Revert "Contributed GYM Forms, some of the table.sql files include inserts into list_...
[openemr.git] / interface / patient_file / encounter / other.php
blob2bb7874f9b1b50181f82ef9fb07f5d2fab3b6052
1 <?php
2 include_once("../../globals.php");
3 include_once("$srcdir/sql.inc");
5 //the number of rows to display before resetting and starting a new column:
6 $N=10
7 ?>
9 <html>
10 <head>
11 <?php html_header_show();?>
13 <link rel="stylesheet" href="<?php echo $css_header;?>" type="text/css">
14 </head>
15 <body class="body_bottom">
17 <table border=0 cellspacing=0 cellpadding=0 height=100%>
18 <tr>
20 <td valign=top>
22 <dl>
24 <form method='post' name='other_form' action="diagnosis.php?mode=add&type=OTHER"
25 target='Diagnosis' onsubmit='return top.restoreSession()'>
26 <script type="text/javascript">
27 function clearform(atrib){
28 document.other_form.text.value=document.other_form.textH.value;
29 document.other_form.code.value=document.other_form.codeH.value;
30 document.other_form.fee.value=document.other_form.feeH.value*document.other_form.noofunits.value;
31 document.other_form.units.value=document.other_form.noofunits.value;
32 document.other_form.textH.value='';
33 document.other_form.codeH.value='';
34 document.other_form.feeH.value='';
35 document.other_form.noofunits.value='1';
37 function isNumberKey(evt)
38 {var charCode = (evt.which) ? evt.which : event.keyCode
39 if (charCode > 31 && (charCode < 48 || charCode > 57))
41 alert("<?php xl('Units must be a number','e'); ?>");
42 return false;
44 return true; }
45 </script>
46 <dt><span class=title><?php xl('Other','e'); ?></span></dt>
48 <br>
49 <table>
50 <tr>
51 <td class="text"><?php xl('code','e'); ?></td>
52 <td class="text"><?php xl('description','e'); ?></td>
53 <td class="text">&nbsp;&nbsp;&nbsp;<?php xl('fee','e'); ?></td>
54 <td class="text"><?php xl('units','e'); ?></td>
55 <td></td>
56 </tr>
57 <tr>
58 <input type=hidden name=code>
59 <input type=hidden name=text>
60 <input type=hidden name=fee>
61 <input type=hidden name=units>
62 <td class="text"><input type=entry name=codeH size=4>&nbsp;&nbsp;</td>
63 <td class="text"><input type=entry name=textH size=13 value="">&nbsp;&nbsp;</td>
64 <td class="text"><?php xl('$','e'); ?> </span><input type=entry name=feeH size=5></td>
65 <td> <input type=text name="noofunits" onkeypress="return isNumberKey(event)" size=3 value=1></td>
66 <td>&nbsp;<a class='text' onclick="clearform('clear')" href="javascript:top.restoreSession();document.other_form.submit();">
67 <?php xl('Save','e'); ?> </a>
68 </td>
69 </tr>
70 </table>
71 </form>
73 </dl>
75 </td>
76 </tr>
77 </table>
79 </body>
80 </html>