contrib/forms/xmlformgen/gensurvey_form.xml

   1 <?xml version="1.0" encoding="ISO-8859-1"?>
   2     <!-- Generated by Hand -->
   3 <form>
   4     <table type="form">form_gensurvey</table>
   5     <RealName>General Survey</RealName>
   6     <safename>gensurvey_form</safename>
   7     <style cells_per_row="4">layout</style>
   8     <acl table="patients">med</acl>
   9
  10     <manual>
  11            <section name="patient_particulars" label="Patient Particulars">
  12                 <field name="pts_name" label="Patient Name" type="textfield" size="30" maxlength="255" hoverover="" labelcols="1" cols="1"/>
  13                 <field name="gens_date" label="Date of Visit" type="date" labelcols="1" cols="1"/>
  14                     <field name="genu_age" label="Age" type="textfield" size="10" maxlength="255" hoverover="" labelcols="1" cols="1"/>
  15                         <field name="geny_examined" label="Examined By" type="provider" size="20" hoverover="" labelcols="1" cols="1"/>
  16                 </section>
  17
  18             <section name="gen_survey" label="General Survey">
  19                      <field name="genr_higher" label="Higher Functions" type="textfield" sixe="30" maxlength="255" hoverover="" labelcols="1" cols="1"/>
  20                          <field name="fc_facies" label="Facies" type="textfield" size="30" maxlength="255" hoverover="" labelcols="1" cols="1"/>
  21                          <field name="bu_build" label="Build" type="dropdown_list" size="20" list="build_list" maxlength="255" hoverover="" labelcols="1" cols="1"/>
  22                          <field name="nu_nutri" label="Nutrition" type="textfield" size="30" maxlength="255" hoverver="" labelcols="1" cols="1"/>
  23                          <field name="decu_gen" label="Decubitus" type="dropdown_list" size="20" list="decubitus_list" maxlength="255" hoverover="" labelcols="1" cols="1"/>
  24                          <field name="sur_pal" label="Pallor" type="dropdown_list" size="20" list="present_absent" hoverover="" maxlength="255" labelcols="1" cols="1"/>
  25                          <field name="cya_cyanosis" label="Cyanosis" type="dropdown_list" size="20" list="present_absent" hoverover="" maxlength="255" labelcols="1" cols="1"/>
  26                          <field name="cl_clubbing" label="Clubbing" type="dropdown_list" size="20" list="present_absent" hoverover="" maxlength="255" labelcols="1" cols="1"/>
  27                          <field name="gr_clubgrade" label="Grade of Clubbing" type="dropdown_list" size="20" list="clubbing_grades" maxlength="255" hoverover="" labelcols="1" cols="1"/>
  28                          <field name="ic_icterus" label="Icterus" type="dropdown_list" size="20" list="present_absent" hoverover="" maxlength="255" labelcols="1" cols="1"/>
  29                          <field name="oe_oedema" label="Oedema" type="dropdown_list" size="20" list="present_absent" hoverover="" maxlength="255" labelcols="1" cols="1"/>
  30                          <field name="loc_locoedema" label="Oedema LOcation" type="dropdown_list" size="20" list="oedema_location" maxlength="255" hoverover="" labelcols="1" cols="1"/>
  31                          <field name="vit_vitals" label="Vitals Recorded" type="dropdown_list" size="20" list="yesno" hoverover="" maxlength="255" labelcols="1" cols="1"/>
  32                          <field name="no_node" label="Lymph Nodes" type="textfield" sixe="30" maxlength="255" hoverover="" labelcols="1" cols="1"/>
  33                          <field name="ne_vein" label="Neck Vein" type="textfield" size="30" maxlength="255" hoverover="" labelcols="1" cols="1"/>
  34                          <field name="sk_skin" label="Skin and Appendages" type="textfield" size="30" maxlength="255" hoverover="" labelcols="1" cols="1"/>
  35                          <field name="sku_skull" label="Cranium and Spine" type="textfield" size="30" maxlength="255" hoverover="" labelcols="1" cols="1"/>
  36                          <field name="ex_extra" label="Extra Points" type="textfield" size="30" maxlength="255" hoverover="" labelcols="1" cols="1"/>
  37                          <field name="imp_impression" label="Impression" type="textfield" size="50" maxlength="255" hoverover="" labelcols="1" cols="1"/>
  38                 </section>
  39
  40         </manual>
  41
  42         <list id="build_list" name="build_list" label="Build List" type="standard" import="yes">
  43             <listitem id='1' label="Healthy" order='1'>Healthy</listitem>
  44                 <listitem id='2' label="Average" order='2'>Average</listitem>
  45                 <listitem id='3' label="Lean" order='3'>Lean</listitem>
  46                 <listitem id='4' label="Cachexic" order='4'>Cachexic</listitem>
  47         </list>
  48
  49         <list id="decubitus_list" name="decubitus_list" label="Decubitus List" type="standard" import="yes">
  50             <listitem id='1' label="Of Choice" order='1'>Of Choice</listitem>
  51                 <listitem id='2' label="Sitting" order='2'>Sitting</listitem>
  52                 <listitem id='3' label="Propped Up" order='3'>Propped Up</listitem>
  53                 <listitem id='4' label="Right Lateral" order='4'>Right Lateral</listitem>
  54                 <listitem id='5' label="Left Lateral" order='5'>Left Lateral</listitem>
  55                 <listitem id='6' label="Restless" order='6'>Restless</listitem>
  56         </list>
  57
  58         <list id="clubbing_grades" name="clubbing_grades" label="Clubbing Grades" type="standard" import="yes">
  59             <listitem id='1' label="First Degree" order='1'>First Degree</listitem>
  60                 <listitem id='2' label="Second Degree" order='2'>Second Degree</listitem>
  61                 <listitem id='3' label="Third Degree" order='3'>Third Degree</listitem>
  62                 <listitem id='4' label="Fourth Degree" order='4'>Fourth Degree</listitem>
  63         </list>
  64
  65         <list id="oedema_location" name="oedema_location" label="Oedema Location" type="standard" import="yes">
  66             <listitem id='1' label="Pedal Unilateral Dipping" order='1'>Pedal Unilateral Dipping</listitem>
  67                 <listitem id='2' label="Pedal Bilateral Dipping" order='2'>Pedal Bilateral Dipping</listitem>
  68                 <listitem id='3' label="Pedal Unilateral Non dipping" order='3'>Pedal Unilateral Non dipping</listitem>
  69                 <listitem id='4' label="Pedal Bilateral Non dipping" order='4'>Pedal Bilateral Non dipping</listitem>
  70                 <listitem id='5' label="Parietal" order='5'>Parietal</listitem>
  71                 <listitem id='6' label="Facial" order='6'>Facial</listitem>
  72         </list>
  73
  74         <list name="present_absent" label="Present Absent" type="standard" id="present_absent" import="no"/>
  75         <list name="yesno" label="Yes/No" type="standard" id="yesno" import="no"/>
  76 </form>