interface/forms/treatment_plan/new.php

   1 <?php
   2 /**
   3  *
   4  * Copyright (C) 2012-2013 Naina Mohamed <naina@capminds.com> CapMinds Technologies
   5  *
   6  * LICENSE: This program is free software; you can redistribute it and/or
   7  * modify it under the terms of the GNU General Public License
   8  * as published by the Free Software Foundation; either version 3
   9  * of the License, or (at your option) any later version.
  10  * This program is distributed in the hope that it will be useful,
  11  * but WITHOUT ANY WARRANTY; without even the implied warranty of
  12  * MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the
  13  * 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, see <http://opensource.org/licenses/gpl-license.php>;.
  16  *
  17  * @package OpenEMR
  18  * @author  Naina Mohamed <naina@capminds.com>
  19  * @link    http://www.open-emr.org
  20  */
  21
  22 //SANITIZE ALL ESCAPES
  23  $sanitize_all_escapes=true;
  24
  25  //STOP FAKE REGISTER GLOBALS
  26  $fake_register_globals=false;
  27
  28 include_once("../../globals.php");
  29 include_once("$srcdir/api.inc");
  30 require_once("$srcdir/patient.inc");
  31 require_once("$srcdir/options.inc.php");
  32 formHeader("Form:Treatment Planning");
  33 $returnurl = $GLOBALS['concurrent_layout'] ? 'encounter_top.php' : 'patient_encounter.php';
  34 $formid = 0 + (isset($_GET['id']) ? $_GET['id'] : '');
  35 $obj = $formid ? formFetch("form_treatment_plan", $formid) : array();
  36
  37
  38 // Get the providers list.
  39  $ures = sqlStatement("SELECT id, username, fname, lname FROM users WHERE " .
  40   "authorized != 0 AND active = 1 ORDER BY lname, fname");
  41 ?>
  42 <html><head>
  43 <?php html_header_show();?>
  44 <script type="text/javascript" src="../../../library/dialog.js"></script>
  45 <!-- pop up calendar -->
  46 <style type="text/css">@import url(<?php echo $GLOBALS['webroot'] ?>/library/dynarch_calendar.css);</style>
  47 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/dynarch_calendar.js"></script>
  48 <?php include_once("{$GLOBALS['srcdir']}/dynarch_calendar_en.inc.php"); ?>
  49 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/dynarch_calendar_setup.js"></script>
  50 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/textformat.js"></script>
  51 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/dialog.js"></script>
  52 <link rel="stylesheet" href="<?php echo $css_header;?>" type="text/css">
  53 </head>
  54 <body class="body_top">
  55 <p><span class="forms-title"><?php echo xlt('Treatment Planning'); ?></span></p>
  56 </br>
  57 <?php
  58 echo "<form method='post' name='my_form' " .
  59   "action='$rootdir/forms/treatment_plan/save.php?id=" . attr($formid) ."'>\n";
  60 ?>
  61
  62 <table  border="0">
  63
  64 <tr>
  65 <td align="left" class="forms" class="forms"><?php echo xlt('Client Name' ); ?>:</td>
  66                 <td class="forms">
  67                         <label class="forms-data"> <?php if (is_numeric($pid)) {
  68
  69     $result = getPatientData($pid, "fname,lname,squad");
  70    echo text($result['fname'])." ".text($result['lname']);}
  71    $patient_name=($result['fname'])." ".($result['lname']);
  72    ?>
  73    </label>
  74    <input type="hidden" name="client_name" value="<?php echo attr($patient_name);?>">
  75                 </td>
  76                 <td align="left"  class="forms"><?php echo xlt('DOB'); ?>:</td>
  77                 <td class="forms">
  78                 <label class="forms-data"> <?php if (is_numeric($pid)) {
  79
  80     $result = getPatientData($pid, "*");
  81    echo text($result['DOB']);}
  82    $dob=($result['DOB']);
  83    ?>
  84    </label>
  85      <input type="hidden" name="DOB" value="<?php echo attr($dob);?>">
  86                 </td>
  87                 </tr>
  88         <tr>
  89
  90
  91
  92                 <td align="left"  class="forms"><?php echo xlt('Client Number'); ?>:</td>
  93                 <td class="forms">
  94                         <label class="forms-data" > <?php if (is_numeric($pid)) {
  95
  96     $result = getPatientData($pid, "*");
  97    echo text($result['pid']);}
  98    $patient_id=$result['pid'];
  99    ?>
 100    </label>
 101     <input type="hidden" name="client_number" value="<?php echo attr($patient_id);?>">
 102                 </td>
 103
 104
 105                 <td align="left" class="forms"><?php echo xlt('Admit Date'); ?>:</td>
 106                 <td class="forms">
 107                            <input type='text' size='10' name='admit_date' id='admission_date' <?php echo attr($disabled) ?>;
 108                            value='<?php echo attr($obj{"admit_date"}); ?>'
 109                            title='<?php echo xla('yyyy-mm-dd Date of service'); ?>'
 110        onkeyup='datekeyup(this,mypcc)' onblur='dateblur(this,mypcc)' />
 111         <img src='../../pic/show_calendar.gif' align='absbottom' width='24' height='22'
 112         id='img_admission_date' border='0' alt='[?]' style='cursor:pointer;cursor:hand'
 113         title='<?php echo xla('Click here to choose a date'); ?>'>
 114                 </td>
 115
 116                 </tr>
 117                 <tr>
 118                 <td align="left" class="forms"><?php echo xlt('Provider'); ?>:</td>
 119                  <td class="forms" width="280px">
 120  <?php
 121
 122     echo "<select name='provider' style='width:60%' />";
 123     while ($urow = sqlFetchArray($ures)) {
 124       echo "    <option value='" . attr($urow['lname']) . "'";
 125       if ($urow['lname'] == attr($obj{"provider"})) echo " selected";
 126       echo ">" . text($urow['lname']);
 127       if ($urow['fname']) echo ", " . text($urow['fname']);
 128       echo "</option>\n";
 129     }
 130     echo "</select>";
 131 ?>
 132                 </td>
 133
 134                 </tr>
 135
 136         <tr>
 137
 138   <td colspan='3' nowrap style='font-size:8pt'>
 139    &nbsp;
 140         </td>
 141         </tr>
 142
 143         <tr>
 144                 <td align="left" class="forms"><?php echo xlt('Presenting Issue(s)'); ?>:</td>
 145                 <td colspan="3"><textarea name="presenting_issues" rows="2" cols="60" wrap="virtual name"><?php echo text($obj{"presenting_issues"});?></textarea></td>
 146
 147         </tr>
 148         <tr>
 149                 <td align="left" class="forms"><?php echo xlt('Patient History'); ?>:</td>
 150                 <td colspan="3"><textarea name="patient_history" rows="2" cols="60" wrap="virtual name"><?php echo text($obj{"patient_history"});?></textarea></td>
 151
 152         </tr>
 153         <tr>
 154
 155                 <td align="left" class="forms"><?php echo xlt('Medications'); ?>:</td>
 156                 <td colspan="3"><textarea name="medications" rows="2" cols="60" wrap="virtual name"><?php echo text($obj{"medications"});?></textarea></td>
 157
 158
 159         </tr>
 160         <tr>
 161                 <td align="left" class="forms"><?php echo xlt('Anyother Relevant Information'); ?>:</td>
 162                 <td colspan="3"><textarea name="anyother_relevant_information" rows="2" cols="60" wrap="virtual name"><?php echo text($obj{"anyother_relevant_information"});?></textarea></td>
 163
 164         </tr>
 165         <tr>
 166                 <td align="left" class="forms"><?php echo xlt('Diagnosis'); ?>:</td>
 167                 <td colspan="3"><textarea name="diagnosis" rows="2" cols="60" wrap="virtual name"><?php echo text($obj{"diagnosis"});?></textarea></td>
 168
 169         </tr>
 170         <tr>
 171                 <td align="left" class="forms"><?php echo xlt('Treatment Received'); ?>:</td>
 172                 <td colspan="3"><textarea name="treatment_received" rows="2" cols="60" wrap="virtual name"><?php echo text($obj{"treatment_received"});?></textarea></td>
 173
 174         </tr>
 175         <tr>
 176                 <td align="left" class="forms"><?php echo xlt('Recommendation For Follow Up'); ?>:</td>
 177                 <td colspan="3"><textarea name="recommendation_for_follow_up" rows="2" cols="60" wrap="virtual name"><?php echo text($obj{"recommendation_for_follow_up"});?></textarea></td>
 178
 179         </tr>
 180         <tr>
 181                 <td align="left colspan="3" style="padding-bottom:7px;"></td>
 182         </tr>
 183         <tr>
 184                 <td align="left colspan="3" style="padding-bottom:7px;"></td>
 185         </tr>
 186         <tr>
 187                 <td></td>
 188     <td><input type='submit'  value='<?php echo xlt('Save');?>' class="button-css">&nbsp;
 189         <input type='button'  value="Print" onclick="window.print()" class="button-css">&nbsp;
 190         <input type='button' class="button-css" value='<?php echo xlt('Cancel');?>'
 191  onclick="top.restoreSession();location='<?php echo "$rootdir/patient_file/encounter/$returnurl" ?>'" /></td>
 192         </tr>
 193 </table>
 194 </form>
 195 <script language="javascript">
 196 /* required for popup calendar */
 197 Calendar.setup({inputField:"admission_date", ifFormat:"%Y-%m-%d", button:"img_admission_date"});
 198
 199 </script>
 200 <?php
 201 formFooter();
 202 ?>