interface/new/new.php

   1 <?php
   2 /**
   3 *
   4 * LICENSE: This program is free software; you can redistribute it and/or
   5 * modify it under the terms of the GNU General Public License
   6 * as published by the Free Software Foundation; either version 3
   7 * of the License, or (at your option) any later version.
   8 * This program is distributed in the hope that it will be useful,
   9 * but WITHOUT ANY WARRANTY; without even the implied warranty of
  10 * MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE.  See the
  11 * GNU General Public License for more details.
  12 * You should have received a copy of the GNU General Public License
  13 * along with this program.  If not, see <http://opensource.org/licenses/gpl-license.php>.
  14 *
  15 * @package   OpenEMR
  16 * @author    Brady Miller <brady.g.miller@gmail.com>
  17 * @link      http://www.open-emr.org
  18 */
  19
  20 include_once("../globals.php");
  21
  22 if ($GLOBALS['full_new_patient_form']) {
  23   require("new_comprehensive.php");
  24   exit;
  25 }
  26
  27 // For a layout field return 0=unused, 1=optional, 2=mandatory.
  28 function getLayoutUOR($form_id, $field_id) {
  29   $crow = sqlQuery("SELECT uor FROM layout_options WHERE " .
  30     "form_id = '$form_id' AND field_id = '$field_id' LIMIT 1");
  31   return 0 + $crow['uor'];
  32 }
  33
  34 // Determine if the registration date should be requested.
  35 $regstyle = getLayoutUOR('DEM','regdate') ? "" : " style='display:none'";
  36
  37 $form_pubpid    = $_POST['pubpid'   ] ? trim($_POST['pubpid'   ]) : '';
  38 $form_title     = $_POST['title'    ] ? trim($_POST['title'    ]) : '';
  39 $form_fname     = $_POST['fname'    ] ? trim($_POST['fname'    ]) : '';
  40 $form_mname     = $_POST['mname'    ] ? trim($_POST['mname'    ]) : '';
  41 $form_lname     = $_POST['lname'    ] ? trim($_POST['lname'    ]) : '';
  42 $form_refsource = $_POST['refsource'] ? trim($_POST['refsource']) : '';
  43 $form_sex       = $_POST['sex'      ] ? trim($_POST['sex'      ]) : '';
  44 $form_refsource = $_POST['refsource'] ? trim($_POST['refsource']) : '';
  45 $form_dob       = $_POST['DOB'      ] ? trim($_POST['DOB'      ]) : '';
  46 $form_regdate   = $_POST['regdate'  ] ? trim($_POST['regdate'  ]) : date('Y-m-d');
  47 ?>
  48 <html>
  49
  50 <head>
  51 <?php html_header_show(); ?>
  52 <link rel="stylesheet" href="<?php echo xl($css_header,'e');?>" type="text/css">
  53 <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery-datetimepicker-2-5-4/build/jquery.datetimepicker.min.css">
  54
  55 <script type="text/javascript" src="../../library/textformat.js?v=<?php echo $v_js_includes; ?>"></script>
  56 <script type="text/javascript" src="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery-min-3-1-1/index.js"></script>
  57 <script type="text/javascript" src="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery-datetimepicker-2-5-4/build/jquery.datetimepicker.full.min.js"></script>
  58
  59 <?php include_once("{$GLOBALS['srcdir']}/options.js.php"); ?>
  60
  61 <script LANGUAGE="JavaScript">
  62
  63  var mypcc = '1';
  64
  65  function validate() {
  66   var f = document.forms[0];
  67 <?php if ($GLOBALS['inhouse_pharmacy']) { ?>
  68   if (f.refsource.selectedIndex <= 0) {
  69    alert('Please select a referral source!');
  70    return false;
  71   }
  72 <?php } ?>
  73 <?php if (getLayoutUOR('DEM','sex') == 2) { ?>
  74   if (f.sex.selectedIndex <= 0) {
  75    alert('Please select a value for sex!');
  76    return false;
  77   }
  78 <?php } ?>
  79 <?php if (getLayoutUOR('DEM','DOB') == 2) { ?>
  80   if (f.DOB.value.length == 0) {
  81    alert('Please select a birth date!');
  82    return false;
  83   }
  84 <?php } ?>
  85   top.restoreSession();
  86   return true;
  87  }
  88
  89 $(document).ready(function(){
  90     $('.datepicker').datetimepicker({
  91       <?php $datetimepicker_timepicker = false; ?>
  92       <?php $datetimepicker_showseconds = false; ?>
  93       <?php $datetimepicker_formatInput = false; ?>
  94       <?php require($GLOBALS['srcdir'] . '/js/xl/jquery-datetimepicker-2-5-4.js.php'); ?>
  95       <?php // can add any additional javascript settings to datetimepicker here; need to prepend first setting with a comma ?>
  96     });
  97     $('.datetimepicker').datetimepicker({
  98       <?php $datetimepicker_timepicker = true; ?>
  99       <?php $datetimepicker_showseconds = false; ?>
 100       <?php $datetimepicker_formatInput = false; ?>
 101       <?php require($GLOBALS['srcdir'] . '/js/xl/jquery-datetimepicker-2-5-4.js.php'); ?>
 102       <?php // can add any additional javascript settings to datetimepicker here; need to prepend first setting with a comma ?>
 103     });
 104 });
 105
 106 </script>
 107
 108 </head>
 109
 110 <body class="body_top" onload="javascript:document.new_patient.fname.focus();">
 111
 112 <form name='new_patient' method='post' action="new_patient_save.php"
 113  onsubmit='return validate()'>
 114 <span class='title'><?php xl('Add Patient Record','e');?></span>
 115
 116 <br><br>
 117
 118 <center>
 119
 120 <?php if ($GLOBALS['omit_employers']) { ?>
 121    <input type='hidden' name='title' value='' />
 122 <?php } ?>
 123
 124 <table border='0'>
 125
 126 <?php if (!$GLOBALS['omit_employers']) { ?>
 127  <tr>
 128   <td>
 129    <span class='bold'><?php xl('Title','e');?>: </span>
 130   </td>
 131   <td>
 132    <select name='title'>
 133 <?php
 134 $ores = sqlStatement("SELECT option_id, title FROM list_options " .
 135   "WHERE list_id = 'titles' AND activity = 1 ORDER BY seq");
 136 while ($orow = sqlFetchArray($ores)) {
 137   echo "    <option value='" . $orow['option_id'] . "'";
 138   if ($orow['option_id'] == $form_title) echo " selected";
 139   echo ">" . $orow['title'] . "</option>\n";
 140 }
 141 ?>
 142    </select>
 143   </td>
 144  </tr>
 145 <?php } ?>
 146
 147  <tr>
 148   <td>
 149    <span class='bold'><?php xl('First Name','e');?>: </span>
 150   </td>
 151   <td>
 152    <input type='entry' size='15' name='fname' value='<?php echo $form_fname; ?>'>
 153   </td>
 154  </tr>
 155
 156  <tr>
 157   <td>
 158    <span class='bold'><?php xl('Middle Name','e');?>: </span>
 159   </td>
 160   <td>
 161    <input type='entry' size='15' name='mname' value='<?php echo $form_mname; ?>'>
 162   </td>
 163  </tr>
 164
 165  <tr>
 166   <td>
 167    <span class='bold'><?php xl('Last Name','e');?>: </span>
 168   </td>
 169   <td>
 170    <input type='entry' size='15' name='lname' value='<?php echo $form_lname; ?>'>
 171   </td>
 172  </tr>
 173
 174  <tr>
 175   <td>
 176    <span class='bold'><?php xl('Sex','e'); ?>: </span>
 177   </td>
 178   <td>
 179    <select name='sex'>
 180     <option value=''>Unassigned</option>
 181 <?php
 182 $ores = sqlStatement("SELECT option_id, title FROM list_options " .
 183   "WHERE list_id = 'sex' AND activity = 1 ORDER BY seq");
 184 while ($orow = sqlFetchArray($ores)) {
 185   echo "    <option value='" . $orow['option_id'] . "'";
 186   if ($orow['option_id'] == $form_sex) echo " selected";
 187   echo ">" . $orow['title'] . "</option>\n";
 188 }
 189 ?>
 190    </select>
 191   </td>
 192  </tr>
 193
 194 <?php if ($GLOBALS['inhouse_pharmacy']) { ?>
 195  <tr>
 196   <td>
 197    <span class='bold'><?php xl('Referral Source','e'); ?>: </span>
 198   </td>
 199   <td>
 200    <select name='refsource'>
 201     <option value=''>Unassigned</option>
 202 <?php
 203 $ores = sqlStatement("SELECT option_id, title FROM list_options " .
 204   "WHERE list_id = 'refsource' AND activity = 1 ORDER BY seq");
 205 while ($orow = sqlFetchArray($ores)) {
 206   echo "    <option value='" . $orow['option_id'] . "'";
 207   if ($orow['option_id'] == $form_refsource) echo " selected";
 208   echo ">" . $orow['title'] . "</option>\n";
 209 }
 210 ?>
 211    </select>
 212   </td>
 213  </tr>
 214 <?php } ?>
 215
 216  <tr>
 217   <td>
 218    <span class='bold'><?php xl('Birth Date','e');?>: </span>
 219   </td>
 220   <td>
 221    <input type='text' size='10' class='datepicker' name='DOB' id='DOB'
 222     value='<?php echo $form_dob; ?>'
 223     title='yyyy-mm-dd' />
 224   </td>
 225  </tr>
 226
 227  <tr<?php echo $regstyle ?>>
 228   <td>
 229    <span class='bold'><?php xl('Registration Date','e');?>: </span>
 230   </td>
 231   <td>
 232    <input type='text' size='10' class='datepicker' name='regdate' id='regdate'
 233     value='<?php echo $form_regdate; ?>'
 234     title='yyyy-mm-dd' />
 235   </td>
 236  </tr>
 237
 238  <tr>
 239   <td>
 240    <span class='bold'><?php xl('Patient Number','e');?>: </span>
 241   </td>
 242   <td>
 243    <input type='entry' size='5' name='pubpid' value='<?php echo $form_pubpid; ?>'>
 244    <span class='text'><?php xl('omit to autoassign','e');?> &nbsp; &nbsp; </span>
 245   </td>
 246  </tr>
 247
 248  <tr>
 249   <td colspan='2'>
 250    &nbsp;<br>
 251    <input type='submit' name='form_create' value=<?php xl('Create New Patient','e'); ?> />
 252   </td>
 253   <td>
 254   </td>
 255  </tr>
 256
 257 </table>
 258 </center>
 259 </form>
 260 <script language="Javascript">
 261 <?php
 262 if ($form_pubpid) {
 263   echo "alert('" . xl('This patient ID is already in use!') . "');\n";
 264 }
 265 ?>
 266 </script>
 267
 268 </body>
 269 </html>