Improve flexibility of which code types are used in claims and other misc.
[openemr.git] / contrib / forms / documents / new.php
blobdba281e24230d2e18ff94033a6e975c0eabcacaf
1 <?php
4 // file new.php
6 // presents a blank form to upload an image file
8 // this file made by andres@paglayan.com on 2004-04-23
10 // custom from for uploading scanned documents into the emr.
12 include_once("../../globals.php");
14 include_once("../../../library/api.inc");
16 formHeader("Scanned Documents Input");
22 <html><head>
23 <?php html_header_show();?>
25 <link rel=stylesheet href="<?echo $css_header;?>" type="text/css">
27 </head>
29 <body <?echo $top_bg_line;?> topmargin=0 rightmargin=0 leftmargin=2 bottommargin=0 marginwidth=2 marginheight=0>
33 <!--REM note that every input method has the same name as a valid column, this will make things easier in save.php -->
37 <br>
39 <form method='post' action="<?echo $rootdir;?>/forms/documents/save.php?mode=new" name='document_form' enctype="multipart/form-data">
41 <span class=title>Scanned Documents Input</span>
43 <br>
47 <span class=text>Document:</span><br>
49 <input type="file" name="document_image"><br>
53 <br>
55 <span class=text>Description:</span> <input type=text name="document_description">
57 <br>
61 <span class=text>Who sent it?:</span> <input type=text name="document_source">
63 <br>
67 <!--REM note our nifty jscript submit -->
69 <input type="hidden" name="action" value="submit">
71 <a href="javascript:top.restoreSession();document.document_form.submit();" class="link_submit">[Save]</a>
73 <br>
77 <a href="<?php echo $GLOBALS['form_exit_url']; ?>" class="link" onclick="top.restoreSession()">[Don't Save]</a>
79 </form>
83 <?php
85 formFooter();