
 831                   $fldlength = empty($frow['fld_length']) ?  20 : $frow['fld_length'];
 832                   $fldlength = htmlspecialchars( $fldlength, ENT_QUOTES);
 833                   $result2[$field_id]['resnote'] = htmlspecialchars( $result2[$field_id]['resnote'], ENT_QUOTES);
 834                   $result2[$field_id]['resdate'] = htmlspecialchars( $result2[$field_id]['resdate'], ENT_QUOTES);
 835                 } else if ($data_type == 2) {
 836                    $result2[$field_id]['resnote'] = nl2br(htmlspecialchars($currvalue,ENT_NOQUOTES));
 837                 }
 838               }
 839             ?>
 840             <style>
 841               .data td{
 842                 font-size:0.7em;
 843               }
 844               .data input[type="text"] {
 845                width:90px;
 846               }
 847               #form_box {
 848                 width:90px;
 849               }
 850             </style>
 851
 852             <tbody>
 853                 <tr>
 854                   <td class="right" nowrap><?php echo xlt('Marital'); ?>:</td>
 855                   <td colspan="3"><input type="text" style="width:75px;" name="marital_status" id="marital_status" value="<?php echo attr($patient['status']); ?>">
 856                   &nbsp;<?php echo xlt('Occupation'); ?>:&nbsp;<input type="text" style="width:175px;" name="occupation" id="occupation" value="<?php echo attr($patient['occupation']); ?>"></td>
 857                 </tr>
 858                 <tr>
 859                   <td></td>
 860                   <td colspan="2">
 861                     <select name="form_tobacco" id="form_tobacco" onchange="radioChange(this.options[this.selectedIndex].value)" title="<?php xla('Tobacco use'); ?>">
 862                       <option value="" <?php if ($result2['tobacco']['reslist'] =='') echo "selected"; ?>><?php echo xlt('Unassigned'); ?></option>
 863                       <option value="1" <?php if ($result2['tobacco']['reslist'] =='1') echo "selected"; ?>><?php echo xlt('Current every day smoker'); ?></option>
 864                       <option value="2" <?php if ($result2['tobacco']['reslist'] =='2') echo "selected"; ?>><?php echo xlt('Current some day smoker<'); ?>/option>
 865                       <option value="3" <?php if ($result2['tobacco']['reslist'] =='3') echo "selected"; ?>><?php echo xlt('Former smoker'); ?></option>
 866                       <option value="4" <?php if ($result2['tobacco']['reslist'] =='4') echo "selected"; ?>><?php echo xlt('Never smoker'); ?></option>
 867                       <option value="5" <?php if ($result2['tobacco']['reslist'] =='5') echo "selected"; ?>><?php echo xlt('Smoker, current status unknown'); ?></option>
 868                       <option value="9" <?php if ($result2['tobacco']['reslist'] =='9') echo "selected"; ?>><?php echo xlt('Unknown if ever smoked'); ?></option>
 869                       <option value="15" <?php if ($result2['tobacco']['reslist'] =='15') echo "selected"; ?>><?php echo xlt('Heavy tobacco smoker'); ?></option>
 870                       <option value="16" <?php if ($result2['tobacco']['reslist'] =='16') echo "selected"; ?>><?php echo xlt('Light tobacco smoker'); ?></option>
 871                     </select>
 872                   </td>
 873                   <td nowrap><span style="text-decoration:underline;padding-right:3px;">Never</span></td>
 874                   <td>
 875                     <span style="text-decoration:underline;"><?php echo xlt('N/A{{not applicable}}'); ?></span></td>
 876                 </tr>
 877
 878                 <tr>
 879                   <td class="right"  nowrap><?php echo xlt('Tobacco'); ?>:</td>
 880                   <td class="text data" colspan="4">
 881                     <table cellpadding="0" cellspacing="0">
 882                       <tr>
 883                         <td><input type="text" name="form_text_tobacco" id="form_box" size="20" value="<?php echo attr($PMSFH[0]['SOCH']['tobacco']['resnote']); ?>">&nbsp;</td>
 884                         <td class="bold">&nbsp;&nbsp;</td>
 885                         <td class="text">
 886                           <input type="radio" name="radio_tobacco" id="radio_tobacco[current]" value="currenttobacco" onclick="smoking_statusClicked(this)" <?php if ($result2['tobacco']['restype'] =='currenttobacco') echo "checked"; ?>><?php echo xlt('Current'); ?>&nbsp;</td>
 887                         <td class="text"><input type="radio" name="radio_tobacco" id="radio_tobacco[quit]" value="quittobacco" onclick="smoking_statusClicked(this)" <?php if ($result2['tobacco']['restype'] =='quittobacco') echo "checked"; ?>><?php echo xlt('Quit'); ?>&nbsp;</td>
 888                         <td class="text" onclick='top.restoreSession();resolvedClicked(this);'>
 889                           <input type="text" size="6"
 890                           name="date_tobacco" id="date_tobacco"
 891                           value="<?php echo attr($result2['tobacco']['resdate']); ?>"
 892                           title="<?php echo xla('Tobacco use'); ?>"
 893                           onkeyup="datekeyup(this,mypcc)"
 894                           onblur="dateblur(this,mypcc)"><img src="<?php echo $GLOBALS['webroot']; ?>/interface/pic/show_calendar.gif" align="absbottom"
 895                           width="15" height="15"
 896                           id="img_tobacco"
 897                           border="0" alt="[?]" style="cursor:pointer"
 898                           title="<?php echo xla('Click here to choose a date'); ?>">&nbsp;
 899                         </td>
 900                         <td class="text">
 901                           <input type="radio" name="radio_tobacco" id="radio_tobacco[never]" value="nevertobacco" onclick="smoking_statusClicked(this)" <?php if ($result2['tobacco']['restype'] =='nevertobacco') echo "checked"; ?>><?php echo xlt('Never'); ?>&nbsp;
 902                         </td>
 903                         <td><input name="radio_tobacco" type="radio" id="radio_tobacco[not_applicable]" <?php if ($PMSFH[0]['SOCH']['tobacco']['restype'] =='not_applicable') echo "checked"; ?> value="not_applicabletobacco">
 904                         <label class="fa fa-history input-helper  nodisplay" for="radio_tobacco[not_applicable]"></label>
 905                         </td>
 906                       </tr>
 907                     </table>
 908                   </td>
 909                 </tr>
 910
 911                 <tr>
 912                   <td  class="right" nowrap><?php echo xlt('Coffee'); ?>:</td>
 913                   <td class="text data" colspan="4">
 914                     <table cellpadding="0" cellspacing="0">
 915                       <tbody>
 916                         <tr>
 917                           <td><input type="text" name="form_coffee" id="form_box" size="20" value="<?php echo attr($result2['coffee']['resnote']); ?>">&nbsp;</td>
 918                           <td class="bold">&nbsp;&nbsp;</td>
 919                           <td class="text"><input type="radio" name="radio_coffee" id="radio_coffee[current]" value="currentcoffee" <?php if ($PMSFH[0]['SOCH']['coffee']['restype'] =='currentcoffee') echo "checked"; ?>><?php echo xlt('Current'); ?>&nbsp;</td>
 920                           <td class="text"><input type="radio" name="radio_coffee" id="radio_coffee[quit]" value="quitcoffee" <?php if ($PMSFH[0]['SOCH']['coffee']['restype'] =='quitcoffee') echo "checked"; ?>><?php echo xlt('Quit'); ?>&nbsp;</td>
 921                           <td class="text"><input type="text" size="6" name="date_coffee" id="date_coffee" value="" title="<?php echo xla('Caffeine consumption'); ?>" onkeyup="datekeyup(this,mypcc)" onblur="dateblur(this,mypcc)"><img src="<?php echo $GLOBALS['webroot']; ?>/interface/pic/show_calendar.gif" align="absbottom" width="15" height="15" id="img_coffee" border="0" alt="[?]" style="cursor:pointer" title="<?php echo xla('Click here to choose a date'); ?>">&nbsp;</td>
 922                           <td class="text"><input type="radio" name="radio_coffee" id="radio_coffee[never]" value="nevercoffee" <?php if ($PMSFH[0]['SOCH']['coffee']['restype'] =='nevercoffee') echo "checked"; ?>><?php echo xlt('Never'); ?>&nbsp;</td>
 923                           <td><input name="radio_coffee" type="radio" id="radio_coffee[not_applicable]" <?php if ($PMSFH[0]['SOCH']['coffee']['restype'] =='not_applicable') echo "checked"; ?> value="not_applicablecoffee">
 924                             <label class="fa fa-history input-helper nodisplay" for="radio_coffee[not_applicable]"></label>
 925                             </td>
 926                         </tr>
 927                       </tbody>
 928                     </table>
 929                   </td>
 930                 </tr>
 931
 932                 <tr>
 933                   <td class="right"  nowrap><?php echo xlt('Alcohol'); ?>:</td>
 934                   <td class="text data" colspan="4">
 935                     <table cellpadding="0" cellspacing="0">
 936                       <tbody>
 937                         <tr><td><input type="text" name="form_alcohol" id="form_box" size="20" value="<?php echo attr($result2['alcohol']['resnote']); ?>">&nbsp;</td><td class="bold">&nbsp;&nbsp;</td><td class="text"><input type="radio" name="radio_alcohol" id="radio_alcohol[current]" value="currentalcohol" <?php if ($PMSFH[0]['SOCH']['alcohol']['restype'] =='currentalcohol') echo "checked"; ?>><?php echo xlt('Current'); ?>&nbsp;</td>
 938                           <td class="text"><input type="radio" name="radio_alcohol" id="radio_alcohol[quit]" value="quitalcohol" <?php if ($PMSFH[0]['SOCH']['alcohol']['restype'] =='quitalcohol') echo "checked"; ?>><?php echo xlt('Quit'); ?>&nbsp;</td>
 939                           <td class="text"><input type="text" size="6" name="date_alcohol" id="date_alcohol" value="" title="<?php echo xla('Alcohol consumption'); ?>" onkeyup="datekeyup(this,mypcc)" onblur="dateblur(this,mypcc)"><img src="<?php echo $GLOBALS['webroot']; ?>/interface/pic/show_calendar.gif" align="absbottom" width="15" height="15" id="img_alcohol" border="0" alt="[?]" style="cursor:pointer" title="<?php echo attr('Click here to choose a date'); ?>">&nbsp;</td>
 940                           <td class="text"><input type="radio" name="radio_alcohol" id="radio_alcohol[never]" value="neveralcohol" <?php if ($PMSFH[0]['SOCH']['alcohol']['restype'] =='neveralcohol') echo "checked"; ?>><?php echo xlt('Never'); ?>&nbsp;</td>
 941                           <td><input name="radio_alcohol" type="radio" id="radio_alcohol[not_applicable]" value="not_applicablealcohol" <?php if ($PMSFH[0]['SOCH']['alcohol']['restype'] =='not_applicable') echo "checked"; ?>>
 942                         <label class="fa fa-history input-helper nodisplay" for="radio_alcohol[not_applicable]"></label>
 943
 944                         </td>
 945                         </tr>
 946                       </tbody>
 947                     </table>
 948                   </td>
 949                 </tr>
 950
 951                 <tr>
 952                   <td class="right"  nowrap><?php echo xlt('Drugs'); ?>:</td>
 953                   <td class="text data" colspan="4">
 954                     <table cellpadding="0" cellspacing="0">
 955                       <tbody>
 956                         <tr>
 957                           <td><input type="text" name="form_recreational_drugs" id="form_box" size="20" value="<?php echo attr($result2['recreational_drugs']['resnote']); ?>">&nbsp;</td><td class="bold">&nbsp;&nbsp;</td>
 958                           <td class="text"><input type="radio" name="radio_recreational_drugs" id="radio_recreational_drugs[current]" value="currentrecreational_drugs" <?php if ($PMSFH[0]['SOCH']['recreational_drugs']['restype'] =='currentrecreational_drugs') echo "checked"; ?>><?php echo xlt('Current'); ?>&nbsp;</td>
 959                           <td class="text"><input type="radio" name="radio_recreational_drugs" id="radio_recreational_drugs[quit]" value="quitrecreational_drugs" <?php if ($PMSFH[0]['SOCH']['recreational_drugs']['restype'] =='quitrecreational_drugs') echo "checked"; ?>><?php echo xlt('Quit'); ?>&nbsp;</td>
 960                           <td class="text"><input type="text" size="6" name="date_recreational_drugs" id="date_recreational_drugs" value="" title="<?php echo xla('Recreational drug use'); ?>" onkeyup="datekeyup(this,mypcc)" onblur="dateblur(this,mypcc)"><img src="<?php echo $GLOBALS['webroot']; ?>/interface/pic/show_calendar.gif" align="absbottom" width="15" height="15" id="img_recreational_drugs" border="0" alt="[?]" style="cursor:pointer" title="<?php echo xla('Click here to choose a date'); ?>">&nbsp;</td>
 961                           <td class="text"><input type="radio" name="radio_recreational_drugs" id="radio_recreational_drugs[never]" value="neverrecreational_drugs" <?php if ($PMSFH[0]['SOCH']['recreational_drugs']['restype'] =='neverrecreational_drugs') echo "checked"; ?>><?php echo xlt('Never'); ?>&nbsp;</td>
 962                           <td><input name="radio_recreational_drugs" type="radio" id="radio_recreational_drugs[not_applicable]" <?php if ($PMSFH[0]['SOCH']['recreational_drugs']['restype'] =='not_applicable') echo "checked"; ?> value="not_applicablerecreational_drugs">
 963                         <label class="fa fa-history input-helper nodisplay" for="radio_recreational_drugs[not_applicable]"></label>
 964                       </td>
 965                         </tr>
 966                       </tbody>
 967                     </table>
 968                   </td>
 969                 </tr>
 970
 971                 <tr class="nodisplay" >
 972                   <td class="right"  nowrap><?php echo xlt('Counseling'); ?>:</td>
 973                   <td class="text data" colspan="4">
 974                     <table cellpadding="0" cellspacing="0"><tbody><tr><td><input type="text" name="form_counseling" id="form_box" size="20" value="<?php echo attr($result2['counseling']['resnote']); ?>">&nbsp;</td><td class="bold">&nbsp;&nbsp;</td><td class="text"><input type="radio" name="radio_counseling" id="radio_counseling[current]" value="currentcounseling" <?php if ($PMSFH[0]['SOCH']['counseling']['restype'] =='currentcounseling') echo "checked"; ?>><?php echo xlt('Current'); ?>&nbsp;</td>
 975                   <td class="text"><input type="radio" name="radio_counseling" id="radio_counseling[quit]" value="quitcounseling" <?php if ($PMSFH[0]['SOCH']['counseling']['restype'] =='quitcounseling') echo "checked"; ?>><?php echo xlt('Quit'); ?>&nbsp;</td>
 976                   <td class="text"><input type="text" size="6" name="date_counseling" id="date_counseling" value="" title="<?php echo xla('Counseling activities') ?>" onkeyup="datekeyup(this,mypcc)" onblur="dateblur(this,mypcc)"><img src="<?php echo $GLOBALS['webroot']; ?>/interface/pic/show_calendar.gif" align="absbottom" width="15" height="15" id="img_counseling" border="0" alt="[?]" style="cursor:pointer" title="<?php echo xla('Click here to choose a date'); ?>">&nbsp;</td>
 977                   <td class="text"><input type="radio" name="radio_counseling" id="radio_counseling[never]" value="nevercounseling" <?php if ($PMSFH[0]['SOCH']['counseling']['restype'] =='nevercounseling') echo "checked"; ?>><?php echo xlt('Never'); ?>&nbsp;</td>
 978                   <td><input name="radio_counseling" type="radio" id="radio_counseling[not_applicable]" value="not_applicablecounseling" <?php if ($PMSFH[0]['SOCH']['counseling']['restype'] =='not_applicable') echo "checked"; ?>>
 979                     <label class="fa fa-history input-helper nodisplay" for="radio_counseling[not_applicable]"></label>
 980                   </td>
 981                 </tr></tbody></table></td></tr>
 982
 983                 <tr>
 984                   <td class="right" nowrap>
 985                   <?php echo xlt('Exercise'); ?>:</td>
 986                   <td class="text data" colspan="4">
 987                     <table cellpadding="0" cellspacing="0">
 988                       <tbody><tr><td><input type="text" name="form_exercise_patterns" id="form_box" size="20" value="<?php echo attr($result2['exercise_patterns']['resnote']); ?>">&nbsp;</td><td class="bold">&nbsp;&nbsp;</td><td class="text"><input type="radio" name="radio_exercise_patterns" id="radio_exercise_patterns[current]" value="currentexercise_patterns" <?php if ($PMSFH[0]['SOCH']['exercise_patterns']['restype'] =='currentexercise_patterns') echo "checked"; ?>><?php echo xlt('Current'); ?>&nbsp;</td>
 989                       <td class="text"><input type="radio" name="radio_exercise_patterns" id="radio_exercise_patterns[quit]" value="quitexercise_patterns" <?php if ($PMSFH[0]['SOCH']['exercise_patterns']['restype'] =='quitexercise_patterns') echo "checked"; ?>><?php echo xlt('Quit') ?>&nbsp;</td>
 990                       <td class="text"><input type="text" name="date_exercise_patterns" id="date_exercise_patterns" value="" title="<?php echo xla('Exercise patterns') ?>" onkeyup="datekeyup(this,mypcc)" onblur="dateblur(this,mypcc)"><img src="<?php echo $GLOBALS['webroot']; ?>/interface/pic/show_calendar.gif" align="absbottom" width="15" height="15" id="img_exercise_patterns" border="0" alt="[?]" style="cursor:pointer" title="<?php echo xla('Click here to choose a date'); ?>">&nbsp;</td>
 991                       <td class="text"><input type="radio" name="radio_exercise_patterns" id="radio_exercise_patterns[never]" value="neverexercise_patterns"<?php if ($PMSFH[0]['SOCH']['exercise_patterns']['restype'] =='neverexercise_patterns') echo "checked"; ?>><?php echo xlt('Never') ?>&nbsp;</td>
 992                       <td><input name="radio_exercise_patterns" type="radio" id="radio_exercise_patterns[not_applicable]" <?php if ($PMSFH[0]['SOCH']['exercise_patterns']['restype'] =='not_applicable') echo "checked"; ?> value="not_applicableexercise_patterns"><label class="fa fa-history input-helper nodisplay" for="radio_exercise_patterns[not_applicable]"></label>
 993                       </td>
 994                         </tr>
 995                       </tbody>
 996                     </table>
 997                   </td>
 998                 </tr>
 999
1000                 <tr class="nodisplay">
1001                   <td class="right"  nowrap><?php echo xlt('Hazardous Activities'); ?>:</td>
1002                   <td class="text data" colspan="4">
1003                     <table cellpadding="0" cellspacing="0">
1004                       <tbody><tr><td><input type="text" name="form_hazardous_activities" id="form_box" size="20" value="<?php echo attr($result2['hazardous_activities']['resnote']); ?>">&nbsp;</td><td class="bold">&nbsp;&nbsp;</td><td class="text"><input type="radio" name="radio_hazardous_activities" id="radio_hazardous_activities[current]" value="currenthazardous_activities" <?php if ($PMSFH[0]['SOCH']['hazardous_activities']['restype'] =='currenthazardous_activities') echo "checked"; ?>><?php echo xlt('Current'); ?>&nbsp;</td>
1005                       <td class="text"><input type="radio" name="radio_hazardous_activities" id="radio_hazardous_activities[quit]" value="quithazardous_activities" <?php if ($PMSFH[0]['SOCH']['hazardous_activities']['restype'] =='quithazardous_activities') echo "checked"; ?>><?php echo xlt('Quit') ?>&nbsp;</td>
1006                       <td class="text"><input type="text" name="date_hazardous_activities" id="date_hazardous_activities" value="" title="<?php echo xla('Hazardous activities') ?>" onkeyup="datekeyup(this,mypcc)" onblur="dateblur(this,mypcc)"><img src="<?php echo $GLOBALS['webroot']; ?>/interface/pic/show_calendar.gif" align="absbottom" width="15" height="15" id="img_hazardous_activities" border="0" alt="[?]" style="cursor:pointer" title="<?php echo xla('Click here to choose a date'); ?>">&nbsp;</td>
1007                       <td class="text"><input type="radio" name="radio_hazardous_activities" id="radio_hazardous_activities[never]" value="neverhazardous_activities" <?php if ($PMSFH[0]['SOCH']['hazardous_activities']['restype'] =='neverhazardous_activities') echo "checked"; ?>><?php echo xlt('Never') ?>&nbsp;</td>
1008                       <td><input name="radio_hazardous_activities" type="radio" id="radio_hazardous_activities[not_applicable]" <?php if ($PMSFH[0]['SOCH']['hazardous_activities']['restype'] =='not_applicable') echo "checked"; ?> value="not_applicablehazardous_activities" onclick="hazardous_activities_statusClicked(this)"><label class="fa fa-history input-helper nodisplay" for="radio_hazardous_activities[not_applicable]"></label>
1009                       </td>
1010                       </tr>
1011                       </tbody>
1012                     </table>
1013                   </td>
1014                 </tr>
1015
1016                 <tr>
1017                   <td class="right"  nowrap><?php echo xlt('Sleep'); ?>:</td>
1018                   <td class="text data" colspan="4">
1019                     <table cellpadding="0" cellspacing="0">
1020                       <tbody>
1021                         <tr><td><input type="text" name="form_sleep_patterns" id="form_box" size="20" title="<?php echo xla('Sleep patterns'); ?>" value="<?php echo attr($result2['sleep_patterns']['resnote']); ?>"></td>
1022                           <td class="left"  nowrap><?php echo xlt('Seatbelt'); ?>:
1023                           </td>
1024                           <td><input type="text" name="form_seatbelt_use" id="form_box" size="20" title="<?php echo xla('Seatbelt use'); ?>" value="<?php echo attr($result2['seatbelt_use']['resnote']); ?>">
1025                           </td>
1026                         </tr>
1027                       </tbody>
1028                     </table>
1029                   </td>
1030                 </tr>
1031             </tbody>
1032       </table>
1033       <table id="row_FH" name="row_FH" width="90%">
1034         <tr>
1035           <td class="right" nowrap><?php echo xlt('Glaucoma'); ?>:</td>
1036           <td class="text data"><input type="radio" onclick='negate_radio(this);' id="radio_usertext11" name="radio_usertext11" <?php if (!$result1['usertext11']) echo "checked='checked'"; ?>>
1037             <input type="text" name="usertext11" id="usertext11" onclick='clear_option(this)' value="<?php echo attr($result1['usertext11']); ?>"></td>
1038           <td class="right" nowrap><?php echo xlt('Cataract'); ?>:</td>
1039           <td class="text data"><input type="radio" onclick='negate_radio(this);' id="radio_usertext12" name="radio_usertext12" <?php if (!$result1['usertext12']) echo "checked='checked'"; ?>>
1040             <input type="text" name="usertext12" id="usertext12" onclick='clear_option(this)' value="<?php echo attr($result1['usertext12']); ?>"></td>
1041         </tr>
1042         <tr>
1043           <td class="right" nowrap><?php echo xlt('AMD{{age related macular degeneration}}'); ?>:</td>
1044           <td class="text data"><input type="radio" onclick='negate_radio(this);' id="radio_usertext13" name="radio_usertext13" <?php if (!$result1['usertext13']) echo "checked='checked'"; ?>>
1045             <input type="text" name="usertext13" id="usertext13" onclick='clear_option(this)' value="<?php echo attr($result1['usertext13']); ?>"></td>
1046           <td class="right" nowrap><?php echo xlt('RD{{retinal detachment}}'); ?>:</td>
1047           <td class="text data"><input type="radio" onclick='negate_radio(this);' id="radio_usertext14" name="radio_usertext14" <?php if (!$result1['usertext14']) echo "checked='checked'"; ?>>
1048             <input type="text" name="usertext14" id="usertext14" onclick='clear_option(this)' value="<?php echo attr($result1['usertext14']); ?>"></td>
1049         </tr>
1050         <tr>
1051           <td class="right" nowrap><?php echo xlt('Blindness'); ?>:</td>
1052           <td class="text data"><input type="radio" onclick='negate_radio(this);' id="radio_usertext15" name="radio_usertext15" <?php if (!$result1['usertext15']) echo "checked='checked'"; ?>>
1053             <input type="text" name="usertext15" id="usertext15" onclick='clear_option(this)' value="<?php echo attr($result1['usertext15']); ?>"></td>
1054           <td class="right" nowrap><?php echo xlt('Amblyopia'); ?>:</td>
1055           <td class="text data"><input type="radio" onclick='negate_radio(this);' id="radio_usertext16" name="radio_usertext16" <?php if (!$result1['usertext16']) echo "checked='checked'"; ?>>
1056             <input type="text" name="usertext16" id="usertext16" onclick='clear_option(this)' value="<?php echo attr($result1['usertext16']); ?>"></td>
1057         </tr>
1058         <tr>
1059           <td class="right" nowrap><?php echo xlt('Strabismus'); ?>:</td>
1060           <td class="text data"><input type="radio" onclick='negate_radio(this);' id="radio_usertext17" name="radio_usertext17" <?php if (!$result1['usertext17']) echo "checked='checked'"; ?>>
1061             <input type="text" name="usertext17" id="usertext17" onclick='clear_option(this)' value="<?php echo attr($result1['usertext17']); ?>"></td>
1062           <td class="right" nowrap><?php echo xlt('Epilepsy'); ?>:</td>
1063           <td class="text data">
1064             <input type="radio" onclick='negate_radio(this);' id="radio_relatives_epilepsy" name="radio_relatives_epilepsy" <?php if (!$result1['relatives_epilepsy']) echo "checked='checked'"; ?>>
1065             <input type="text" name="relatives_epilepsy" id="relatives_epilepsy" onclick='clear_option(this)' value="<?php echo attr($result1['relatives_epilepsy']); ?>"></td>
1066         </tr>
1067         <tr>
1068           <td class="right" nowrap><?php echo xlt('Cancer'); ?>:</td>
1069           <td class="text data">
1070             <input type="radio" onclick='negate_radio(this);' id="radio_relatives_cancer" name="radio_relatives_cancer" <?php if (!$result1['relatives_cancer']) echo "checked='checked'"; ?>>
1071             <input type="text" name="relatives_cancer" id="relatives_cancer" onclick='clear_option(this)' value="<?php echo attr($result1['relatives_cancer']); ?>"></td>
1072           <td class="right" nowrap><?php echo xlt('Diabetes'); ?>:</td>
1073           <td class="text data">
1074             <input type="radio" onclick='negate_radio(this);' id="radio_relatives_diabetes" name="radio_relatives_diabetes" <?php if (!$result1['relatives_diabetes']) echo "checked='checked'"; ?>>
1075             <input type="text" name="relatives_diabetes" id="relatives_diabetes" onclick='clear_option(this)' value="<?php echo attr($result1['relatives_diabetes']); ?>"></td>
1076         </tr>
1077         <tr>
1078           <td class="right" nowrap><?php echo xlt('HTN{{hypertension}}'); ?>:</td>
1079           <td class="text data">
1080             <input type="radio" onclick='negate_radio(this);' id="radio_relatives_high_blood_pressure" name="radio_relatives_high_blood_pressure" <?php if (!$result1['relatives_high_blood_pressure']) echo "checked='checked'"; ?>>
1081             <input type="text" name="relatives_high_blood_pressure" id="relatives_high_blood_pressure" onclick='clear_option(this)' value="<?php echo attr($result1['relatives_high_blood_pressure']); ?>"></td>
1082           <td class="right" nowrap><?php echo xlt('Cardiac'); ?>:</td>
1083           <td class="text data">
1084             <input type="radio" onclick='negate_radio(this);' id="radio_relatives_heart_problems" name="radio_relatives_heart_problems" <?php if (!$result1['relatives_heart_problems']) echo "checked='checked'"; ?>>
1085             <input type="text" name="relatives_heart_problems" id="relatives_heart_problems" onclick='clear_option(this)' value="<?php echo attr($result1['relatives_heart_problems']); ?>"></td>
1086         </tr>
1087         <tr>
1088           <td class="right" nowrap><?php echo xlt('Stroke'); ?>:</td>
1089           <td class="text data">
1090             <input type="radio" onclick='negate_radio(this);' id="radio_relatives_stroke" name="radio_relatives_stroke" <?php if (!$result1['relatives_stroke']) echo "checked='checked'"; ?>>
1091             <input type="text" name="relatives_stroke" id="relatives_stroke" onclick='clear_option(this)' value="<?php echo attr($result1['relatives_stroke']); ?>"></td>
1092           <td class="right" nowrap><?php echo xlt('Other'); ?>:</td>
1093           <td class="text data"><input type="radio" onclick='negate_radio(this);' id="radio_usertext18" name="radio_usertext18" <?php if (!$result1['usertext18']) echo "checked='checked'"; ?>>
1094             <input type="text" name="usertext18" id="usertext18" onclick='clear_option(this)' value="<?php echo attr($result1['usertext18']); ?>"></td>
1095         </tr>
1096       </table>
1097       <table id="row_ROS" name="row_ROS" class="ROS_class">
1098         <tr>
1099           <td>
1100            &nbsp;
1101           </td>
1102         </tr>
1103         <tr>
1104           <td></td>
1105           <td>
1106             <span class="underline"><?php echo xlt('Neg{{negative}}'); ?></span><span class="underline" style="margin:30px;"><?php echo xlt('Positive'); ?></span>
1107           </td>
1108           <td></td>
1109           <td><span class="underline"><?php echo xlt('Neg{{negative}}'); ?></span><span class="underline" style="margin:30px;"><?php echo xlt('Positive'); ?></span>
1110           </td>
1111         </tr>
1112         <tr>
1113           <td class="right" nowrap><label for="ROSGENERAL" class="input-helper input-helper--checkbox"><?php echo xlt('General'); ?>:</label></td>
1114           <td>
1115             <input type="radio" onclick='negate_radio(this);' id="radio_ROSGENERAL" name="radio_ROSGENERAL" <?php if (!$ROSGENERAL) echo "checked='checked'"; ?>>
1116             <input type="text" name="ROSGENERAL" id="ROSGENERAL" onclick='clear_option(this)' value="<?php echo attr($ROSGENERAL); ?>"></td>
1117           <td class="right" nowrap><label for="ROSGENERAL" class="input-helper input-helper--checkbox"><?php echo xlt('HEENT'); ?>:</td>
1118           <td>
1119             <input type="radio" onclick='negate_radio(this);' id="radio_ROSHEENT" name="radio_ROSHEENT"<?php if (!$ROSHEENT) echo "checked='checked'"; ?>>
1120             <input type="text" name="ROSHEENT" id="ROSHEENT" onclick='clear_option(this)' value="<?php echo attr($ROSHEENT); ?>"></td>
1121         </tr>
1122         <tr>
1123           <td class="right" nowrap><label for="ROSGENERAL" class="input-helper input-helper--checkbox"><?php echo xlt('CV{{cardiovascular}}'); ?>:</td>
1124           <td>
1125             <input type="radio" onclick='negate_radio(this);' id="radio_ROSCV" name="radio_ROSCV"<?php if (!$ROSCV) echo "checked='checked'"; ?>>
1126             <input type="text" name="ROSCV" id="ROSCV" onclick='clear_option(this)' value="<?php echo attr($ROSCV); ?>"></td>
1127           <td class="right" nowrap><label for="ROSGENERAL" class="input-helper input-helper--checkbox"><?php echo xlt('Pulmonary'); ?>:</td>
1128           <td>
1129             <input type="radio" onclick='negate_radio(this);' id="radio_ROSPULM" name="radio_ROSPULM"<?php if (!$ROSPULM) echo "checked='checked'"; ?>>
1130             <input type="text" name="ROSPULM" id="ROSPULM" onclick='clear_option(this)' value="<?php echo attr($ROSPULM); ?>"></td>
1131           </tr>
1132         <tr>
1133           <td class="right" nowrap><label for="ROSGENERAL" class="input-helper input-helper--checkbox"><?php echo xlt('GI{{gastroenterology}}'); ?>:</td>
1134           <td>
1135             <input type="radio" onclick='negate_radio(this);' id="radio_ROSGI" name="radio_ROSGI"<?php if (!$ROSGI) echo "checked='checked'"; ?>>
1136             <input type="text" name="ROSGI" id="ROSGI" onclick='clear_option(this)' value="<?php echo attr($ROSGI); ?>"></td>
1137           <td class="right" nowrap><label for="ROSGENERAL" class="input-helper input-helper--checkbox"><?php echo xlt('GU{{genitourinary}}'); ?>:</td>
1138           <td>
1139             <input type="radio" onclick='negate_radio(this);' id="radio_ROSGU" name="radio_ROSGU"<?php if (!$ROSGU) echo "checked='checked'"; ?>>
1140             <input type="text" name="ROSGU" id="ROSGU" onclick='clear_option(this)' value="<?php echo attr($ROSGU); ?>"></td>
1141         </tr>
1142         <tr>
1143           <td class="right" nowrap><label for="ROSGENERAL" class="input-helper input-helper--checkbox"><?php echo xlt('Derm{{dematologic}}'); ?>:</td>
1144           <td>
1145             <input type="radio" onclick='negate_radio(this);' id="radio_ROSDERM" name="radio_ROSDERM"<?php if (!$ROSDERM) echo "checked='checked'"; ?>>
1146             <input type="text" name="ROSDERM" id="ROSDERM" onclick='clear_option(this)' value="<?php echo attr($ROSDERM); ?>"></td>
1147           <td class="right" nowrap><label for="ROSGENERAL" class="input-helper input-helper--checkbox"><?php echo xlt('Neuro{{neurologic}}'); ?>:</td>
1148           <td>
1149             <input type="radio" onclick='negate_radio(this);' id="radio_ROSNEURO" name="radio_ROSNEURO"<?php if (!$ROSNEURO) echo "checked='checked'"; ?>>
1150             <input type="text" name="ROSNEURO" id="ROSNEURO" onclick='clear_option(this)' value="<?php echo attr($ROSNEURO); ?>"></td>
1151         </tr>
1152         <tr>
1153           <td class="right" nowrap><label for="ROSGENERAL" class="input-helper input-helper--checkbox"><?php echo xlt('Psych{{psychiatric}}'); ?>:</td>
1154           <td>
1155             <input type="radio" onclick='negate_radio(this);' id="radio_ROSPSYCH" name="radio_ROSPSYCH"<?php if (!$ROSPSYCH) echo "checked='checked'"; ?>>
1156             <input type="text" name="ROSPSYCH" id="ROSPSYCH" onclick='clear_option(this)' value="<?php echo attr($ROSPSYCH); ?>"></td>
1157           <td class="right" nowrap><label for="ROSGENERAL" class="input-helper input-helper--checkbox"><?php echo xlt('Musculo{{musculoskeletal}}'); ?>:</td>
1158           <td>
1159             <input type="radio" onclick='negate_radio(this);' id="radio_ROSMUSCULO" name="radio_ROSMUSCULO"<?php if (!$ROSMUSCULO) echo "checked='checked'"; ?>>
1160             <input type="text" name="ROSMUSCULO" id="ROSMUSCULO" onclick='clear_option(this)' value="<?php echo attr($ROSMUSCULO); ?>"></td>
1161           </tr>
1162         <tr>
1163           <td class="right" nowrap><label for="ROSGENERAL" class="input-helper input-helper--checkbox"><?php echo xlt('Immuno{{immunologic}}'); ?>:</td>
1164           <td>
1165             <input type="radio" onclick='negate_radio(this);' id="radio_ROSIMMUNO" name="radio_ROSIMMUNO"<?php if (!$ROSIMMUNO) echo "checked='checked'"; ?>>
1166             <input type="text" name="ROSIMMUNO" id="ROSIMMUNO" onclick='clear_option(this)' value="<?php echo attr($ROSIMMUNO); ?>"></td>
1167           <td class="right" nowrap><label for="ROSGENERAL" class="input-helper input-helper--checkbox"><?php echo xlt('Endocrine'); ?>:</td>
1168           <td>
1169             <input type="radio" onclick='negate_radio(this);' id="radio_ROSENDOCRINE" name="radio_ROSENDOCRINE"<?php if (!$ROSENDOCRINE) echo "checked='checked'"; ?>>
1170             <input type="text" name="ROSENDOCRINE" id="ROSENDOCRINE" onclick='clear_option(this)' value="<?php echo attr($ROSENDOCRINE); ?>"></td>
1171           </tr>
1172         <tr><td></td></tr>
1173       </table>
1174       <table id="row_PLACEHOLDER" name="row_PLACEHOLDER" width="90%">
1175         <tr>
1176           <td>
1177           </td>
1178         </tr>
1179       </table>
1180     </div>
1181     <center>
1182       <p style="margin-top:10px;">
1183         <input type="hidden" type="text" id="issue_js" name="issue_js" value="test">
1184         <input type="hidden" type="text" id="pid" name="pid" value="<?php echo $pid; ?>">
1185         <input type='button' id='form_save' name='form_save'
1186         class="ui-button ui-widget ui-state-default ui-corner-all ui-button-text-only"
1187         onclick='top.restoreSession();submit_this_form();' value='<?php echo xla('Save'); ?>' />
1188         <?php
1189             $display_delete = "nodisplay";
1190           ?>
1191         &nbsp;
1192         <input type='button' name='delete_button' id='delete_button'
1193         class="<?php echo $display_delete; ?> ui-button ui-widget ui-state-default ui-corner-all ui-button-text-only"
1194         onclick='top.restoreSession();deleteme();' value='<?php echo xla('Delete'); ?>' />
1195         &nbsp;
1196         <input type='button' name='cancel_button' id='cancel_button'
1197         class="ui-button ui-widget ui-state-default ui-corner-all ui-button-text-only"
1198         value='<?php echo xla('Cancel'); ?>' onclick='clearme();' />
1199         </p>
1200       </center>
1201     </form>
1202   </div>
1203   <script language='JavaScript'>
1204      newtype('<?php if (!$form_index) { echo "POH"; } else { echo $type_index; } ?>');
1205      Calendar.setup({inputField:"form_begin", ifFormat:"%Y-%m-%d", button:"img_begin"});
1206      Calendar.setup({inputField:"form_end", ifFormat:"%Y-%m-%d", button:"img_end"});
1207      <?php
1208      $has_cal ="tobacco,coffee,alcohol,recreational_drugs,exercise_patterns";
1209      foreach (explode(',',$has_cal) as $item) {
1210       echo 'Calendar.setup({inputField:"date_'.$item.'", ifFormat:"%Y-%m-%d", button:"img_'.$item.'"});';
1211      } ?>
1212
1213     $(document).ready(function() {
1214       $('[title]').qtip({
1215                     position: {
1216                       my: 'top Right',  // Position my top left...
1217                       at: 'bottom Left', // at the bottom right of...
1218                       target: 'mouse' // my target
1219                     }
1220                   });
1221       $("input,textarea,text").css("background-color","#FFF8DC");
1222
1223     });
1224   </script>
1225 </body>
1226 </html>
1227