contrib/forms/example/view.php

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