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
  20 $fake_register_globals=false;
  21 $sanitize_all_escapes=true;
  22
  23 include_once("../../globals.php");
  24 include_once("$srcdir/api.inc");
  25 formHeader("Form: note");
  26 $returnurl = $GLOBALS['concurrent_layout'] ? 'encounter_top.php' : 'patient_encounter.php';
  27 $provider_results = sqlQuery("select fname, lname from users where username=?",array($_SESSION{"authUser"}));
  28 /* name of this form */
  29 $form_name = "note";
  30 ?>
  31
  32 <html><head>
  33 <?php html_header_show();?>
  34
  35 <!-- supporting javascript code -->
  36 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/js/jquery.js"></script>
  37 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/textformat.js"></script>
  38
  39 <!-- pop up calendar -->
  40 <style type="text/css">@import url(<?php echo $GLOBALS['webroot'] ?>/library/dynarch_calendar.css);</style>
  41 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/dynarch_calendar.js"></script>
  42 <?php include_once("{$GLOBALS['srcdir']}/dynarch_calendar_en.inc.php"); ?>
  43 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/dynarch_calendar_setup.js"></script>
  44
  45 <link rel="stylesheet" href="<?php echo $css_header;?>" type="text/css">
  46
  47 <script language="JavaScript">
  48 // required for textbox date verification
  49 var mypcc = '<?php echo $GLOBALS['phone_country_code'] ?>';
  50 </script>
  51
  52 </head>
  53
  54 <body class="body_top">
  55 <?php echo date("F d, Y", time()); ?>
  56
  57 <form method=post action="<?php echo $rootdir."/forms/".$form_name."/save.php?mode=new";?>" name="my_form" id="my_form">
  58 <span class="title"><?php echo xlt('Work/School Note'); ?></span><br></br>
  59
  60 <div style="margin: 10px;">
  61 <input type="button" class="save" value="    <?php echo xla('Save'); ?>    "> &nbsp;
  62 <input type="button" class="dontsave" value="<?php echo xla('Don\'t Save'); ?>"> &nbsp;
  63 </div>
  64
  65 <select name="note_type">
  66 <option value="WORK NOTE"><?php echo xlt('WORK NOTE'); ?></option>
  67 <option value="SCHOOL NOTE"><?php echo xlt('SCHOOL NOTE'); ?></option>
  68 </select>
  69 <br>
  70 <b><?php echo xlt('MESSAGE:'); ?></b>
  71 <br>
  72 <textarea name="message" id="message" rows="7" cols="47"></textarea>
  73 <br>
  74
  75 <?php
  76 // commented out below private field, because no field in database, and causes error.
  77 ?>
  78 <!--
  79 <input type="checkbox" name="private" id="private"><label for="private">This note is private</label>
  80 <br>
  81 -->
  82
  83 <br>
  84 <b><?php echo xlt('Signature:'); ?></b>
  85 <br>
  86
  87 <table>
  88 <tr><td>
  89 <?php echo xlt('Doctor:'); ?>
  90 <input type="text" name="doctor" id="doctor" value="<?php echo attr($provider_results["fname"]).' '.attr($provider_results["lname"]); ?>">
  91 </td>
  92
  93 <td>
  94 <span class="text"><?php echo xlt('Date'); ?></span>
  95    <input type='text' size='10' name='date_of_signature' id='date_of_signature'
  96     value='<?php echo date('Y-m-d', time()); ?>'
  97     title='<?php echo xla('yyyy-mm-dd'); ?>'
  98     onkeyup='datekeyup(this,mypcc)' onblur='dateblur(this,mypcc)' />
  99    <img src='../../pic/show_calendar.gif' align='absbottom' width='24' height='22'
 100     id='img_date_of_signature' border='0' alt='[?]' style='cursor:pointer;cursor:hand'
 101     title='<?php echo xla('Click here to choose a date'); ?>'>
 102 </td>
 103 </tr>
 104 </table>
 105
 106 <div style="margin: 10px;">
 107 <input type="button" class="save" value="    <?php echo xla('Save'); ?>    "> &nbsp;
 108 <input type="button" class="dontsave" value="<?php echo xla('Don\'t Save'); ?>"> &nbsp;
 109 </div>
 110
 111 </form>
 112
 113 </body>
 114
 115 <script language="javascript">
 116 /* required for popup calendar */
 117 Calendar.setup({inputField:"date_of_signature", ifFormat:"%Y-%m-%d", button:"img_date_of_signature"});
 118
 119 // jQuery stuff to make the page a little easier to use
 120
 121 $(document).ready(function(){
 122     $(".save").click(function() { top.restoreSession(); $('#my_form').submit(); });
 123     $(".dontsave").click(function() { location.href='<?php echo "$rootdir/patient_file/encounter/$returnurl";?>'; });
 124     //$("#printform").click(function() { PrintForm(); });
 125 });
 126
 127 </script>
 128
 129 </html>