interface/de_identification_forms/de_identification_screen1.php

   1 <?php
   2 /********************************************************************************\
   3  * Copyright (C) ViCarePlus, Visolve (vicareplus_engg@visolve.com)              *
   4  *                                                                              *
   5  * This program is free software; you can redistribute it and/or                *
   6  * modify it under the terms of the GNU General Public License                  *
   7  * as published by the Free Software Foundation; either version 2               *
   8  * of the License, or (at your option) any later version.                       *
   9  *                                                                              *
  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  *                                                                              *
  15  * You should have received a copy of the GNU General Public License            *
  16  * along with this program; if not, write to the Free Software                  *
  17  * Foundation, Inc., 59 Temple Place - Suite 330, Boston, MA  02111-1307, USA.  *
  18  \********************************************************************************/
  19 require_once("../globals.php");
  20 require_once("$srcdir/lists.inc");
  21 require_once("$srcdir/patient.inc");
  22 require_once("$srcdir/acl.inc");
  23 require_once("$srcdir/options.inc.php");
  24 ?>
  25
  26 <html>
  27 <head>
  28 <title><?php xl('De Identification','e'); ?></title>
  29 <link rel="stylesheet" href='<?php echo $css_header ?>' type='text/css'>
  30 <link rel="stylesheet" href='<?php echo $GLOBALS['webroot'] ?>/library/dynarch_calendar.css' type='text/css'>
  31 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/dialog.js?v=<?php echo $v_js_includes; ?>"></script>
  32 <style type="text/css">
  33 .style1 {
  34         text-align: center;
  35 }</style>
  36 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/dynarch_calendar.js"></script>
  37 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/dynarch_calendar_en.js"></script>
  38 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/dynarch_calendar_setup.js"></script>
  39 <script language="JavaScript">
  40 //get value from popup window
  41 function set_related(s,type) {
  42  var list;
  43  if(type == "diagnosis")
  44         list = "diagnosis_list";
  45  else if(type == "drugs")
  46    list = "drug_list";
  47  else if(type == "immunizations")
  48    list = "immunization_list";
  49
  50  var p=s.split("#");
  51  var elSel = document.getElementById(list);
  52  var i,k;
  53  for (i=0;p[i]!=null;i++)
  54  {
  55   for(k=0;k<elSel.length;k++)
  56   {
  57    if((elSel.options[k].value)==p[i])
  58     p[i]= " ";
  59   }
  60   if(p[i]!= " ")
  61   {
  62   var elOptNew = document.createElement('option');
  63   elOptNew.text = p[i];
  64   elOptNew.value = p[i];
  65   try {
  66     elSel.add(elOptNew, null); // standards compliant; doesn't work in IE
  67   }
  68   catch(ex) {
  69     elSel.add(elOptNew); // IE only
  70   }
  71   }
  72  }
  73  show_value(type);
  74 }
  75
  76 function get_values(type)
  77 {
  78  if(type == "diagnosis")
  79         dlgopen('find_code_popup.php', '_blank', 500, 400,true);
  80  else if(type == "drugs")
  81    dlgopen('find_drug_popup.php', '_blank', 500, 400,true);
  82  else if(type == "immunizations")
  83    dlgopen('find_immunization_popup.php', '_blank', 500, 400,true);
  84 }
  85
  86 //remove item selected from list
  87 function remove_selected(type)
  88 {
  89   var list;
  90   if(type == "diagnosis")
  91         list = "diagnosis_list";
  92  else if(type == "drugs")
  93    list = "drug_list";
  94  else if(type == "immunizations")
  95    list = "immunization_list";
  96   var elSel = document.getElementById(list);
  97   var i;
  98   for (i = elSel.length - 1; i>=0; i--) {
  99     if (elSel.options[i].selected)
 100         {
 101       elSel.remove(i);
 102         }
 103   }
 104   show_value(type);
 105 }
 106
 107 function show_value(type)
 108 {
 109  var list,text,radio;
 110   if(type == "diagnosis")
 111         { radio = "diagnosis"; list = "diagnosis_list"; text="diagnosis_text"; }
 112  else if(type == "drugs")
 113   { radio = "drugs";  list = "drug_list"; text="drug_text"; }
 114  else if(type == "immunizations")
 115   { radio = "immunizations"; list = "immunization_list"; text="immunization_text"; }
 116  if(document.getElementById(radio) == "all")
 117  {
 118         document.getElementById(text).value="all";
 119  }
 120  else
 121 {
 122  var str;
 123  var elSel = document.getElementById(list);
 124   var i;
 125   for (i = elSel.length - 1; i>=0; i--)
 126   {
 127           if(!str)
 128            str = elSel.options[i].value;
 129           else
 130       str = str +"#"+elSel.options[i].value;
 131
 132     }
 133  document.getElementById(text).value=str;
 134  }
 135 }
 136
 137 //disable - enable other checkbox when all checkbox is clicked
 138 function disable_other_chkbox()
 139 {
 140  var value = document.forms[0].all.checked;
 141  if(value == 1)
 142  {
 143  document.forms[0].history_data.disabled = true;
 144  document.forms[0].prescriptions.disabled = true;
 145  document.forms[0].lists.disabled = true;
 146  document.forms[0].immunization.disabled = true;
 147  document.forms[0].transactions.disabled = true;
 148  document.forms[0].billing_data.disabled = true;
 149  document.forms[0].insurance_data.disabled = true;
 150  }
 151  else
 152  {
 153  document.forms[0].history_data.disabled = false;
 154  document.forms[0].prescriptions.disabled = false;
 155  document.forms[0].lists.disabled = false;
 156  document.forms[0].immunization.disabled = false;
 157  document.forms[0].transactions.disabled = false;
 158  document.forms[0].billing_data.disabled = false;
 159  document.forms[0].insurance_data.disabled = false;
 160  }
 161 }
 162
 163 //disable list,add button,remove button when all option is selected
 164 function disable_controls(type)
 165 {
 166  var list,button1,button2;
 167  if(type == "diagnosis")
 168  {      button1 = "add_diagnosis"; button2 = "remove_diagnosis"; list = "diagnosis_list"; text="diagnosis_text";  }
 169  else if(type == "drugs")
 170   { button1 = "add_drug";  button2 = "remove_drug"; list = "drug_list";  text="drug_text";}
 171  else if(type == "immunizations")
 172   { button1 = "add_immunization"; button2 = "remove_immunization"; list = "immunization_list"; text="immunization_text"; }
 173   document.getElementById(button1).disabled = true;
 174   document.getElementById(button2).disabled = true;
 175   document.getElementById(list).disabled = true;
 176   document.getElementById(text).value = "all";
 177 }
 178
 179 function enable_controls(type)
 180 {
 181  var list,button1,button2;
 182  if(type == "diagnosis")
 183  {      button1 = "add_diagnosis"; button2 = "remove_diagnosis"; list = "diagnosis_list";  }
 184  else if(type == "drugs")
 185   { button1 = "add_drug";  button2 = "remove_drug"; list = "drug_list";  }
 186  else if(type == "immunizations")
 187   { button1 = "add_immunization"; button2 = "remove_immunization"; list = "immunization_list";
 188  }
 189   document.getElementById(button1).disabled = false;
 190   document.getElementById(button2).disabled = false;
 191   document.getElementById(list).disabled = false;
 192   show_value(type);
 193 }
 194
 195
 196 function form_validate()
 197 {
 198  if(document.forms[0].begin_date.value >= document.forms[0].end_date.value)
 199  {
 200   alert("<?php echo xl('End date should be greater than Begin date');?>");
 201   return false;
 202  }
 203
 204  if(document.forms[0].all.checked == false &&
 205  document.forms[0].history_data.checked == false &&
 206  document.forms[0].prescriptions.checked == false &&
 207  document.forms[0].immunization.checked == false &&
 208  document.forms[0].lists.checked == false &&
 209  document.forms[0].transactions.checked == false &&
 210  document.forms[0].billing_data.checked == false &&
 211  document.forms[0].insurance_data.checked == false)
 212  {
 213   alert("<?php echo xl('Select Data Required for De Identification');?>");
 214   return false;
 215  }
 216
 217  if(document.forms[0].diagnosis_text.value == "undefined" || document.forms[0].diagnosis_text.value == "")
 218  {
 219   alert("<?php echo xl('Select Diagnosis for De Identification request');?>");
 220   return false;
 221  }
 222  if(document.forms[0].drug_text.value == "undefined" || document.forms[0].drug_text.value == "")
 223  {
 224   alert("<?php echo xl('Select Drugs for De Identification request');?>");
 225   return false;
 226  }
 227  if(document.forms[0].immunization_text.value == "undefined" || document.forms[0].immunization_text.value == "")
 228  {
 229   alert("<?php echo xl('Select Immunizations for De Identification request');?>");
 230   return false;
 231  }
 232  alert("<?php echo xl('De Identification process is started and running in background'); echo '\n'; echo xl('Please visit the screen after some time');?>");
 233  top.restoreSession();
 234  return true;
 235 }
 236
 237 function download_file()
 238 {
 239  alert("<?php echo xl('De-identification files will be saved in'); echo ' `'.$GLOBALS['temporary_files_dir'].'` '; echo xl('location of the openemr machine and may contain sensitive data, so it is recommended to manually delete the files after its use');?>");
 240  document.de_identification.submit();
 241 }
 242
 243 </script>
 244 </head>
 245 <body class="body_top">
 246 <form name="de_identification" id="de_identification" action="de_identification_screen2.php" method="post" onsubmit="return form_validate();">
 247 <strong><?php xl('De Identification','e'); ?></strong>
 248 <?php
 249  $row = sqlQuery("SHOW TABLES LIKE 'de_identification_status'");
 250  if (empty($row))
 251  {
 252    ?>
 253    <table>  <tr>        <td>&nbsp;</td> <td>&nbsp;</td> </tr>
 254               <tr>  <td>&nbsp;</td> <td>&nbsp;</td> </tr>
 255  </table>
 256  <table class="de_identification_status_message" align="center" >
 257         <tr valign="top">
 258                 <td>&nbsp;</td>
 259                 <td rowspan="3">
 260                 <br>
 261         <?php echo xl('Please upgrade OpenEMR Database to include De Identification procedures, function, tables'); ?>
 262         </br></br><a  target="Blank" href="../../contrib/util/de_identification_upgrade.php"><?php echo xl('Click here');?></a>
 263         <?php echo xl('to run');
 264         echo " de_identification_upgrade.php</br>";?><br>
 265                 </td>
 266                 <td>&nbsp;</td>
 267         </tr>
 268         <tr>
 269                 <td>&nbsp;</td>
 270                 <td>&nbsp;</td>
 271         </tr>
 272         <tr>
 273                 <td>&nbsp;</td>
 274                 <td>&nbsp;</td>
 275         </tr>
 276         </table>
 277   <?php
 278   }
 279  else {
 280  $query = "select status from de_identification_status";
 281  $res = sqlStatement($query);
 282  if ($row = sqlFetchArray($res))
 283  {
 284    $deIdentificationStatus = addslashes($row['status']);
 285  /* $deIdentificationStatus:
 286  *  0 - There is no De Identification in progress. (start new De Identification process)
 287  *  1 - A De Identification process is currently in progress.
 288  *  2 - The De Identification process completed and xls file is ready to download
 289  *  3 - The De Identification process completed with error
 290  */
 291  }
 292  if($deIdentificationStatus == 1)
 293  {
 294   //1 - A De Identification process is currently in progress.
 295  ?>
 296  <table>  <tr>  <td>&nbsp;</td> <td>&nbsp;</td> </tr>
 297               <tr>  <td>&nbsp;</td> <td>&nbsp;</td> </tr>
 298  </table>
 299  <table class="de_identification_status_message" align="center" >
 300         <tr valign="top">
 301                 <td>&nbsp;</td>
 302                 <td rowspan="3">
 303                 <br>
 304         <?php echo xl('De Identification Process is ongoing');
 305         echo "</br></br>";
 306         echo xl('Please visit De Identification screen after some time');
 307         echo "</br>";   ?>      <br>
 308                 </td>
 309                 <td>&nbsp;</td>
 310         </tr>
 311         <tr>
 312                 <td>&nbsp;</td>
 313                 <td>&nbsp;</td>
 314         </tr>
 315         <tr>
 316                 <td>&nbsp;</td>
 317                 <td>&nbsp;</td>
 318         </tr>
 319         </table>
 320  <?php
 321  }
 322  else if($deIdentificationStatus == 2)
 323  {
 324   //2 - The De Identification process completed and xls file is ready to download
 325   $query = "SELECT count(*) as count FROM de_identified_data ";
 326      $res = sqlStatement($query);
 327      if ($row = sqlFetchArray($res))
 328      {
 329       $no_of_items = addslashes($row['count']);
 330           }
 331       if($no_of_items <= 1)
 332       {
 333          //start new search - no patient record fount
 334          $query = "update de_identification_status set status = 0";
 335  $res = sqlStatement($query);
 336          ?>
 337          <table>  <tr>  <td>&nbsp;</td> <td>&nbsp;</td> </tr>
 338               <tr>  <td>&nbsp;</td> <td>&nbsp;</td> </tr>
 339  </table>
 340  <table class="de_identification_status_message" align="center" >
 341             <tr valign="top">
 342
 343                 <td>&nbsp;</td>
 344                 <td rowspan="3">
 345                 <br>
 346        <?php echo xl('No Patient record found for given Selection criteria');
 347         echo "</br></br>";
 348         echo xl('Please start new De Identification process');
 349     echo "</br>";       ?> </br>
 350                 </td>
 351                 <td>&nbsp;</td>
 352         </tr>
 353         <tr> <td>&nbsp;</td> <td>&nbsp;</td> </tr>
 354
 355         <tr> <td>&nbsp;</td> <td>&nbsp;</td> </tr>
 356         </table>
 357
 358         <table align="center">
 359         <tr> <td>&nbsp;</td> <td>&nbsp;</td> </tr>
 360       </table>
 361          <?php
 362       }
 363      else {
 364  ?>
 365  <table>  <tr>  <td>&nbsp;</td> <td>&nbsp;</td> </tr>
 366               <tr>  <td>&nbsp;</td> <td>&nbsp;</td> </tr>
 367  </table>
 368  <table class="de_identification_status_message" align="center" >
 369             <tr valign="top">
 370                 <td>&nbsp;</td>
 371                 <td rowspan="3">
 372                 <br>
 373         <?php echo xl('De Identification Process is completed');
 374         echo "</br></br>";
 375         echo xl('Please Click download button to download the De Identified data');
 376     echo "</br>";       ?>      <br>
 377                 </td>
 378                 <td>&nbsp;</td>
 379         </tr>
 380         <tr> <td>&nbsp;</td> <td>&nbsp;</td> </tr>
 381         <tr> <td>&nbsp;</td> <td>&nbsp;</td> </tr>
 382         </table>
 383         <table align="center">
 384         <tr> <td>&nbsp;</td> <td>&nbsp;</td> </tr>
 385    <tr>
 386    <td colspan="2" class="style1">
 387                 <input type="button" name="Download" value=<?php echo xl("Download");?> onclick="download_file()" ></td>
 388    </tr>
 389    </table>
 390  <?php
 391         }
 392  }
 393  else if($deIdentificationStatus == 3)
 394  {
 395   //3 - The De Identification process completed with error
 396   ?>
 397    <table>  <tr> <td>&nbsp;</td> <td>&nbsp;</td> </tr>
 398                 <tr> <td>&nbsp;</td> <td>&nbsp;</td> </tr>
 399    </table>
 400  <table class="de_identification_status_message" align="center" >
 401             <tr valign="top">
 402                 <td>&nbsp;</td>
 403                 <td rowspan="3">
 404                 <br>
 405         <?php echo xl('Some error has occured during De Identification Process');
 406         echo "</br></br>";
 407         echo xl('De Identified data may not be complete');
 408     echo "</br></br>";
 409    ?><span class="text"><?php echo xl('Please view De Identification error log table for more details');
 410     echo "</br>";       ?></span>       <br>
 411                 </td>
 412                 <td>&nbsp;</td>
 413         </tr>
 414         <tr> <td>&nbsp;</td> <td>&nbsp;</td> </tr>
 415         <tr> <td>&nbsp;</td> <td>&nbsp;</td> </tr>
 416         </table>
 417         <table align="center">
 418         <tr> <td>&nbsp;</td> <td>&nbsp;</td> </tr>
 419    <tr>
 420    <td colspan="2" class="style1">
 421                 <input type="button" name="Download" value=<?php echo xl("Download Anyway");?>  onclick="download_file()"></td>
 422    </tr>
 423    </table>
 424  </tr>
 425  </table>
 426
 427   <?php
 428   }
 429   if($deIdentificationStatus == 0 )
 430   {
 431   //0 - There is no De Identification in progress. (start new De Identification process)
 432  ?>
 433 <div id="overDiv" style="position: absolute; visibility: hidden; z-index: 1000;">
 434 </div>
 435 <table style="width: 74%" border=0>
 436         <tr rowspan=2>
 437                 <td>&nbsp;</td>
 438                 <td><span class="text"><?php xl('Begin Date','e'); ?></span>
 439                 <input type="text" size="10" name="begin_date" id="begin_date" value="<?php echo $viewmode ? substr($result['date'], 0, 10) : date('Y-m-d'); ?>" title="<?php xl('yyyy-mm-dd Date of service','e'); ?>" onkeyup="datekeyup(this,mypcc)" onblur="dateblur(this,mypcc)" />
 440                 <img src="../pic/show_calendar.gif" align="absbottom" width="24" height="22" id="img_begin_date" border="0" alt="[?]" style="cursor: pointer; cursor: hand" title="<?php xl('Click here to choose a date','e'); ?>">&nbsp;
 441                 </td>
 442                 <td><span class="text"><?php xl('End Date','e'); ?></span>
 443                 <input type="text" size="10" name="end_date" id="end_date" value="<?php echo $viewmode ? substr($result['date'], 0, 10) : date('Y-m-d'); ?>" title="<?php xl('yyyy-mm-dd Date of service','e'); ?>" onkeyup="datekeyup(this,mypcc)" onblur="dateblur(this,mypcc)" />
 444                 <img src="../pic/show_calendar.gif" align="absbottom" width="24" height="22" id="img_end_date" border="0" alt="[?]" style="cursor: pointer; cursor: hand" title="<?php xl('Click here to choose a date','e'); ?>">
 445                 </td>
 446                 <td>&nbsp;</td>
 447                 <td>&nbsp;</td>
 448                 </tr>
 449                 <tr>
 450                 <td>&nbsp;</td> </tr>
 451                 <tr><td>&nbsp;</td>
 452                 <td colspan=2 class="de_identification_input_controls_box"><input type="checkbox" name="unstructured" id="unstructured" value=<?php echo xl("unstructured");?>><span class="text"><?php xl('Include Unstructured data','e'); ?></span></td>
 453                 <td>&nbsp;</td></tr>
 454                 <tr>
 455                 <td>&nbsp;</td>
 456                 <td colspan="2">
 457                 <table class="de_identification_input_controls_box">
 458                         <tr>
 459                                 <td><span class="text"><?php xl('Select data to be included in De Identified data','e'); ?></span>                              <br />
 460                                 <input type="checkbox" name="all" id ="all" value='all' onclick="disable_other_chkbox()"><span class="text"><?php xl('All','e'); ?> </span><br />
 461                                 <input type="checkbox" name="history_data" id="history_data" value='history_data'><span class="text"><?php xl('History Data','e'); ?></span> <br />
 462                                 <input type="checkbox" name="immunization" id="immunization" value="immunizations"><span class="text"><?php xl('Immunizations','e'); ?></span>
 463                                 <br />
 464                                 <input type="checkbox" name="prescriptions" id="prescriptions" value="prescriptions"><span class="text"><?php xl('Prescriptions','e'); ?></span>
 465
 466 &nbsp;</td>             <br />
 467                                 <td><br>
 468                                 <input type="checkbox" name="lists" id="lists" value="lists"><span class="text"><?php xl('Issues','e'); ?> </span><br />
 469                                 <input type="checkbox" name="transactions" id="transactions" value="transactions"><span class="text"><?php xl('Transactions','e'); ?></span>
 470                                 <br />
 471                                 <input type="checkbox" name="insurance_data" id="insurance_data" value="insurance_data"><span class="text"><?php xl('Insurance Data','e'); ?> </span><br />
 472                                 <input type="checkbox" name="billing_data" id="billing_data" value="billing_data"><span class="text"><?php xl('Billing Data','e'); ?></span> <br />
 473
 474 &nbsp;</td>
 475                         </tr>
 476                 </table>
 477                 </td>
 478                 <td>&nbsp;</td>
 479         </tr>
 480         <tr>
 481                 <td>&nbsp;</td>
 482                 <td colspan="2"><br>
 483                 </td>
 484                 <td>&nbsp;</td>
 485         </tr>
 486         <tr>
 487                 <td>&nbsp;</td>
 488                 <td colspan="3">
 489                 <table style="width: 100%">
 490                         <tr valign="top">
 491                                 <!--diagnosis--><td style="width:50%;" class="style1"><span class="text"><?php xl('Enter Diagnosis','e'); ?></span>
 492                                 <input type="radio" id="diagnosis" name="diagnosis" value="all" onclick="disable_controls('diagnosis');" /><span class="text"> <?php xl('All','e'); ?></span>
 493                                 <input type="radio" id="diagnosis" name="diagnosis" value="select_diagnosis" onclick="enable_controls('diagnosis');"    />
 494                                 <span class="text"><?php xl('Select Diagnosis','e'); ?></span>
 495                                 <select id="diagnosis_list" name="diagnosis_list" size="10" style="width: 60%">
 496                                 </select>
 497
 498                                 </td>
 499                                 <td style="width:50%;" class="style1">
 500                                 <!--drugs--><span class="text"><?php xl('Enter Drugs','e'); ?></span>
 501                                 <input type="radio" id="drugs" name="drugs" value="all"); onclick="disable_controls('drugs')"/><span class="text"> <?php xl('All','e'); ?></span>
 502                                 <input type="radio" id="drugs" name="drugs" value="select_drug" onclick="enable_controls('drugs')" />
 503                                 <span class="text"><?php xl('Select Drugs','e'); ?> <br></span>
 504                                 <select id="drug_list" name="drug_list" size="10" style="width: 60%">
 505                                 </select>
 506
 507                                 </td>
 508                         </tr>
 509                         <tr> <td class="style1">
 510                                 <input type="button" name="add_diagnosis" id = "add_diagnosis" value=<?php echo xl("Add Diagnosis"); ?> onclick="get_values('diagnosis')">
 511                                 <input type="button" name="remove_diagnosis" id="remove_diagnosis"value=<?php echo xl("Remove"); ?> onclick="remove_selected('diagnosis')">&nbsp; </td> <td class="style1">
 512                                 <input type="button" name="add_drug" id="add_drug" value=<?php echo xl("Add Drug"); ?> onclick="get_values('drugs')">
 513                                 <input type="button" name="remove_drug" id="remove_drug" value=<?php echo xl("Remove"); ?> onclick="remove_selected('drugs')">
 514                         </td> </tr>
 515                 </table>
 516                 </td>
 517                 <td>&nbsp;</td>
 518         </tr>
 519         <tr>
 520                 <td>&nbsp;</td>
 521                 <td colspan="2" class="style1">
 522                 <!--immunizations--><br>
 523                 <span class="text"><?php xl('Enter Immunizations','e'); ?></span>
 524                 <input type="radio" id="immunizations" name="immunizations" value="all" onclick="disable_controls('immunizations')"/><span class="text"> <?php xl('All','e'); ?></span>
 525                 <input type="radio" id="immunizations" name="immunizations" value="select_immunization" onclick="enable_controls('immunizations')" />
 526                 <span class="text"><?php xl('Select Immunizations','e'); ?></span> <br>
 527                 <select id="immunization_list" name="immunization_list" size="10" width="300" style="width: 30%">
 528                 </select> <br>
 529                 <input type="button" name="add_immunization" id="add_immunization" value=<?php echo xl("Add Immunization"); ?> onclick="get_values('immunizations')">
 530                 <input type="button" name="remove_immunization" id="remove_immunization" value=<?php echo xl("Remove"); ?> onclick="remove_selected('immunizations')">
 531                 <br>
 532 &nbsp;</td>
 533                 <td>&nbsp;</td>
 534         </tr>
 535         <tr>
 536                 <td>&nbsp;</td>
 537                 <td colspan="2" class="style1">
 538                 <input type="submit" name="Submit" value=<?php echo xl("Submit"); ?> ></td>
 539                 <td>&nbsp;</td>
 540         </tr>
 541
 542         <input type="hidden" name="diagnosis_text" id="diagnosis_text"><br>
 543                 <input type="hidden" name="drug_text" id="drug_text"><br>
 544                 <input type="hidden" name="immunization_text" id="immunization_text">
 545 </table>
 546 <script language='JavaScript'>
 547 /* required for popup calendar */
 548 Calendar.setup({inputField:"begin_date", ifFormat:"%Y-%m-%d", button:"img_begin_date"});
 549 Calendar.setup({inputField:"end_date", ifFormat:"%Y-%m-%d", button:"img_end_date"});
 550 </script>
 551         <?php
 552         }
 553        }
 554
 555    ?>
 556 </form>
 557 </body>
 558 </html>