contrib/forms/example/view.php

   1 <?php
   2
   3 include("../../../library/api.inc");
   4 formHeader("View my form");
   5 ?>
   6
   7 <form method=post action=save.php name=new_encounter>
   8 <input type=hidden name=id value='<?php echo $_GET["id"];?>'>
   9 <span class=title>New Patient Encounter Form</span>
  10 <br>
  11
  12 <span class=text>Reason for Visit:</span><br>
  13 <textarea name=reason cols=40 rows=6 wrap=virtual><?php
  14
  15 $result = formFetch('newer_patient', "7");
  16
  17 echo $result["reason"];
  18
  19 ?></textarea>
  20
  21 <br>
  22 <?php
  23 echo "<input type='text' name='cats' value='{$result['cats']}'>";
  24 ?>
  25 <br>
  26 <a href="javascript:top.restoreSession();document.new_encounter.submit();" class="link_submit">[Save]</a>
  27 <br>
  28 </form>
  29
  30 <?php
  31 formFooter();
  32 ?>