1 <!-- Forms generated from formsWiz
-->
3 include_once("../../globals.php");
6 <?php
html_header_show();?
>
7 <link rel
=stylesheet href
="<?php echo $css_header;?>" type
="text/css">
9 <body
class="body_top">
11 include_once("$srcdir/api.inc");
12 $obj = formFetch("form_vision", $_GET["id"]);
14 <form method
=post action
="<?php echo $rootdir?>/forms/vision/save.php?mode=update&id=<?php echo $_GET["id
"];?>" name
="my_form">
15 <span
class="title">Vision
</span
><Br
><br
>
16 <span
class=bold
>Keratometry
</span
><br
>
20 <td
><span
class=text
>OD K1
: </span
></td
><td
><input size
=3 type
=entry name
="od_k1" value
="<?php echo $obj{"od_k1
"};?>" ></td
>
21 <td
><span
class=text
>OD K1 Axis
: </span
></td
><td
><input size
=3 type
=entry name
="od_k1_axis" value
="<?php echo $obj{"od_k1_axis
"};?>" ></td
>
22 <td
><span
class=text
>OD K2
: </span
></td
><td
><input size
=3 type
=entry name
="od_k2" value
="<?php echo $obj{"od_k2
"};?>" ></td
>
23 <td
><span
class=text
>OD K2 Axis
: </span
></td
><td
><input size
=3 type
=entry name
="od_k2_axis" value
="<?php echo $obj{"od_k2_axis
"};?>" ></td
>
27 <span
class=text
>OD Testing Status
: </span
><input type
=entry name
="od_testing_status" value
="<?php echo $obj{"od_testing_status
"};?>" >
35 <td
><span
class=text
>OS K1
: </span
></td
><td
><input size
=3 type
=entry name
="os_k1" value
="<?php echo $obj{"os_k1
"};?>" ></td
>
36 <td
><span
class=text
>OS K1 Axis
: </span
></td
><td
><input size
=3 type
=entry name
="os_k1_axis" value
="<?php echo $obj{"os_k1_axis
"};?>" ></td
>
37 <td
><span
class=text
>OS K2
: </span
></td
><td
><input size
=3 type
=entry name
="os_k2" value
="<?php echo $obj{"os_k2
"};?>" ></td
>
38 <td
><span
class=text
>OS K2 Axis
: </span
></td
><td
><input size
=3 type
=entry name
="os_k2_axis" value
="<?php echo $obj{"os_k2_axis
"};?>" ></td
>
42 <span
class=text
>OS Testing Status
: </span
><input type
=entry name
="os_testing_status" value
="<?php echo $obj{"os_testing_status
"};?>" >
48 <span
class=text
>Additional Notes
: </span
><br
><textarea cols
=40 rows
=8 wrap
=virtual name
="additional_notes" ><?php
echo $obj{"additional_notes"};?
></textarea
>
50 <a href
="javascript:top.restoreSession();document.my_form.submit();" class="link_submit">[Save
]</a
>
52 <a href
="<?php echo $GLOBALS['form_exit_url']; ?>" class="link" onclick
="top.restoreSession()">[Don
't Save Changes]</a>