interface/patient_file/summary/add_edit_issue.php

   1 <?php
   2 // Copyright (C) 2005-2008 Rod Roark <rod@sunsetsystems.com>
   3 //
   4 // 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 2
   7 // of the License, or (at your option) any later version.
   8
   9 require_once("../../globals.php");
  10 require_once("$srcdir/lists.inc");
  11 require_once("$srcdir/patient.inc");
  12 require_once("$srcdir/acl.inc");
  13
  14 if ($ISSUE_TYPES['football_injury']) {
  15   // Most of the logic for the "football injury" issue type comes from this
  16   // included script.  We might eventually refine this approach to support
  17   // a plug-in architecture for custom issue types.
  18   require_once("$srcdir/football_injury.inc.php");
  19 }
  20 if ($ISSUE_TYPES['ippf_gcac']) {
  21   // Similarly for IPPF issues.
  22   require_once("$srcdir/ippf_issues.inc.php");
  23 }
  24
  25 $diagnosis_type = $GLOBALS['athletic_team'] ? 'OSICS10' : 'ICD9';
  26
  27 $issue = $_REQUEST['issue'];
  28 $thispid = $_REQUEST['thispid'] ? $_REQUEST['thispid'] : $pid;
  29 $info_msg = "";
  30
  31 $thisauth = acl_check('patients', 'med');
  32 if ($issue && $thisauth != 'write') die("Edit is not authorized!");
  33 if ($thisauth != 'write' && $thisauth != 'addonly') die("Add is not authorized!");
  34
  35 $tmp = getPatientData($thispid, "squad");
  36 if ($tmp['squad'] && ! acl_check('squads', $tmp['squad']))
  37   die("Not authorized for this squad!");
  38
  39 function QuotedOrNull($fld) {
  40   if ($fld) return "'$fld'";
  41   return "NULL";
  42 }
  43
  44 function rbvalue($rbname) {
  45   $tmp = $_POST[$rbname];
  46   if (! $tmp) $tmp = '0';
  47   return "'$tmp'";
  48 }
  49
  50 function cbvalue($cbname) {
  51   return $_POST[$cbname] ? '1' : '0';
  52 }
  53
  54 function invalue($inname) {
  55   return (int) trim($_POST[$inname]);
  56 }
  57
  58 function txvalue($txname) {
  59   return "'" . trim($_POST[$txname]) . "'";
  60 }
  61
  62 function rbinput($name, $value, $desc, $colname) {
  63   global $irow;
  64   $ret  = "<input type='radio' name='$name' value='$value'";
  65   if ($irow[$colname] == $value) $ret .= " checked";
  66   $ret .= " />$desc";
  67   return $ret;
  68 }
  69
  70 function rbcell($name, $value, $desc, $colname) {
  71  return "<td width='25%' nowrap>" . rbinput($name, $value, $desc, $colname) . "</td>\n";
  72 }
  73
  74 // If we are saving, then save and close the window.
  75 //
  76 if ($_POST['form_save']) {
  77
  78   $i = 0;
  79   $text_type = "unknown";
  80   foreach ($ISSUE_TYPES as $key => $value) {
  81    if ($i++ == $_POST['form_type']) $text_type = $key;
  82   }
  83
  84   $form_begin = fixDate($_POST['form_begin'], '');
  85   $form_end   = fixDate($_POST['form_end'], '');
  86
  87   if ($issue) {
  88
  89    $query = "UPDATE lists SET " .
  90     "type = '"        . $text_type                  . "', " .
  91     "title = '"       . $_POST['form_title']        . "', " .
  92     "comments = '"    . $_POST['form_comments']     . "', " .
  93     "begdate = "      . QuotedOrNull($form_begin)   . ", "  .
  94     "enddate = "      . QuotedOrNull($form_end)     . ", "  .
  95     "returndate = "   . QuotedOrNull($form_return)  . ", "  .
  96     "diagnosis = '"   . $_POST['form_diagnosis']    . "', " .
  97     "occurrence = '"  . $_POST['form_occur']        . "', " .
  98     "classification = '" . $_POST['form_classification'] . "', " .
  99     "referredby = '"  . $_POST['form_referredby']   . "', " .
 100     "extrainfo = '"   . $_POST['form_missed']       . "', " .
 101     "outcome = "      . rbvalue('form_outcome')     . ", "  .
 102 //  "destination = "  . rbvalue('form_destination') . " "   . // radio button version
 103     "destination = '" . $_POST['form_destination']   . "' "  .
 104     "WHERE id = '$issue'";
 105     sqlStatement($query);
 106     if ($text_type == "medication" && enddate != '') {
 107       sqlStatement('UPDATE prescriptions SET '
 108         . 'medication = 0 where patient_id = ' . $thispid
 109         . " and upper(trim(drug)) = '" . strtoupper($_POST['form_title']) . "' "
 110         . ' and medication = 1' );
 111     }
 112
 113   } else {
 114
 115    $issue = sqlInsert("INSERT INTO lists ( " .
 116     "date, pid, type, title, activity, comments, begdate, enddate, returndate, " .
 117     "diagnosis, occurrence, classification, referredby, extrainfo, user, groupname, " .
 118     "outcome, destination " .
 119     ") VALUES ( " .
 120     "NOW(), " .
 121     "'$thispid', " .
 122     "'" . $text_type                 . "', " .
 123     "'" . $_POST['form_title']       . "', " .
 124     "1, "                            .
 125     "'" . $_POST['form_comments']    . "', " .
 126     QuotedOrNull($form_begin)        . ", "  .
 127     QuotedOrNull($form_end)          . ", "  .
 128     QuotedOrNull($form_return)       . ", "  .
 129     "'" . $_POST['form_diagnosis']   . "', " .
 130     "'" . $_POST['form_occur']       . "', " .
 131     "'" . $_POST['form_classification'] . "', " .
 132     "'" . $_POST['form_referredby']  . "', " .
 133     "'" . $_POST['form_missed']      . "', " .
 134     "'" . $$_SESSION['authUser']     . "', " .
 135     "'" . $$_SESSION['authProvider'] . "', " .
 136    rbvalue('form_outcome')           . ", "  .
 137 // rbvalue('form_destination')       . " "   . // radio button version
 138     "'" . $_POST['form_destination'] . "' "  .
 139    ")");
 140
 141   }
 142
 143   if ($text_type == 'football_injury') issue_football_injury_save($issue);
 144   if ($text_type == 'ippf_gcac'      ) issue_ippf_gcac_save($issue);
 145   if ($text_type == 'contraceptive'  ) issue_ippf_con_save($issue);
 146   // if ($text_type == 'ippf_srh'       ) issue_ippf_srh_save($issue);
 147
 148   $tmp_title = $ISSUE_TYPES[$text_type][2] . ": $form_begin " .
 149    substr($_POST['form_title'], 0, 40);
 150
 151   // Close this window and redisplay the updated list of issues.
 152   //
 153   echo "<html><body><script language='JavaScript'>\n";
 154   if ($info_msg) echo " alert('$info_msg');\n";
 155   echo " window.close();\n";
 156   // echo " opener.location.reload();\n";
 157   echo " if (opener.refreshIssue) opener.refreshIssue($issue,'$tmp_title');\n";
 158   echo "</script></body></html>\n";
 159   exit();
 160 }
 161
 162 $irow = array();
 163 $type_index = 0;
 164
 165 if ($issue) {
 166   $irow = sqlQuery("SELECT * FROM lists WHERE id = $issue");
 167   foreach ($ISSUE_TYPES as $key => $value) {
 168     if ($key == $irow['type']) break;
 169     ++$type_index;
 170   }
 171
 172   /*******************************************************************
 173   // Get all of the eligible diagnoses.
 174   // We include the pid in this search for better performance,
 175   // because it's part of the primary key:
 176   $bres = sqlStatement(
 177    "SELECT DISTINCT billing.code, billing.code_text " .
 178    "FROM issue_encounter, billing WHERE " .
 179    "issue_encounter.pid = '$thispid' AND " .
 180    "issue_encounter.list_id = '$issue' AND " .
 181    "billing.encounter = issue_encounter.encounter AND " .
 182    "( billing.code_type LIKE 'ICD%' OR " .
 183    "billing.code_type LIKE 'OSICS' OR " .
 184    "billing.code_type LIKE 'UCSMC' )"
 185   );
 186   *******************************************************************/
 187
 188 }
 189 ?>
 190 <html>
 191 <head>
 192 <?php html_header_show();?>
 193 <title><?php echo $issue ? "Edit" : "Add New" ?><?php xl('Issue','e'); ?></title>
 194 <link rel="stylesheet" href='<?php echo $css_header ?>' type='text/css'>
 195
 196 <style>
 197
 198 td, input, select, textarea {
 199  font-family: Arial, Helvetica, sans-serif;
 200  font-size: 10pt;
 201 }
 202
 203 div.section {
 204  border: solid;
 205  border-width: 1px;
 206  border-color: #0000ff;
 207  margin: 0 0 0 10pt;
 208  padding: 5pt;
 209 }
 210
 211 </style>
 212
 213 <style type="text/css">@import url(../../../library/dynarch_calendar.css);</style>
 214 <script type="text/javascript" src="../../../library/dynarch_calendar.js"></script>
 215 <script type="text/javascript" src="../../../library/dynarch_calendar_en.js"></script>
 216 <script type="text/javascript" src="../../../library/dynarch_calendar_setup.js"></script>
 217 <script type="text/javascript" src="../../../library/textformat.js"></script>
 218 <script type="text/javascript" src="../../../library/dialog.js"></script>
 219
 220 <script language="JavaScript">
 221
 222  var mypcc = '<?php echo $GLOBALS['phone_country_code'] ?>';
 223
 224  var aitypes = new Array(); // issue type attributes
 225  var aopts   = new Array(); // Option objects
 226 <?php
 227  // "Clickoptions" is a feature by Mark Leeds that provides for one-click
 228  // access to preselected lists of issues in each category.  Here we get
 229  // the issue titles from the user-customizable file and write JavaScript
 230  // statements that will build an array of arrays of Option objects.
 231  //
 232  $clickoptions = array();
 233  if (is_file("../../../custom/clickoptions.txt"))
 234   $clickoptions = file("../../../custom/clickoptions.txt");
 235  $i = 0;
 236  foreach ($ISSUE_TYPES as $key => $value) {
 237   echo " aitypes[$i] = " . $value[3] . ";\n";
 238   echo " aopts[$i] = new Array();\n";
 239   foreach($clickoptions as $line) {
 240    $line = trim($line);
 241    if (substr($line, 0, 1) != "#") {
 242     if (strpos($line, $key) !== false) {
 243      $text = addslashes(substr($line, strpos($line, "::") + 2));
 244      echo " aopts[$i][aopts[$i].length] = new Option('$text', '$text', false, false);\n";
 245     }
 246    }
 247   }
 248   ++$i;
 249  }
 250 ?>
 251
 252 <?php require($GLOBALS['srcdir'] . "/restoreSession.php"); ?>
 253
 254  // React to selection of an issue type.  This loads the associated
 255  // shortcuts into the selection list of titles, and determines which
 256  // rows are displayed or hidden.
 257  function newtype(index) {
 258   var f = document.forms[0];
 259   var theopts = f.form_titles.options;
 260   theopts.length = 0;
 261   var i = 0;
 262   for (i = 0; i < aopts[index].length; ++i) {
 263    theopts[i] = aopts[index][i];
 264   }
 265   document.getElementById('row_titles').style.display = i ? '' : 'none';
 266   // Show or hide various rows depending on issue type, except do not
 267   // hide the comments or referred-by fields if they have data.
 268   var comdisp = (aitypes[index] == 1) ? 'none' : '';
 269   var revdisp = (aitypes[index] == 1) ? '' : 'none';
 270   var injdisp = (aitypes[index] == 2) ? '' : 'none';
 271   document.getElementById('row_enddate'       ).style.display = comdisp;
 272   document.getElementById('row_active'        ).style.display = revdisp;
 273   document.getElementById('row_diagnosis'     ).style.display = comdisp;
 274   document.getElementById('row_occurrence'    ).style.display = comdisp;
 275   document.getElementById('row_classification').style.display = injdisp;
 276   document.getElementById('row_referredby'    ).style.display = (f.form_referredby.value) ? '' : comdisp;
 277   document.getElementById('row_comments'      ).style.display = (f.form_comments.value  ) ? '' : revdisp;
 278 <?php if ($GLOBALS['athletic_team']) { ?>
 279   document.getElementById('row_returndate').style.display = comdisp;
 280   document.getElementById('row_missed'    ).style.display = comdisp;
 281 <?php } ?>
 282 <?php
 283   if ($ISSUE_TYPES['football_injury']) {
 284     // Generate more of these for football injury fields.
 285     issue_football_injury_newtype();
 286   }
 287   if ($ISSUE_TYPES['ippf_gcac'] && !$_POST['form_save']) {
 288     // Generate more of these for gcac and contraceptive fields.
 289     if (empty($issue) || $irow['type'] == 'ippf_gcac'    ) issue_ippf_gcac_newtype();
 290     if (empty($issue) || $irow['type'] == 'contraceptive') issue_ippf_con_newtype();
 291     // if (empty($issue) || $irow['type'] == 'ippf_srh'     ) issue_ippf_srh_newtype();
 292   }
 293 ?>
 294  }
 295
 296  // If a clickoption title is selected, copy it to the title field.
 297  function set_text() {
 298   var f = document.forms[0];
 299   f.form_title.value = f.form_titles.options[f.form_titles.selectedIndex].text;
 300   f.form_titles.selectedIndex = -1;
 301  }
 302
 303  // Process click on Delete link.
 304  function deleteme() {
 305   dlgopen('../deleter.php?issue=<?php echo $issue ?>', '_blank', 500, 450);
 306   return false;
 307  }
 308
 309  // Called by the deleteme.php window on a successful delete.
 310  function imdeleted() {
 311   window.close();
 312  }
 313
 314  // Called when the Active checkbox is clicked.  For consistency we
 315  // use the existence of an end date to indicate inactivity, even
 316  // though the simple verion of the form does not show an end date.
 317  function activeClicked(cb) {
 318   var f = document.forms[0];
 319   if (cb.checked) {
 320    f.form_end.value = '';
 321   } else {
 322    var today = new Date();
 323    f.form_end.value = '' + (today.getYear() + 1900) + '-' +
 324     (today.getMonth() + 1) + '-' + today.getDate();
 325   }
 326  }
 327
 328 // This is for callback by the find-code popup.
 329 // Appends to or erases the current list of diagnoses.
 330 function set_related(codetype, code, selector, codedesc) {
 331  var f = document.forms[0];
 332  var s = f.form_diagnosis.value;
 333  if (code) {
 334   if (s.length > 0) s += ';';
 335   s += codetype + ':' + code;
 336  } else {
 337   s = '';
 338  }
 339  f.form_diagnosis.value = s;
 340 }
 341
 342 // This invokes the find-code popup.
 343 function sel_diagnosis() {
 344  dlgopen('../encounter/find_code_popup.php?codetype=<?php echo $diagnosis_type ?>', '_blank', 500, 400);
 345 }
 346
 347 // Check for errors when the form is submitted.
 348 function validate() {
 349  var f = document.forms[0];
 350  if (! f.form_title.value) {
 351   alert('Please enter a title!');
 352   return false;
 353  }
 354  top.restoreSession();
 355  return true;
 356 }
 357
 358 // Supports customizable forms (currently just for IPPF).
 359 function divclick(cb, divid) {
 360  var divstyle = document.getElementById(divid).style;
 361  if (cb.checked) {
 362   divstyle.display = 'block';
 363  } else {
 364   divstyle.display = 'none';
 365  }
 366  return true;
 367 }
 368
 369 </script>
 370
 371 </head>
 372
 373 <body class="body_top" style="padding-right:0.5em">
 374
 375 <form method='post' name='theform' action='add_edit_issue.php?issue=<?php echo $issue ?>'
 376  onsubmit='return validate()'>
 377
 378 <table border='0' width='100%'>
 379
 380  <tr>
 381   <td valign='top' width='1%' nowrap><b><?php xl('Type','e'); ?>:</b></td>
 382   <td>
 383 <?php
 384  $index = 0;
 385  foreach ($ISSUE_TYPES as $value) {
 386   if ($issue) {
 387     if ($index == $type_index) {
 388       echo $value[1];
 389       echo "<input type='hidden' name='form_type' value='$index'>\n";
 390     }
 391   } else {
 392     echo "   <input type='radio' name='form_type' value='$index' onclick='newtype($index)'";
 393     if ($index == $type_index) echo " checked";
 394     echo " />" . $value[1] . "&nbsp;\n";
 395   }
 396   ++$index;
 397  }
 398 ?>
 399   </td>
 400  </tr>
 401
 402  <tr id='row_titles'>
 403   <td valign='top' nowrap>&nbsp;</td>
 404   <td valign='top'>
 405    <select name='form_titles' size='4' onchange='set_text()'>
 406    </select> (Select one of these, or type your own title)
 407   </td>
 408  </tr>
 409
 410  <tr>
 411   <td valign='top' nowrap><b><?php xl('Title','e'); ?>:</b></td>
 412   <td>
 413    <input type='text' size='40' name='form_title' value='<?php echo $irow['title'] ?>' style='width:100%' />
 414   </td>
 415  </tr>
 416
 417  <tr>
 418   <td valign='top' nowrap><b><?php xl('Begin Date','e'); ?>:</b></td>
 419   <td>
 420
 421    <input type='text' size='10' name='form_begin' id='form_begin'
 422     value='<?php echo $irow['begdate'] ?>'
 423     onkeyup='datekeyup(this,mypcc)' onblur='dateblur(this,mypcc)'
 424     title='<?php xl('yyyy-mm-dd date of onset, surgery or start of medication','e'); ?>' />
 425    <img src='../../pic/show_calendar.gif' align='absbottom' width='24' height='22'
 426     id='img_begin' border='0' alt='[?]' style='cursor:pointer'
 427     title='<?php xl('Click here to choose a date','e'); ?>' />
 428   </td>
 429  </tr>
 430
 431  <tr id='row_enddate'>
 432   <td valign='top' nowrap><b><?php xl('End Date','e'); ?>:</b></td>
 433   <td>
 434    <input type='text' size='10' name='form_end' id='form_end'
 435     value='<?php echo $irow['enddate'] ?>'
 436     onkeyup='datekeyup(this,mypcc)' onblur='dateblur(this,mypcc)'
 437     title='<?php xl('yyyy-mm-dd date of recovery or end of medication','e'); ?>' />
 438    <img src='../../pic/show_calendar.gif' align='absbottom' width='24' height='22'
 439     id='img_end' border='0' alt='[?]' style='cursor:pointer'
 440     title='<?php xl('Click here to choose a date','e'); ?>' />
 441     &nbsp;(<?php xl('leave blank if still active','e'); ?>)
 442   </td>
 443  </tr>
 444
 445  <tr id='row_active'>
 446   <td valign='top' nowrap><b><?php xl('Active','e'); ?>:</b></td>
 447   <td>
 448    <input type='checkbox' name='form_active' value='1' <?php echo $irow['enddate'] ? "" : "checked"; ?>
 449     onclick='activeClicked(this);'
 450     title='<?php xl('Indicates if this issue is currently active','e'); ?>' />
 451   </td>
 452  </tr>
 453
 454  <tr<?php if (! $GLOBALS['athletic_team']) echo " style='display:none;'"; ?> id='row_returndate'>
 455   <td valign='top' nowrap><b><?php xl('Returned to Play','e'); ?>:</b></td>
 456   <td>
 457    <input type='text' size='10' name='form_return' id='form_return'
 458     value='<?php echo $irow['returndate'] ?>'
 459     onkeyup='datekeyup(this,mypcc)' onblur='dateblur(this,mypcc)'
 460     title='<?php xl('yyyy-mm-dd date returned to play','e'); ?>' />
 461    <img src='../../pic/show_calendar.gif' align='absbottom' width='24' height='22'
 462     id='img_return' border='0' alt='[?]' style='cursor:pointer'
 463     title='<?php xl('Click here to choose a date','e'); ?>' />
 464     &nbsp;(<?php xl('leave blank if still active','e'); ?>)
 465   </td>
 466  </tr>
 467
 468  <tr id='row_diagnosis'>
 469   <td valign='top' nowrap><b><?php xl('Diagnosis','e'); ?>:</b></td>
 470   <td>
 471
 472 <?php /************************************************************ ?>
 473    <select name='form_diagnosis' title='<?php xl('Diagnosis must be coded into a linked encounter','e'); ?>'>
 474     <option value=""><?php xl('Unknown or N/A','e'); ?></option>
 475 <?php
 476  while ($brow = sqlFetchArray($bres)) {
 477   echo "   <option value='" . $brow['code'] . "'";
 478   if ($brow['code'] == $irow['diagnosis']) echo " selected";
 479   echo ">" . $brow['code'] . " " . substr($brow['code_text'], 0, 40) . "</option>\n";
 480  }
 481 ?>
 482    </select>
 483 <?php ************************************************************/ ?>
 484
 485    <input type='text' size='50' name='form_diagnosis'
 486     value='<?php echo $irow['diagnosis'] ?>' onclick='sel_diagnosis()'
 487     title='<?php xl('Click to select or change diagnoses','e'); ?>'
 488     style='width:100%' readonly />
 489
 490   </td>
 491  </tr>
 492
 493  <tr id='row_occurrence'>
 494   <td valign='top' nowrap><b><?php xl('Occurrence','e'); ?>:</b></td>
 495   <td>
 496    <select name='form_occur'>
 497 <?php
 498  foreach ($ISSUE_OCCURRENCES as $key => $value) {
 499   echo "   <option value='$key'";
 500   if ($key == $irow['occurrence']) echo " selected";
 501   echo ">$value\n";
 502  }
 503 ?>
 504    </select>
 505   </td>
 506  </tr>
 507
 508  <tr id='row_classification'>
 509   <td valign='top' nowrap><b><?php xl('Classification','e'); ?>:</b></td>
 510   <td>
 511    <select name='form_classification'>
 512 <?php
 513  foreach ($ISSUE_CLASSIFICATIONS as $key => $value) {
 514   echo "   <option value='$key'";
 515   if ($key == $irow['classification']) echo " selected";
 516   echo ">$value\n";
 517  }
 518 ?>
 519    </select>
 520   </td>
 521  </tr>
 522
 523  <tr<?php if (! $GLOBALS['athletic_team']) echo " style='display:none;'"; ?> id='row_missed'>
 524   <td valign='top' nowrap><b><?php xl('Missed','e'); ?>:</b></td>
 525   <td>
 526    <input type='text' size='3' name='form_missed' value='<?php echo $irow['extrainfo'] ?>'
 527     title='<?php xl('Number of games or events missed, if any','e'); ?>' />
 528    &nbsp;<?php xl('games/events','e'); ?>
 529   </td>
 530  </tr>
 531
 532  <tr<?php if ($GLOBALS['athletic_team']) echo " style='display:none;'"; ?> id='row_referredby'>
 533   <td valign='top' nowrap><b><?php xl('Referred by','e'); ?>:</b></td>
 534   <td>
 535    <input type='text' size='40' name='form_referredby' value='<?php echo $irow['referredby'] ?>'
 536     style='width:100%' title='<?php xl('Referring physician and practice','e'); ?>' />
 537   </td>
 538  </tr>
 539
 540  <tr id='row_comments'>
 541   <td valign='top' nowrap><b><?php xl('Comments','e'); ?>:</b></td>
 542   <td>
 543    <textarea name='form_comments' rows='4' cols='40' wrap='virtual' style='width:100%'><?php echo $irow['comments'] ?></textarea>
 544   </td>
 545  </tr>
 546
 547  <tr<?php if ($GLOBALS['athletic_team'] || $GLOBALS['ippf_specific']) echo " style='display:none;'"; ?>>
 548   <td valign='top' nowrap><b><?php xl('Outcome','e'); ?>:</b></td>
 549   <td>
 550    <?php echo rbinput('form_outcome', '1', 'Resolved'        , 'outcome') ?>&nbsp;
 551    <?php echo rbinput('form_outcome', '2', 'Improved'        , 'outcome') ?>&nbsp;
 552    <?php echo rbinput('form_outcome', '3', 'Status quo'      , 'outcome') ?>&nbsp;
 553    <?php echo rbinput('form_outcome', '4', 'Worse'           , 'outcome') ?>&nbsp;
 554    <?php echo rbinput('form_outcome', '5', 'Pending followup', 'outcome') ?>
 555   </td>
 556  </tr>
 557
 558  <tr<?php if ($GLOBALS['athletic_team'] || $GLOBALS['ippf_specific']) echo " style='display:none;'"; ?>>
 559   <td valign='top' nowrap><b><?php xl('Destination','e'); ?>:</b></td>
 560   <td>
 561 <?php if (true) { ?>
 562    <input type='text' size='40' name='form_destination' value='<?php echo $irow['destination'] ?>'
 563     style='width:100%' title='GP, Secondary care specialist, etc.' />
 564 <?php } else { // leave this here for now, please -- Rod ?>
 565    <?php echo rbinput('form_destination', '1', 'GP'                 , 'destination') ?>&nbsp;
 566    <?php echo rbinput('form_destination', '2', 'Secondary care spec', 'destination') ?>&nbsp;
 567    <?php echo rbinput('form_destination', '3', 'GP via physio'      , 'destination') ?>&nbsp;
 568    <?php echo rbinput('form_destination', '4', 'GP via podiatry'    , 'destination') ?>
 569 <?php } ?>
 570   </td>
 571  </tr>
 572
 573 </table>
 574
 575 <?php
 576   if ($ISSUE_TYPES['football_injury']) {
 577     issue_football_injury_form($issue);
 578   }
 579   if ($ISSUE_TYPES['ippf_gcac']) {
 580     if (empty($issue) || $irow['type'] == 'ippf_gcac')
 581       issue_ippf_gcac_form($issue, $thispid);
 582     if (empty($issue) || $irow['type'] == 'contraceptive')
 583       issue_ippf_con_form($issue, $thispid);
 584     // if (empty($issue) || $irow['type'] == 'ippf_srh')
 585     //   issue_ippf_srh_form($issue, $thispid);
 586   }
 587 ?>
 588
 589 <center>
 590 <p>
 591
 592 <input type='submit' name='form_save' value='<?php xl('Save','e'); ?>' />
 593
 594 <?php if ($issue && acl_check('admin', 'super')) { ?>
 595 &nbsp;
 596 <input type='button' value='<?php xl('Delete','e'); ?>' style='color:red' onclick='deleteme()' />
 597 <?php } ?>
 598
 599 &nbsp;
 600 <input type='button' value='<?php xl('Cancel','e'); ?>' onclick='window.close()' />
 601
 602 </p>
 603 </center>
 604
 605 </form>
 606 <script language='JavaScript'>
 607  newtype(<?php echo $type_index ?>);
 608  Calendar.setup({inputField:"form_begin", ifFormat:"%Y-%m-%d", button:"img_begin"});
 609  Calendar.setup({inputField:"form_end", ifFormat:"%Y-%m-%d", button:"img_end"});
 610  Calendar.setup({inputField:"form_return", ifFormat:"%Y-%m-%d", button:"img_return"});
 611 </script>
 612 </body>
 613 </html>