contrib/forms/ped_pain/new.php

   1 <?php
   2
   3 // file new.php
   4
   5 // presents a blank form for evaluating pediatric pain
   6
   7 // this file made by andres@paglayan.com on 2004-09-23
   8
   9 // input designed by Lowell Gordon, MD lgordon@whssf.org
  10
  11 // to max the billing complexity coding
  12
  13
  14
  15 include_once("../../globals.php");
  16
  17 include_once("../../../library/api.inc");
  18
  19 formHeader("Pediatric Pain Evaluation");
  20
  21
  22
  23 ?>
  24
  25 <html><head>
  26 <?php html_header_show();?>
  27
  28 <link rel="stylesheet" href="<?php echo $css_header;?>" type="text/css">
  29
  30 </head>
  31
  32 <body class="body_top">
  33
  34
  35
  36 <!--REM note that every input method has the same name as a valid column, this will make things easier in save.php -->
  37
  38
  39
  40 <br>
  41
  42 <form method='post' action="<?php echo $rootdir;?>/forms/ped_pain/save.php?mode=new" name='ped_pain' >
  43
  44
  45
  46 <!-- the form goes here -->
  47
  48 <?php
  49
  50         $obj=array(); // just to avoid undeclared var warning
  51
  52         include ('form.php'); // to use a single file for both, empty and editing
  53
  54 ?>
  55
  56 <!-- the form ends here -->
  57
  58
  59
  60 <!--REM note our nifty jscript submit -->
  61
  62 <a href="javascript:top.restoreSession();document.ped_pain.submit();" class="link_submit">[Save]</a>
  63
  64 <br>
  65
  66
  67
  68 <a href="<?php echo $GLOBALS['form_exit_url']; ?>" class="link" onclick="top.restoreSession()">[Don't Save]</a>
  69
  70 </form>
  71
  72
  73
  74 <?php
  75
  76 formFooter();
  77
  78 ?>
  79