contrib/forms/hand/templates/general_new.html

   1 <html>
   2 <head>
   3 {php}html_header_show();{/php}
   4 {literal}
   5
   6  <style type="text/css" title="mystyles" media="all">
   7 <!--
   8 td {
   9         font-size:12pt;
  10         font-family:helvetica;
  11 }
  12 li{
  13         font-size:11pt;
  14         font-family:helvetica;
  15         margin-left: 15px;
  16 }
  17 a {
  18         font-size:11pt;
  19         font-family:helvetica;
  20 }
  21 .title {
  22         font-family: sans-serif;
  23         font-size: 12pt;
  24         font-weight: bold;
  25         text-decoration: none;
  26         color: #000000;
  27 }
  28
  29 .form_text{
  30         font-family: sans-serif;
  31         font-size: 9pt;
  32         text-decoration: none;
  33         color: #000000;
  34 }
  35
  36 -->
  37 </style>
  38 {/literal}
  39 </head>
  40 <body bgcolor="{$STYLE.BGCOLOR2}">
  41 <p><span class="title">Grip Strength</span></p>
  42 <form name="soap" method="post" action="{$FORM_ACTION}/interface/forms/hand/save.php"
  43  onsubmit="return top.restoreSession()">
  44 <table border='1px' cellspacing='1px'; cellpadding='1px'>
  45         <tr>
  46                 <td><b>Grip Strength</b></td>
  47                 <td><b>1st</b></td>
  48                 <td><b>2nd</b></td>
  49                 <td><b>3rd</b></td>
  50         </tr>
  51         <tr>
  52                 <td><b>Left Hand</b></td>
  53                 <td><b><input type='text' size='15px' name='left_1' value='{$data->get_left_1()}'> fp</td>
  54                 <td><b><input type='text' size='15px' name='left_2' value='{$data->get_left_2()}'> fp</td>
  55                 <td><b><input type='text' size='15px' name='left_3' value='{$data->get_left_3()}'> fp</td>
  56         </tr>
  57         <tr>
  58                 <td><b>Right Hand</b></td>
  59                 <td><b><input type='text' size='15px' name='right_1' value='{$data->get_right_1()}'> fp</td>
  60                 <td><b><input type='text' size='15px' name='right_2' value='{$data->get_right_2()}'> fp</td>
  61                 <td><b><input type='text' size='15px' name='right_3' value='{$data->get_right_3()}'> fp</td>
  62         </tr>
  63 </table>
  64
  65 <table border=0 cellpadding=0 cellspacing=0>
  66         <tr>
  67         <td>Handedness:</td>
  68         <td><INPUT TYPE=radio NAME='handedness' VALUE='Left' '{$data->get_handedness_l()}'></td><td><span class='text'>Left</span></td>
  69         <td><INPUT TYPE=radio NAME='handedness' VALUE='Right'  '{$data->get_handedness_r()}'></td><td><span class='text'>Right</span></td>
  70         <td><INPUT TYPE=radio NAME='handedness' VALUE='Both' '{$data->get_handedness_b()}'></td><td><span class='text'>Both</span></td>
  71         </tr>
  72 </table>
  73
  74 </p>
  75 <table border='0' cellpadding='0' cellspacing='0' class='text'>
  76         <tr class='text'>
  77                 <td><b>NOTES</b></td>
  78         </tr>
  79         <tr class='text'>
  80                 <td><textarea cols='80' rows='5' name='notes'>{$data->get_notes()}</textarea></td>
  81         </tr>
  82 </table>
  83
  84 <table>
  85         <tr>
  86                 <td>
  87                         <input type="submit" name="Submit" value="Save Form">
  88                 </td>
  89                 <td>
  90                         <a href="{$DONT_SAVE_LINK}" class="link">[Don't Save]</a>
  91                 </td>
  92         </tr>
  93 </table>
  94 <input type="hidden" name="id" value="{$data->get_id()}" />
  95 <input type="hidden" name="pid" value="{$data->get_pid()}">
  96 <input type="hidden" name="process" value="true">
  97 </form>
  98 </body>
  99 </html>