interface/forms/note/new.php

   1 <!-- Work/School Note Form created by Nikolai Vitsyn: 2004/02/13 and update 2005/03/30
   2      Copyright (C) Open Source Medical Software
   3
   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.
   8
   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.
  13
  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. -->
  17
  18 <?php
  19 include_once("../../globals.php");
  20 include_once("$srcdir/api.inc");
  21 formHeader("Form: note");
  22 $returnurl = $GLOBALS['concurrent_layout'] ? 'encounter_top.php' : 'patient_encounter.php';
  23 $provider_results = sqlQuery("select fname, lname from users where username='" . $_SESSION{"authUser"} . "'");
  24 /* name of this form */
  25 $form_name = "note";
  26 ?>
  27
  28 <html><head>
  29 <?php html_header_show();?>
  30
  31 <!-- supporting javascript code -->
  32 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/js/jquery.js"></script>
  33 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/textformat.js"></script>
  34
  35 <!-- pop up calendar -->
  36 <style type="text/css">@import url(<?php echo $GLOBALS['webroot'] ?>/library/dynarch_calendar.css);</style>
  37 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/dynarch_calendar.js"></script>
  38 <?php include_once("{$GLOBALS['srcdir']}/dynarch_calendar_en.inc.php"); ?>
  39 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/dynarch_calendar_setup.js"></script>
  40
  41 <link rel="stylesheet" href="<?php echo $css_header;?>" type="text/css">
  42
  43 <script language="JavaScript">
  44 // required for textbox date verification
  45 var mypcc = '<?php echo $GLOBALS['phone_country_code'] ?>';
  46 </script>
  47
  48 </head>
  49
  50 <body class="body_top">
  51 <?php echo date("F d, Y", time()); ?>
  52
  53 <form method=post action="<?php echo $rootdir."/forms/".$form_name."/save.php?mode=new";?>" name="my_form" id="my_form">
  54 <span class="title"><?php xl('Work/School Note','e'); ?></span><br></br>
  55
  56 <div style="margin: 10px;">
  57 <input type="button" class="save" value="    <?php xl('Save','e'); ?>    "> &nbsp;
  58 <input type="button" class="dontsave" value="<?php xl('Don\'t Save','e'); ?>"> &nbsp;
  59 </div>
  60
  61 <select name="note_type">
  62 <option value="WORK NOTE"><?php xl('WORK NOTE','e'); ?></option>
  63 <option value="SCHOOL NOTE"><?php xl('SCHOOL NOTE','e'); ?></option>
  64 </select>
  65 <br>
  66 <b><?php xl('MESSAGE:','e'); ?></b>
  67 <br>
  68 <textarea name="message" id="message" rows="7" cols="47"></textarea>
  69 <br>
  70
  71 <?php
  72 // commented out below private field, because no field in database, and causes error.
  73 ?>
  74 <!--
  75 <input type="checkbox" name="private" id="private"><label for="private">This note is private</label>
  76 <br>
  77 -->
  78
  79 <br>
  80 <b><?php xl('Signature:','e'); ?></b>
  81 <br>
  82
  83 <table>
  84 <tr><td>
  85 <?php xl('Doctor:','e'); ?>
  86 <input type="text" name="doctor" id="doctor" value="<?php echo $provider_results["fname"].' '.$provider_results["lname"]; ?>">
  87 </td>
  88
  89 <td>
  90 <span class="text"><?php xl('Date','e'); ?></span>
  91    <input type='text' size='10' name='date_of_signature' id='date_of_signature'
  92     value='<?php echo date('Y-m-d', time()); ?>'
  93     title='<?php xl('yyyy-mm-dd','e'); ?>'
  94     onkeyup='datekeyup(this,mypcc)' onblur='dateblur(this,mypcc)' />
  95    <img src='../../pic/show_calendar.gif' align='absbottom' width='24' height='22'
  96     id='img_date_of_signature' border='0' alt='[?]' style='cursor:pointer;cursor:hand'
  97     title='<?php xl('Click here to choose a date','e'); ?>'>
  98 </td>
  99 </tr>
 100 </table>
 101
 102 <div style="margin: 10px;">
 103 <input type="button" class="save" value="    <?php xl('Save','e'); ?>    "> &nbsp;
 104 <input type="button" class="dontsave" value="<?php xl('Don\'t Save','e'); ?>"> &nbsp;
 105 </div>
 106
 107 </form>
 108
 109 </body>
 110
 111 <script language="javascript">
 112 /* required for popup calendar */
 113 Calendar.setup({inputField:"date_of_signature", ifFormat:"%Y-%m-%d", button:"img_date_of_signature"});
 114
 115 // jQuery stuff to make the page a little easier to use
 116
 117 $(document).ready(function(){
 118     $(".save").click(function() { top.restoreSession(); $('#my_form').submit(); });
 119     $(".dontsave").click(function() { location.href='<?php echo "$rootdir/patient_file/encounter/$returnurl";?>'; });
 120     //$("#printform").click(function() { PrintForm(); });
 121 });
 122
 123 </script>
 124
 125 </html>