contrib/forms/xmlformgen/pelvic_soap.xml

   1 <?xml version="1.0" encoding="ISO-8859-1"?>
   2         <!-- Generated by Hand -->
   3 <form>
   4         <table type="form">form_pelvic_soap</table>
   5         <RealName>POP</RealName>
   6         <safename>pelvic_soap</safename>
   7         <style cells_per_row="2">layout</style>
   8         <acl table="patients">med</acl>
   9
  10         <manual>
  11
  12                 <section name="subjective" label="Subjective">
  13                         <field name="pelvic_complaints" label="Complaints"
  14                                 type="checkbox_combo_list" list="Pelvic_Complaints" size="140" maxlength="255"
  15                                 labelcols="1" cols="1" />
  16                 </section>
  17
  18                 <section name="objective" label="Objective">
  19                         <field name="pelvic_exam" label="Exam"
  20                                 type="checkbox_combo_list" list="Pelvic_Exam" size="140" maxlength="255"
  21                                 labelcols="1" cols="1" />
  22                 </section>
  23
  24                 <section name="assessment" label="Assessment">
  25                         <field name="pelvic_assessment" label="Assessment"
  26                                 type="checkbox_combo_list" list="Pelvic_Assessment" size="140" maxlength="255"
  27                                 labelcols="1" cols="1" />
  28                 </section>
  29
  30                 <section name="plan" label="Plan">
  31                         <field name="pelvic_plan" label="Pelvic Plan" type="checkbox_combo_list"
  32                                 list="Pelvic_Plan" size="140" maxlength="255" labelcols="1" cols="1" />
  33                         <field name="plan_discussion" label="Discussion" type="textarea"
  34                                 columns="151" labelcols="1" cols="1" />
  35                 </section>
  36
  37         </manual>
  38
  39         <list id="Pelvic_Complaints" name="Pelvic_Complaints" label="Pelvic Complaints"
  40                 type="standard" import="yes">
  41                 <listitem id='1' label="Pressure" order="1">Pressure</listitem>
  42                 <listitem id='2' label="Something Down There" order="2">Something Down There</listitem>
  43                 <listitem id='3' label="Bladder Changes" order="3">Bladder Changes</listitem>
  44                 <listitem id='4' label="Bleeding" order="4">Bleeding</listitem>
  45                 <listitem id='5' label="Pain" order="5">Pain</listitem>
  46                 <listitem id='6' label="Other" order="6">Other</listitem>
  47         </list>
  48
  49         <list id="Pelvic_Exam" name="Pelvic_Exam"
  50                 label="Pelvic Exam" type="standard" import="yes">
  51                 <listitem id='1' label="Apical" order="1">Apical</listitem>
  52                 <listitem id='2' label="Cystocele" order="2">Cystocele</listitem>
  53                 <listitem id='3' label="Rectocele" order="3">Rectocele</listitem>
  54                 <listitem id='4' label="POP Q" order="4">POP Q</listitem>
  55                 <listitem id='5' label="Urethra" order="5">Urethra</listitem>
  56                 <listitem id='6' label="Kegels" order="6">Kegels</listitem>
  57                 <listitem id='7' label="Other" order="7">Other</listitem>
  58         </list>
  59
  60         <list id="Pelvic_Assessment" name="Pelvic_Assessment"
  61                 label="Pelvic Assessment" type="standard" import="yes">
  62                 <listitem id='1' label="POP" order="1">POP</listitem>
  63                 <listitem id='2' label="Cystocele" order="2">Cystocele</listitem>
  64                 <listitem id='3' label="Rectocele" order="3">Rectocele</listitem>
  65                 <listitem id='4' label="Apical Prolapse" order="4">Apical Prolapse</listitem>
  66                 <listitem id='5' label="Hypermobile Urethra" order="5">Hypermobile Urethra</listitem>
  67                 <listitem id='6' label="Other" order="6">Other</listitem>
  68         </list>
  69
  70         <list id="Pelvic_Plan" name="Pelvic_Plan" label="Pelvic Plan"
  71                 type="standard" import="yes">
  72                 <listitem id='1' label="Anterior Repair Elevate" order='1'>Anterior Repair Elevate</listitem>
  73                 <listitem id='2' label="Posterior Repair Elevate" order='2'>Posterior Repair Elevate</listitem>
  74                 <listitem id='3' label="Robotic ASC" order='3'>Robotic ASC</listitem>
  75                 <listitem id='4' label="Mini-arc" order='4'>Mini-arc</listitem>
  76                 <listitem id='5' label="Transobterator" order="5">Transoperative Tape (TOT)</listitem>
  77                 <listitem id='6' label="Transvaginal Tape (TVT)" order="6">Transvaginal Tape (TVT)</listitem>
  78                 <listitem id='7' label="Sonogram" order="7">Sonogram</listitem>
  79                 <listitem id='8' label="Cystoscopy" order='8'>Cystoscopy</listitem>
  80                 <listitem id='9' label="Cystometrogram" order='9'>Cystometrogram</listitem>
  81                 <listitem id='10' label="Pessary" order='10'>Pessary</listitem>
  82                 <listitem id='11' label="Kegels" order='11'>Kegels</listitem>
  83                 <listitem id='12' label="Other" order='12'>Other</listitem>
  84         </list>
  85 </form>