interface/forms/treatment_plan/new.php

   1 <?php
   2 /**
   3  *
   4  * Copyright (C) 2012-2013 Naina Mohamed <naina@capminds.com> CapMinds Technologies
   5  * Copyright (C) 2017 Brady Miller <brady.g.miller@gmail.com>
   6  *
   7  * LICENSE: This program is free software; you can redistribute it and/or
   8  * modify it under the terms of the GNU General Public License
   9  * as published by the Free Software Foundation; either version 3
  10  * of the License, or (at your option) any later version.
  11  * This program is distributed in the hope that it will be useful,
  12  * but WITHOUT ANY WARRANTY; without even the implied warranty of
  13  * MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the
  14  * GNU General Public License for more details.
  15  * You should have received a copy of the GNU General Public License
  16  * along with this program. If not, see <http://opensource.org/licenses/gpl-license.php>;.
  17  *
  18  * @package OpenEMR
  19  * @author  Naina Mohamed <naina@capminds.com>
  20  * @author  Brady Miller <brady.g.miller@gmail.com>
  21  * @link    http://www.open-emr.org
  22  */
  23
  24 //SANITIZE ALL ESCAPES
  25  $sanitize_all_escapes=true;
  26
  27  //STOP FAKE REGISTER GLOBALS
  28  $fake_register_globals=false;
  29
  30 include_once("../../globals.php");
  31 include_once("$srcdir/api.inc");
  32 require_once("$srcdir/patient.inc");
  33 require_once("$srcdir/options.inc.php");
  34 formHeader("Form:Treatment Planning");
  35 $returnurl = 'encounter_top.php';
  36 $formid = 0 + (isset($_GET['id']) ? $_GET['id'] : '');
  37 $obj = $formid ? formFetch("form_treatment_plan", $formid) : array();
  38
  39 // Get the providers list.
  40  $ures = sqlStatement("SELECT id, username, fname, lname FROM users WHERE " .
  41   "authorized != 0 AND active = 1 ORDER BY lname, fname");
  42 ?>
  43 <html><head>
  44 <?php html_header_show();?>
  45
  46 <link rel="stylesheet" href="<?php echo $css_header;?>" type="text/css">
  47 <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery-datetimepicker-2-5-4/build/jquery.datetimepicker.min.css">
  48
  49 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/textformat.js?v=<?php echo $v_js_includes; ?>"></script>
  50 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/dialog.js?v=<?php echo $v_js_includes; ?>"></script>
  51 <script type="text/javascript" src="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery-min-3-1-1/index.js"></script>
  52 <script type="text/javascript" src="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery-datetimepicker-2-5-4/build/jquery.datetimepicker.full.min.js"></script>
  53
  54 <script language="JavaScript">
  55  $(document).ready(function() {
  56   var win = top.printLogSetup ? top : opener.top;
  57   win.printLogSetup(document.getElementById('printbutton'));
  58
  59   $('.datepicker').datetimepicker({
  60    <?php $datetimepicker_timepicker = false; ?>
  61    <?php $datetimepicker_showseconds = false; ?>
  62    <?php $datetimepicker_formatInput = false; ?>
  63    <?php require($GLOBALS['srcdir'] . '/js/xl/jquery-datetimepicker-2-5-4.js.php'); ?>
  64    <?php // can add any additional javascript settings to datetimepicker here; need to prepend first setting with a comma ?>
  65   });
  66  });
  67 </script>
  68
  69 </head>
  70 <body class="body_top">
  71 <p><span class="forms-title"><?php echo xlt('Treatment Planning'); ?></span></p>
  72 </br>
  73 <?php
  74 echo "<form method='post' name='my_form' " .
  75   "action='$rootdir/forms/treatment_plan/save.php?id=" . attr($formid) ."'>\n";
  76 ?>
  77
  78 <table  border="0">
  79
  80 <tr>
  81 <td align="left" class="forms" class="forms"><?php echo xlt('Client Name' ); ?>:</td>
  82                 <td class="forms">
  83                         <label class="forms-data"> <?php if (is_numeric($pid)) {
  84
  85     $result = getPatientData($pid, "fname,lname,squad");
  86    echo text($result['fname'])." ".text($result['lname']);}
  87    $patient_name=($result['fname'])." ".($result['lname']);
  88    ?>
  89    </label>
  90    <input type="hidden" name="client_name" value="<?php echo attr($patient_name);?>">
  91                 </td>
  92                 <td align="left"  class="forms"><?php echo xlt('DOB'); ?>:</td>
  93                 <td class="forms">
  94                 <label class="forms-data"> <?php if (is_numeric($pid)) {
  95
  96     $result = getPatientData($pid, "*");
  97    echo text($result['DOB']);}
  98    $dob=($result['DOB']);
  99    ?>
 100    </label>
 101      <input type="hidden" name="DOB" value="<?php echo attr($dob);?>">
 102                 </td>
 103                 </tr>
 104         <tr>
 105           <td align="left"  class="forms"><?php echo xlt('Client Number'); ?>:</td>
 106                 <td class="forms">
 107                         <label class="forms-data" > <?php if (is_numeric($pid)) {
 108
 109     $result = getPatientData($pid, "*");
 110    echo text($result['pid']);}
 111    $patient_id=$result['pid'];
 112    ?>
 113    </label>
 114     <input type="hidden" name="client_number" value="<?php echo attr($patient_id);?>">
 115                 </td>
 116
 117
 118                 <td align="left" class="forms"><?php echo xlt('Admit Date'); ?>:</td>
 119                 <td class="forms">
 120                            <input type='text' size='10' class='datepicker' name='admit_date' id='admission_date' <?php echo attr($disabled) ?>;
 121                            value='<?php echo attr($obj{"admit_date"}); ?>'
 122                            title='<?php echo xla('yyyy-mm-dd Date of service'); ?>' />
 123                 </td>
 124
 125                 </tr>
 126                 <tr>
 127                 <td align="left" class="forms"><?php echo xlt('Provider'); ?>:</td>
 128                  <td class="forms" width="280px">
 129  <?php
 130
 131     echo "<select name='provider' style='width:60%' />";
 132     while ($urow = sqlFetchArray($ures)) {
 133       echo "    <option value='" . attr($urow['lname']) . "'";
 134       if ($urow['lname'] == attr($obj{"provider"})) echo " selected";
 135       echo ">" . text($urow['lname']);
 136       if ($urow['fname']) echo ", " . text($urow['fname']);
 137       echo "</option>\n";
 138     }
 139     echo "</select>";
 140 ?>
 141                 </td>
 142
 143                 </tr>
 144
 145         <tr>
 146
 147   <td colspan='3' nowrap style='font-size:8pt'>
 148    &nbsp;
 149         </td>
 150         </tr>
 151
 152         <tr>
 153                 <td align="left" class="forms"><?php echo xlt('Presenting Issue(s)'); ?>:</td>
 154                 <td colspan="3"><textarea name="presenting_issues" rows="2" cols="60" wrap="virtual name"><?php echo text($obj{"presenting_issues"});?></textarea></td>
 155
 156         </tr>
 157         <tr>
 158                 <td align="left" class="forms"><?php echo xlt('Patient History'); ?>:</td>
 159                 <td colspan="3"><textarea name="patient_history" rows="2" cols="60" wrap="virtual name"><?php echo text($obj{"patient_history"});?></textarea></td>
 160
 161         </tr>
 162         <tr>
 163
 164                 <td align="left" class="forms"><?php echo xlt('Medications'); ?>:</td>
 165                 <td colspan="3"><textarea name="medications" rows="2" cols="60" wrap="virtual name"><?php echo text($obj{"medications"});?></textarea></td>
 166
 167
 168         </tr>
 169         <tr>
 170                 <td align="left" class="forms"><?php echo xlt('Anyother Relevant Information'); ?>:</td>
 171                 <td colspan="3"><textarea name="anyother_relevant_information" rows="2" cols="60" wrap="virtual name"><?php echo text($obj{"anyother_relevant_information"});?></textarea></td>
 172
 173         </tr>
 174         <tr>
 175                 <td align="left" class="forms"><?php echo xlt('Diagnosis'); ?>:</td>
 176                 <td colspan="3"><textarea name="diagnosis" rows="2" cols="60" wrap="virtual name"><?php echo text($obj{"diagnosis"});?></textarea></td>
 177
 178         </tr>
 179         <tr>
 180                 <td align="left" class="forms"><?php echo xlt('Treatment Received'); ?>:</td>
 181                 <td colspan="3"><textarea name="treatment_received" rows="2" cols="60" wrap="virtual name"><?php echo text($obj{"treatment_received"});?></textarea></td>
 182
 183         </tr>
 184         <tr>
 185                 <td align="left" class="forms"><?php echo xlt('Recommendation For Follow Up'); ?>:</td>
 186                 <td colspan="3"><textarea name="recommendation_for_follow_up" rows="2" cols="60" wrap="virtual name"><?php echo text($obj{"recommendation_for_follow_up"});?></textarea></td>
 187
 188         </tr>
 189         <tr>
 190                 <td align="left colspan="3" style="padding-bottom:7px;"></td>
 191         </tr>
 192         <tr>
 193                 <td align="left colspan="3" style="padding-bottom:7px;"></td>
 194         </tr>
 195         <tr>
 196                 <td></td>
 197     <td><input type='submit'  value='<?php echo xlt('Save');?>' class="button-css">&nbsp;
 198   <input type='button' value='<?php echo xla('Print'); ?>' id='printbutton' />&nbsp;
 199
 200         <input type='button' class="button-css" value='<?php echo xlt('Cancel');?>'
 201  onclick="top.restoreSession();location='<?php echo "$rootdir/patient_file/encounter/$returnurl" ?>'" /></td>
 202         </tr>
 203 </table>
 204 </form>
 205 <?php
 206 formFooter();
 207 ?>