interface/forms/eye_mag/SpectacleRx.php

   1 <?php
   2
   3 /**
   4  * forms/eye_mag/SpectacleRx.php
   5  *
   6  * Functions for printing a glasses prescription
   7  *
   8  * Copyright (C) 2016 Raymond Magauran <magauran@MedFetch.com>
   9  *
  10  * LICENSE: This program is free software: you can redistribute it and/or modify
  11  *  it under the terms of the GNU Affero General Public License as
  12  *  published by the Free Software Foundation, either version 3 of the
  13  *  License, or (at your option) any later version.
  14  *
  15  *  This program is distributed in the hope that it will be useful,
  16  *  but WITHOUT ANY WARRANTY; without even the implied warranty of
  17  *  MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE.  See the
  18  *  GNU Affero General Public License for more details.
  19  *
  20  *  You should have received a copy of the GNU Affero General Public License
  21  *  along with this program.  If not, see <http://www.gnu.org/licenses/>.
  22  *
  23  * @package OpenEMR
  24  * @author Ray Magauran <magauran@MedFetch.com>
  25  * @link http://www.open-emr.org
  26  */
  27
  28
  29 require_once("../../globals.php");
  30 require_once("$srcdir/api.inc");
  31 require_once("$srcdir/acl.inc");
  32 require_once("$srcdir/forms.inc");
  33 require_once("$srcdir/lists.inc");
  34 require_once("$srcdir/options.inc.php");
  35 require_once("$srcdir/patient.inc");
  36 require_once("$srcdir/report.inc");
  37
  38 use OpenEMR\Services\FacilityService;
  39
  40 $facilityService = new FacilityService();
  41
  42 $form_name = "Eye Form";
  43 $form_folder = "eye_mag";
  44 require_once("php/" . $form_folder . "_functions.php");
  45
  46 $RX_expir = "+1 years";
  47 $CTL_expir = "+6 months";
  48 //echo "<pre>";var_dump($_REQUEST);exit;
  49 if (!$_REQUEST['pid'] && $_REQUEST['id']) {
  50     $_REQUEST['pid'] = $_REQUEST['id'];
  51 }
  52 if (!$_REQUEST['pid']) {
  53     $_REQUEST['pid'] = $_SESSION['pid'];
  54 }
  55
  56 $query = "select  *,form_encounter.date as encounter_date
  57                from forms,form_encounter,form_eye_base,
  58                 form_eye_hpi,form_eye_ros,form_eye_vitals,
  59                 form_eye_acuity,form_eye_refraction,form_eye_biometrics,
  60                 form_eye_external, form_eye_antseg,form_eye_postseg,
  61                 form_eye_neuro,form_eye_locking
  62                     where
  63                     forms.deleted != '1'  and
  64                     forms.formdir='eye_mag' and
  65                     forms.encounter=form_encounter.encounter  and
  66                     forms.form_id=form_eye_base.id and
  67                     forms.form_id=form_eye_hpi.id and
  68                     forms.form_id=form_eye_ros.id and
  69                     forms.form_id=form_eye_vitals.id and
  70                     forms.form_id=form_eye_acuity.id and
  71                     forms.form_id=form_eye_refraction.id and
  72                     forms.form_id=form_eye_biometrics.id and
  73                     forms.form_id=form_eye_external.id and
  74                     forms.form_id=form_eye_antseg.id and
  75                     forms.form_id=form_eye_postseg.id and
  76                     forms.form_id=form_eye_neuro.id and
  77                     forms.form_id=form_eye_locking.id and
  78                     forms.encounter=? and
  79                     forms.pid=? ";
  80
  81 $data = sqlQuery($query, array($_REQUEST['encounter'], $_REQUEST['pid']));
  82 $data['ODMPDD'] = $data['ODPDMeasured'];
  83 $data['OSMPDD'] = $data['OSPDMeasured'];
  84 $data['BPDD']   = $data['ODMPDD'] + $data['OSMPDD'];
  85 @extract($data);
  86
  87 $ODMPDD     = $ODPDMeasured;
  88 $OSMPDD     = $OSPDMeasured;
  89 $BPDD       = $ODMPDD + $OSMPDD;
  90
  91 $query      = "SELECT * FROM users where id = ?";
  92 $prov_data  = sqlQuery($query, array($data['provider_id']));
  93
  94 $query      = "SELECT * FROM patient_data where pid=?";
  95 $pat_data   = sqlQuery($query, array($data['pid']));
  96
  97 $practice_data = $facilityService->getPrimaryBusinessEntity();
  98
  99 $visit_date = oeFormatShortDate($data['encounter_date']);
 100
 101 if ($_REQUEST['mode'] == "update") {  //store any changed fields in dispense table
 102     $table_name = "form_eye_mag_dispense";
 103     $query = "show columns from " . $table_name;
 104     $dispense_fields = sqlStatement($query);
 105     $fields = array();
 106
 107     if (sqlNumRows($dispense_fields) > 0) {
 108         while ($row = sqlFetchArray($dispense_fields)) {
 109             //exclude critical columns/fields, define below as needed
 110             if ($row['Field'] == 'id' ||
 111                 $row['Field'] == 'pid' ||
 112                 $row['Field'] == 'user' ||
 113                 $row['Field'] == 'groupname' ||
 114                 $row['Field'] == 'authorized' ||
 115                 $row['Field'] == 'activity' ||
 116                 $row['Field'] == 'date'
 117             ) {
 118                 continue;
 119             }
 120
 121             if (isset($_POST[$row['Field']])) {
 122                 $fields[$row['Field']] = $_POST[$row['Field']];
 123             }
 124         }
 125         $fields['RXTYPE'] = $RXTYPE;
 126         $insert_this_id = formUpdate($table_name, $fields, $_POST['id'], $_SESSION['userauthorized']);
 127     }
 128
 129     exit;
 130 } else if ($_REQUEST['mode'] == "remove") {
 131     $query = "DELETE FROM form_eye_mag_dispense where id=?";
 132     sqlStatement($query, array($_REQUEST['delete_id']));
 133     echo xlt('Prescription successfully removed.');
 134     exit;
 135 } else if ($_REQUEST['RXTYPE']) {  //store any changed fields
 136     $query = "UPDATE form_eye_mag_dispense set RXTYPE=? where id=?";
 137     sqlStatement($query, array($_REQUEST['RXTYPE'], $_REQUEST['id']));
 138     exit;
 139 }
 140
 141 formHeader("OpenEMR Eye: " . text($prov_data['facility']));
 142
 143 if ($_REQUEST['REFTYPE']) {
 144     $REFTYPE = $_REQUEST['REFTYPE'];
 145     if ($REFTYPE == "AR") {
 146         $RXTYPE = "Bifocal";
 147     }
 148
 149     if ($REFTYPE == "MR") {
 150         $RXTYPE = "Bifocal";
 151     }
 152
 153     if ($REFTYPE == "CTL") {
 154         $RXTYPE = "Bifocal";
 155     }
 156
 157     $id = $_REQUEST['id'];
 158     $table_name = "form_eye_mag";
 159     if (!$_REQUEST['encounter']) {
 160         $encounter = $_SESSION['encounter'];
 161     } else {
 162         $encounter = $_REQUEST['encounter'];
 163     }
 164
 165
 166
 167     if ($REFTYPE =="W") {
 168         //we have rx_number 1-5 to process...
 169         $query = "select * from form_eye_mag_wearing where ENCOUNTER=? and FORM_ID=? and PID=? and RX_NUMBER=?";
 170         $wear = sqlStatement($query, array($encounter,$_REQUEST['form_id'],$_REQUEST['pid'],$_REQUEST['rx_number']));
 171         $wearing = sqlFetchArray($wear);
 172         $ODSPH = $wearing['ODSPH'];
 173         $ODAXIS = $wearing['ODAXIS'];
 174         $ODCYL = $wearing['ODCYL'];
 175         $OSSPH = $wearing['OSSPH'];
 176         $OSCYL = $wearing['OSCYL'];
 177         $OSAXIS = $wearing['OSAXIS'];
 178         $COMMENTS = $wearing['COMMENTS'];
 179         $ODMIDADD = $wearing['ODMIDADD'];
 180         $ODADD2 = $wearing['ODADD'];
 181         $OSMIDADD = $wearing['OSMIDADD'];
 182         $OSADD2 = $wearing['OSADD'];
 183         @extract($wearing);
 184         if ($wearing['RX_TYPE']=='0') {
 185             $Single="checked='checked'";
 186             $RXTYPE="Single";
 187         } elseif ($wearing['RX_TYPE']=='1') {
 188             $Bifocal ="checked='checked'";
 189             $RXTYPE="Bifocal";
 190         } elseif ($wearing['RX_TYPE']=='2') {
 191             $Trifocal ="checked='checked'";
 192             $RXTYPE="Trifocal";
 193         } elseif ($wearing['RX_TYPE']=='3') {
 194             $Progressive ="checked='checked'";
 195             $RXTYPE="Progressive";
 196         }
 197
 198         //do LT and Lens materials
 199     } elseif ($REFTYPE == "AR") {
 200         $ODSPH      = $data['ARODSPH'];
 201         $ODAXIS     = $data['ARODAXIS'];
 202         $ODCYL      = $data['ARODCYL'];
 203         $ODPRISM    = $data['ARODPRISM'];
 204         $OSSPH      = $data['AROSSPH'];
 205         $OSCYL      = $data['AROSCYL'];
 206         $OSAXIS     = $data['AROSAXIS'];
 207         $OSPRISM    = $data['AROSPRISM'];
 208         $COMMENTS   = $data['CRCOMMENTS'];
 209         $ODADD2     = $data['ARODADD'];
 210         $OSADD2     = $data['AROSADD'];
 211         $Bifocal    = "checked='checked'";
 212     } elseif ($REFTYPE == "MR") {
 213         $ODSPH      = $data['MRODSPH'];
 214         $ODAXIS     = $data['MRODAXIS'];
 215         $ODCYL      = $data['MRODCYL'];
 216         $ODPRISM    = $data['MRODPRISM'];
 217         $OSSPH      = $data['MROSSPH'];
 218         $OSCYL      = $data['MROSCYL'];
 219         $OSAXIS     = $data['MROSAXIS'];
 220         $OSPRISM    = $data['MROSPRISM'];
 221         $COMMENTS   = $data['CRCOMMENTS'];
 222         $ODADD2     = $data['MRODADD'];
 223         $OSADD2     = $data['MROSADD'];
 224         $Bifocal    = "checked='checked'";
 225     } elseif ($REFTYPE == "CR") {
 226         $ODSPH      = $data['CRODSPH'];
 227         $ODAXIS     = $data['CRODAXIS'];
 228         $ODCYL      = $data['CRODCYL'];
 229         $ODPRISM    = $data['CRODPRISM'];
 230         $OSSPH      = $data['CROSSPH'];
 231         $OSCYL      = $data['CROSCYL'];
 232         $OSAXIS     = $data['CROSAXIS'];
 233         $OSPRISM    = $data['CROSPRISM'];
 234         $COMMENTS   = $data['CRCOMMENTS'];
 235     } elseif ($REFTYPE == "CTL") {
 236         $ODSPH      = $data['CTLODSPH'];
 237         $ODAXIS     = $data['CTLODAXIS'];
 238         $ODCYL      = $data['CTLODCYL'];
 239         $ODPRISM    = $data['CTLODPRISM'];
 240
 241         $OSSPH      = $data['CTLOSSPH'];
 242         $OSCYL      = $data['CTLOSCYL'];
 243         $OSAXIS     = $data['CTLOSAXIS'];
 244         $OSPRISM    = $data['CTLOSPRISM'];
 245
 246         $ODBC       = $data['CTLODBC'];
 247         $ODDIAM     = $data['CTLODDIAM'];
 248         $ODADD      = $data['CTLODADD'];
 249         $ODVA       = $data['CTLODVA'];
 250
 251         $OSBC       = $data['CTLOSBC'];
 252         $OSDIAM     = $data['CTLOSDIAM'];
 253         $OSADD      = $data['CTLOSADD'];
 254         $OSVA       = $data['CTLOSVA'];
 255
 256         $COMMENTS   = $data['COMMENTS'];//in form_eye_mag_dispense there is no leading 'CTL_'
 257
 258         $CTLMANUFACTUREROD  = getListItemTitle('CTLManufacturer', $data['CTLMANUFACTUREROD']);
 259         $CTLMANUFACTUREROS  = getListItemTitle('CTLManufacturer', $data['CTLMANUFACTUREROS']);
 260         $CTLSUPPLIEROD      = getListItemTitle('CTLManufacturer', $data['CTLSUPPLIEROD']);
 261         $CTLSUPPLIEROS      = getListItemTitle('CTLManufacturer', $data['CTLSUPPLIEROS']);
 262         $CTLBRANDOD         = getListItemTitle('CTLManufacturer', $data['CTLBRANDOD']);
 263         $CTLBRANDOS         = getListItemTitle('CTLManufacturer', $data['CTLBRANDOS']);
 264     }
 265
 266     //Since we selected the Print Icon, we must be dispensing this - add to dispensed table now
 267     $table_name      = "form_eye_mag_dispense";
 268     $query           = "show columns from " . $table_name;
 269     $dispense_fields = sqlStatement($query);
 270     $fields          = array();
 271
 272     if (sqlNumRows($dispense_fields) > 0) {
 273         while ($row = sqlFetchArray($dispense_fields)) {
 274             //exclude critical columns/fields, define below as needed
 275             if ($row['Field'] == 'id' ||
 276                 $row['Field'] == 'pid' ||
 277                 $row['Field'] == 'user' ||
 278                 $row['Field'] == 'groupname' ||
 279                 $row['Field'] == 'authorized' ||
 280                 $row['Field'] == 'activity' ||
 281                 $row['Field'] == 'RXTYPE' ||
 282                 $row['Field'] == 'REFDATE' ||
 283                 $row['Field'] == 'date'
 284             ) {
 285                 continue;
 286             }
 287             if (isset(${$row['Field']})) {
 288                 $fields[$row['Field']] = ${$row['Field']};
 289             }
 290         }
 291
 292         $fields['RXTYPE'] = $RXTYPE;
 293         $fields['REFDATE'] = $data['date'];
 294         $insert_this_id = formSubmit($table_name, $fields, $form_id, $_SESSION['userauthorized']);
 295     }
 296 }
 297
 298 if ($_REQUEST['dispensed']) {
 299     $query = "SELECT * from form_eye_mag_dispense where pid =? ORDER BY date DESC";
 300     $dispensed = sqlStatement($query, array($_REQUEST['pid']));
 301     ?><html>
 302     <title><?php echo xlt('Rx Dispensed History'); ?></title>
 303     <head>
 304     <script src="<?php echo $GLOBALS['assets_static_relative'] ?>/jquery-1-10-2/jquery.js"></script>
 305     <script src="<?php echo $GLOBALS['assets_static_relative'] ?>/bootstrap/dist/js/bootstrap.min.js"></script>
 306     <script src="<?php echo $GLOBALS['assets_static_relative'] ?>/manual-added-packages/qtip2-2-2-1/jquery.qtip.min.js"></script>
 307     <script type="text/javascript" src="<?php echo $webroot ?>/interface/main/tabs/js/include_opener.js"></script>
 308
 309     <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative'] ?>/bootstrap/dist/css/bootstrap.min.css">
 310     <link rel="stylesheet" href="<?php echo $GLOBALS['css_header']; ?>" type="text/css">
 311     <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative'] ?>/jquery-ui-themes-1-10-4/themes/ui-lightness/jquery-ui.min.css">
 312     <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative'] ?>/pure/0.5.0/pure-min.css">
 313     <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative'] ?>/manual-added-packages/qtip2-2-2-1/jquery.qtip.min.css" />
 314     <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative'] ?>/font-awesome/css/font-awesome.min.css">
 315     <link rel="stylesheet" href="../../forms/<?php echo $form_folder; ?>/css/style.css" type="text/css">
 316
 317     <style>
 318         .title {
 319             font-size:1em;
 320             position:absolute;
 321             right:10px;
 322             top:30px;
 323             font-size: 1em;
 324         }
 325         .refraction {
 326             width:95%;
 327             display: -moz-stack;
 328             vertical-align: middle;
 329             min-height:unset;
 330         }
 331         .refraction td {
 332             text-align:center;
 333             font-size:12px;
 334             width:0.9in;
 335             vertical-align: text-middle;
 336             text-decoration: unset;
 337         }
 338         table {
 339             font-size: 1.0em;
 340             padding: 12px;
 341             color: black;
 342             vertical-align: text-top;
 343         }
 344
 345         input[type=text] {
 346             text-align: center;
 347             width: 60px;
 348         }
 349
 350         .refraction b {
 351             font-weight: bold;
 352         }
 353
 354         .refraction td.right {
 355             text-align: right;
 356             text-decoration: unset;
 357             width: 0.7in;
 358             vertical-align: middle;    font-size:12px;
 359         }
 360
 361         .refraction td.left {
 362             vertical-align: middle;
 363             text-align: left;
 364             font-size:12px;
 365         }
 366
 367         .right {
 368             text-align: right;
 369             vertical-align: middle;}
 370
 371         .left {
 372             vertical-align: middle;
 373             text-align: left;
 374         }
 375
 376         .title {
 377             font-size: 0.9em;
 378             font-weight: normal;
 379         }
 380
 381         .bold {
 382             font-weight: 600;
 383         }
 384
 385         input {
 386             width: 60px;
 387         }
 388
 389         input[type="radio"] {
 390             width: 15px;
 391         }
 392         .underline {
 393             text-decoration:underline !important
 394         }
 395         #CTLODQUANTITY, #CTLOSQUANTITY {
 396             width: 300px;
 397         }
 398     </style>
 399     <script language="JavaScript">
 400         <?php
 401         require_once("$srcdir/restoreSession.php");  ?>
 402
 403         function delete_me(delete_id) {
 404             top.restoreSession();
 405             var url = "../../forms/eye_mag/SpectacleRx.php";
 406             $.ajax({
 407                 type: 'POST',
 408                 url: url,
 409                 data: {
 410                     mode: 'remove',
 411                     delete_id: delete_id,
 412                     dispensed: '1'
 413                 } // our data object
 414             }).done(function (o) {
 415                 $('#RXID_' + delete_id).hide();
 416                 alert(o);
 417             });
 418         }
 419
 420     </script>
 421 </head>
 422 <?php echo report_header($pid, "web"); ?>
 423 <div class="row">
 424     <div class="col-sm-8 offset-sm-2" style="margin:5;text-align:center;width:560px;">
 425         <table>
 426             <tr>
 427                 <td colspan="2"><h4 class="underline"><?php echo xlt('Rx History'); ?></h4></td>
 428             </tr>
 429             <?php
 430             if (sqlNumRows($dispensed) == 0) {
 431                 echo "<tr><td colspan='2' style='font-size:1.2em;text-align:middle;padding:25px;'>" . xlt('There are no Glasses or Contact Lens Presciptions on file for this patient') . "</td></tr>";
 432             }
 433             ?>
 434         </table>
 435         <?php
 436         while ($row = sqlFetchArray($dispensed)) {
 437             $i++;
 438             $Single = '';
 439             $Bifocal = '';
 440             $Trifocal = '';
 441             $Progressive = '';
 442             if ($row['RXTYPE'] == "Single") {
 443                 $Single = "checked='checked'";
 444             }
 445
 446             if ($row['RXTYPE'] == "Bifocal") {
 447                 $Bifocal = "checked='checked'";
 448             }
 449
 450             if ($row['RXTYPE'] == "Trifocal") {
 451                 $Trifocal = "checked='checked'";
 452             }
 453
 454             if ($row['RXTYPE'] == "Progressive") {
 455                 $Progressive = "checked='checked'";
 456             }
 457
 458             $row['date'] = oeFormatShortDate(date('Y-m-d', strtotime($row['date'])));
 459             if ($row['REFTYPE'] == "CTL") {
 460                 $expir = date("Y-m-d", strtotime($CTL_expir, strtotime($row['REFDATE'])));
 461             } else {
 462                 $expir = date("Y-m-d", strtotime($RX_expir, strtotime($row['REFDATE'])));
 463             }
 464             $expir_date = oeFormatShortDate($expir);
 465             $row['REFDATE'] = oeFormatShortDate($row['REFDATE']);
 466
 467             ?>
 468             <div id="RXID_<?php echo attr($row['id']); ?>"
 469                  style="position:relative;text-align:center;margin: 10 auto;">
 470                 <i class="pull-right fa fa-close"
 471                    onclick="delete_me('<?php echo attr(addslashes($row['id'])); ?>');"
 472                    title="<?php echo xla('Remove this Prescription from the list of RXs dispensed'); ?>"></i>
 473                 <table style="margin:2px auto;width:490px;">
 474                     <tr>
 475                         <td class="right bold" style="width:250px;"><b><?php echo xlt('RX Print Date'); ?>: </b></td>
 476                         <td>&nbsp;&nbsp;<?php echo text($row['date']); ?></td>
 477                     </tr>
 478                     <tr>
 479                         <td class="right bold"><b><?php echo xlt('Visit Date'); ?>: </b></td>
 480                         <td>&nbsp;&nbsp;<?php echo text($row['REFDATE']); ?></td>
 481                     </tr>
 482                     <tr>
 483                         <td class="right bold"><b><?php echo xlt('Expiration Date'); ?>: </b></td>
 484                         <td>&nbsp;&nbsp;<?php
 485                             echo text($expir_date);
 486                             ?>
 487                         </td>
 488                     </tr>
 489
 490                     <tr>
 491                         <td class="right bold"><?php echo xlt('Refraction Method'); ?>:</td>
 492                         <td>&nbsp;&nbsp;<?php
 493                         if ($row['REFTYPE'] == "W") {
 494                             echo xlt('Duplicate Rx -- unchanged from current Rx{{The refraction did not change, New Rx=old Rx}}');
 495                         } else if ($row['REFTYPE'] == "CR") {
 496                             echo xlt('Cycloplegic (Wet) Refraction');
 497                         } else if ($row['REFTYPE'] == "MR") {
 498                             echo xlt('Manifest (Dry) Refraction');
 499                         } else if ($row['REFTYPE'] == "AR") {
 500                             echo xlt('Auto-Refraction');
 501                         } else if ($row['REFTYPE'] == "CTL") {
 502                             echo xlt('Contact Lens');
 503                         } else {
 504                             echo $row['REFTYPE'];
 505                         } ?>
 506                             <input type="hidden" name="REFTYPE" value="<?php echo attr($row['REFTYPE']); ?>"/>
 507                         </td>
 508                     </tr>
 509                     <tr>
 510                         <td colspan="2" class="text-center"> <?php
 511                         if ($row['REFTYPE'] != "CTL") { ?>
 512                                 <table id="SpectacleRx" name="SpectacleRx" class="refraction" style="top:0px;">
 513                                     <tr style="font-style:bold;">
 514                                         <td></td>
 515                                         <td></td>
 516                                         <td class="center bold underline"><?php echo xlt('Sph{{Sphere}}'); ?></td>
 517                                         <td class="center bold underline"><?php echo xlt('Cyl{{Cylinder}}'); ?></td>
 518                                         <td class="center bold underline"><?php echo xlt('Axis{{Axis in a glasses prescription}}'); ?></td>
 519                                         <td rowspan="5" class="right bold underline" colspan="2"
 520                                             style="min-width:100px;font-weight:bold;">
 521                                             <?php echo xlt('Rx Type'); ?><br/><br/>
 522                                             <?php echo xlt('Single'); ?>
 523                                             <input type="radio" disabled <?php echo text($Single); ?>><br/>
 524                                             <?php echo xlt('Bifocal'); ?>
 525                                             <input type="radio" disabled <?php echo text($Bifocal); ?>><br/>
 526                                             <?php echo xlt('Trifocal'); ?>
 527                                             <input type="radio" disabled <?php echo text($Trifocal); ?>><br/>
 528                                             <?php echo xlt('Prog.{{Progressive lenses}}'); ?>
 529                                             <input type="radio" disabled <?php echo text($Progressive); ?>><br/>
 530                                         </td>
 531                                     </tr>
 532                                     <tr>
 533                                         <td rowspan="2"
 534                                             style="text-align:right;font-weight:bold;"><?php echo xlt('Distance'); ?></td>
 535                                         <td><b><?php echo xlt('OD{{right eye}}'); ?></b></td>
 536                                         <td><?php echo text($row['ODSPH']); ?></td>
 537                                         <td><?php echo text($row['ODCYL']); ?></td>
 538                                         <td><?php echo text($row['ODAXIS']); ?></td>
 539                                         <td><?php echo text($row['ODPRISM']); ?></td>
 540                                     </tr>
 541                                     <tr>
 542                                         <td><b><?php echo xlt('OS{{left eye}}'); ?></b></td>
 543                                         <td><?php echo text($row['OSSPH']); ?></td>
 544                                         <td><?php echo text($row['OSCYL']); ?></td>
 545                                         <td><?php echo text($row['OSAXIS']); ?></td>
 546                                         <td><?php echo text($row['OSPRISM']); ?></td>
 547                                     </tr>
 548                                     <tr class="NEAR">
 549                                         <td rowspan=2 nowrap><span class="bold"
 550                                                     style="text-decoration:none;"><?php echo xlt('ADD'); ?>
 551                                                 :<br/><?php echo xlt("Mid{{Middle segment in a trifocal glasses prescription}}"); ?>
 552                                                 /<?php echo xlt("Near"); ?></span></td>
 553                                         <td><b><?php echo xlt('OD{{right eye}}'); ?></b></td>
 554                                         <td class="WMid"><?php echo text($row['ODMIDADD']); ?></td>
 555                                         <td class="WAdd2"><?php echo text($row['ODADD2']); ?></td>
 556                                     </tr>
 557                                     <tr class="NEAR">
 558                                         <td><b><?php echo xlt('OS{{left eye}}'); ?></b></td>
 559                                         <td class="WMid"><?php echo text($row['OSMIDADD']); ?></td>
 560                                         <td class="WAdd2"><?php echo text($row['OSADD2']); ?></td>
 561                                     </tr>
 562                                     <tr style="">
 563                                         <td colspan="2" class="up"
 564                                             style="text-align:right;vertical-align:top;top:0px;font-weight:bold;"><?php echo xlt('Comments'); ?>
 565                                             :
 566                                         </td>
 567                                         <td colspan="4" class="up left"></td>
 568                                             <?php echo text($row['CRCOMMENTS']); ?>
 569                                         </td>
 570                                     </tr>
 571                                 </table>
 572                                 <?php
 573                         } else {
 574                             if (!empty($row['ODADD']) || !empty($row['OSADD'])) {
 575                                 $adds =1;
 576                             } else {
 577                                 $adds ='';
 578                             }
 579                             ?>
 580                                 <table id="CTLRx" name="CTLRx" class="refraction">
 581                                     <tr>
 582                                         <td colspan="4"
 583                                         class="bold left text-uppercase text-top" style="display: flex;
 584                                             align-items:top"><u><?php echo xlt('Right Lens'); ?></u>
 585                                         </td>
 586                                     </tr>
 587                                     <tr class="bold underline">
 588                                         <td></td>
 589                                         <td><?php echo xlt('Sph{{Sphere}}'); ?></td>
 590                                         <td><?php echo xlt('Cyl{{Cylinder}}'); ?></td>
 591                                         <td><?php echo xlt('Axis{{Axis in a glasses prescription}}'); ?></td>
 592                                         <td><?php echo xlt('BC{{Base Curve}}'); ?></td>
 593                                         <td><?php echo xlt('Diam{{Diameter}}'); ?></td>
 594                                         <?php
 595                                         if ($adds) {
 596                                             ?>
 597                                             <td><?php echo xlt('ADD'); ?></td>
 598                                             <?php }
 599                                         ?>
 600                                     </tr>
 601                                     <tr>
 602                                         <td></td>
 603                                         <td><?php echo text($row['ODSPH']); ?></td>
 604                                         <td><?php echo text($row['ODCYL']); ?></td>
 605                                         <td><?php echo text($row['ODAXIS']); ?></td>
 606                                         <td><?php echo text($row['ODBC']); ?></td>
 607                                         <td><?php echo text($row['ODDIAM']); ?></td>
 608                                         <?php
 609                                         if ($adds) {
 610                                         ?>
 611                                         <td><?php echo text($row['ODADD']); ?></td>
 612                                         <?php } ?>
 613                                     </tr>
 614                                     <tr>
 615                                         <td colspan="2" class="right bold">
 616                                             <?php echo xlt('Brand'); ?>: <br />
 617                                             <?php echo xlt('Quantity'); ?>: <br />
 618                                             <?php echo xlt('Supplier'); ?>: </td>
 619                                         <td colspan="5" class="left" style="padding-left:10px;vertical-align:top;">
 620                                             <?php echo text($row['CTLBRANDOD']); ?>
 621                                             <?php
 622                                             if (!empty($row['CTLMANUFACTUREROD'])) {
 623                                                 echo "(".text($row['CTLMANUFACTUREROD']).")";
 624                                             } ?>
 625                                             <br />
 626                                             <?php echo text($row['CTLODQUANTITY']); ?><br />
 627                                             <?php echo text($row['CTLSUPPLIEROD']); ?>
 628                                         </td>
 629                                     </tr>
 630                                     <tr>
 631                                         <td colspan="7">
 632                                             <hr />
 633                                         </td>
 634                                     </tr>
 635                                     <tr>
 636                                         <td colspan="4"
 637                                             class="bold left text-uppercase text-top" style="display: flex;align-items:top">
 638                                             <u><?php echo xlt('Left Lens'); ?></u>
 639                                         </td>
 640                                     </tr>
 641                                     <tr class="bold underline">
 642                                         <td></td>
 643                                         <td><?php echo xlt('Sph{{Sphere}}'); ?></td>
 644                                         <td><?php echo xlt('Cyl{{Cylinder}}'); ?></td>
 645                                         <td><?php echo xlt('Axis{{Axis in a glasses prescription}}'); ?></td>
 646                                         <td><?php echo xlt('BC{{Base Curve}}'); ?></td>
 647                                         <td><?php echo xlt('Diam{{Diameter}}'); ?></td>
 648                                         <?php
 649                                         if ($adds) {
 650                                             ?>
 651                                             <td><?php echo xlt('ADD'); ?></td>
 652                                             <?php }
 653                                         ?>
 654                                     </tr>
 655                                     <tr>
 656                                         <td></td>
 657                                         <td><?php echo text($row['OSSPH']); ?></td>
 658                                         <td><?php echo text($row['OSCYL']); ?></td>
 659                                         <td><?php echo text($row['OSAXIS']); ?></td>
 660                                         <td><?php echo text($row['OSBC']); ?></td>
 661                                         <td><?php echo text($row['OSDIAM']); ?></td>
 662                                         <?php
 663                                         if ($adds) {
 664                                             ?>
 665                                             <td><?php echo text($row['OSADD']); ?></td>
 666                                                 <?php
 667                                         } ?>
 668                                     </tr>
 669                                     <tr>
 670                                         <td colspan="2" class="right bold">
 671                                             <?php echo xlt('Brand'); ?>: <br />
 672                                             <?php echo xlt('Quantity'); ?>: <br />
 673                                             <?php echo xlt('Supplier'); ?>: </td>
 674                                         <td colspan="5" class="left" style="padding-left:10px;vertical-align:top;"><?php echo text($row['CTLBRANDOS']); ?>
 675                                             <?php
 676                                             if (!empty($row['CTLMANUFACTUREROS'])) {
 677                                                 echo "(".text($row['CTLMANUFACTUREROS']).")";
 678                                             } ?>
 679                                             <br />
 680                                             <?php echo text($row['CTLOSQUANTITY']); ?><br />
 681                                             <?php echo text($row['CTLSUPPLIEROS']); ?>
 682                                         </td>
 683                                     </tr>
 684                                     <?php if (!empty($row['COMMENTS'])) { ?>
 685                                         <tr><td colspan="7"><hr /></td></tr>
 686                                     <tr>
 687                                         <td colspan="3" class="bold right"><?php echo xlt('Comments'); ?>:
 688                                         </td>
 689                                         <td colspan="3" class="left" style="padding-left:10px;vertical-align:middle;top:0px;">
 690                                             <?php echo text($row['COMMENTS']); ?>
 691                                         </td>
 692                                     </tr>
 693                                     <?php } ?>
 694                                 </table>
 695
 696                                 <?php
 697                         } ?>
 698                         </td>
 699                     </tr>
 700                 </table>
 701                 <hr>
 702
 703             </div>
 704             <?php
 705         } ?>
 706     </div>
 707 </div>
 708 </body>
 709     </html>
 710     <?php
 711     exit;
 712 }
 713
 714    ob_start();
 715     ?>
 716     <html>
 717     <head>
 718     <script src="<?php echo $GLOBALS['assets_static_relative'] ?>/jquery-1-10-2/jquery.js"></script>
 719     <script src="<?php echo $GLOBALS['assets_static_relative'] ?>/bootstrap/dist/js/bootstrap.min.js"></script>
 720     <script src="<?php echo $GLOBALS['assets_static_relative'] ?>/manual-added-packages/qtip2-2-2-1/jquery.qtip.min.js"></script>
 721
 722     <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative'] ?>/bootstrap/dist/css/bootstrap.min.css">
 723     <link rel="stylesheet" href="<?php echo $GLOBALS['css_header']; ?>" type="text/css">
 724     <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative'] ?>/jquery-ui-themes-1-10-4/themes/ui-lightness/jquery-ui.min.css">
 725     <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative'] ?>/pure/0.5.0/pure-min.css">
 726     <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative'] ?>/manual-added-packages/qtip2-2-2-1/jquery.qtip.min.css" />
 727     <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative'] ?>/font-awesome/css/font-awesome.min.css">
 728     <link rel="stylesheet" href="../../forms/<?php echo $form_folder; ?>/css/style.css" type="text/css">
 729
 730     <style>
 731         .title {
 732             font-size:1em;
 733             position:absolute;
 734             right:10px;
 735             top:30px;
 736             font-size: 1em;
 737         }
 738         .refraction {
 739             width:95%;
 740             display: -moz-stack;
 741             vertical-align: middle;
 742             min-height:unset;
 743         }
 744         .refraction td {
 745             text-align:center;
 746             font-size:12px;
 747             padding:5;
 748             width:0.35in;
 749             vertical-align: text-middle;
 750             text-decoration: unset;
 751         }
 752         table {
 753             font-size: 1.0em;
 754             padding: 12px;
 755             color: black;
 756             vertical-align: text-top;
 757         }
 758
 759         input[type=text] {
 760             text-align: center;
 761             width: 60px;
 762             padding: 0.2em 0.4em !important;
 763         }
 764
 765         .refraction b {
 766             font-weight: bold;
 767         }
 768
 769         .refraction td.right {
 770             text-align: right;
 771             text-decoration: unset;
 772             width: 0.7in;
 773             vertical-align: middle;    font-size:12px;
 774         }
 775
 776         .refraction td.left {
 777             vertical-align: middle;
 778             text-align: left;
 779             font-size:12px;
 780         }
 781
 782         .right {
 783             text-align: right;
 784             vertical-align: middle;}
 785
 786         .left {
 787             vertical-align: middle;
 788             text-align: left;
 789         }
 790
 791         .title {
 792             font-size: 0.9em;
 793             font-weight: normal;
 794         }
 795
 796         .bold {
 797             font-weight: 600;
 798         }
 799
 800         input {
 801             width: 60px;
 802         }
 803
 804         input[type="radio"] {
 805             width: 15px;
 806         }
 807         .underline {
 808             text-decoration:underline !important
 809         }
 810         #CTLODQUANTITY, #CTLOSQUANTITY {
 811             width: 300px;
 812             text-align: left;
 813             padding-left: 10px !important;
 814         }
 815         hr {
 816             margin:1px;
 817         }
 818         label {
 819             font-size:12px;
 820         }
 821
 822     </style>
 823     <!-- jQuery library -->
 824
 825     <script language="JavaScript">
 826         <?php require_once("$srcdir/restoreSession.php"); ?>
 827         function pick_rxType(rxtype, id) {
 828             var url = "../../forms/eye_mag/SpectacleRx.php";
 829             var formData = {
 830                 'RXTYPE': rxtype,
 831                 'id': id
 832             };
 833             top.restoreSession();
 834             $.ajax({
 835                 type: 'POST',
 836                 url: url,
 837                 data: formData
 838             });
 839             if (rxtype == 'Trifocal') {
 840                 $("[name$='MIDADD']").show();
 841                 $("[name$='ADD2']").show();
 842             } else if (rxtype == 'Bifocal') {
 843                 $("[name$='MIDADD']").hide().val('');
 844                 $("[name$='ADD2']").show();
 845             } else if (rxtype == 'Progressive') {
 846                 $("[name$='MIDADD']").hide().val('');
 847                 $("[name$='ADD2']").show();
 848             } else if (rxtype == "Single") {
 849                 $("[name$='MIDADD']").hide().val('');
 850                 $("[name$='ADD2']").hide().val('');
 851             }
 852         }
 853
 854         function submit_form() {
 855             var url = "../../forms/eye_mag/SpectacleRx.php?mode=update";
 856             formData = $("form#Spectacle").serialize();
 857             top.restoreSession();
 858             $.ajax({
 859                 type: 'POST',
 860                 url: url,
 861                 data: formData
 862             });
 863         }
 864
 865         //add sph and cyl, flip cyl sign, rotate axis 90.
 866         function reverse_cylinder() {
 867             var Rsph = $('#ODSPH').val();
 868             var Rcyl = $('#ODCYL').val();
 869             var Raxis = $('#ODAXIS').val();
 870             var Lsph = $('#OSSPH').val();
 871             var Lcyl = $('#OSCYL').val();
 872             var Laxis = $('#OSAXIS').val();
 873             if (Rsph == '' && Rcyl == '' && Lsph == '' && lcyl == '') return;
 874             if ((!Rcyl.match(/SPH/i)) && (Rcyl > '')) {
 875                 if (Rsph.match(/plano/i)) Rsph = '0';
 876                 Rsph = Number(Rsph);
 877                 Rcyl = Number(Rcyl);
 878                 Rnewsph = Rsph + Rcyl;
 879                 if (Rnewsph == 0) Rnewsph = "PLANO";
 880                 Rnewcyl = Rcyl * -1;
 881                 if (Rnewcyl > 0) Rnewcyl = "+" + Rnewcyl;
 882                 if (parseInt(Raxis) < 90) {
 883                     Rnewaxis = parseInt(Raxis) + 90;
 884                 } else {
 885                     Rnewaxis = parseInt(Raxis) - 90;
 886                 }
 887                 if (Rnewcyl == '0') Rnewcyl = "SPH";
 888                 if (Rnewsph == '0') {
 889                     Rnewsph = "PLANO";
 890                     if (Rnewcyl == "SPH") Rnewcyl = '';
 891                 }
 892                 $("#ODSPH").val(Rnewsph);
 893                 $("#ODCYL").val(Rnewcyl);
 894                 $("#ODAXIS").val(Rnewaxis);
 895                 $('#ODAXIS').trigger('blur');
 896                 $('#ODSPH').trigger('blur');
 897                 $('#ODCYL').trigger('blur');
 898             }
 899             if ((!Lcyl.match(/SPH/i)) && (Lcyl > '')) {
 900                 if (!Lsph.match(/\d/)) Lsph = '0';
 901                 Lsph = Number(Lsph);
 902                 Lcyl = Number(Lcyl);
 903                 Lnewsph = Lsph + Lcyl;
 904                 Lnewcyl = Lcyl * -1;
 905                 if (Lnewcyl > 0) Lnewcyl = "+" + Lnewcyl;
 906                 if (parseInt(Laxis) < 90) {
 907                     Lnewaxis = parseInt(Laxis) + 90;
 908                 } else {
 909                     Lnewaxis = parseInt(Laxis) - 90;
 910                 }
 911
 912                 if (Lnewcyl == '0') Lnewcyl = "SPH";
 913                 if (Lnewsph == '0') {
 914                     Lnewsph = "PLANO";
 915                     if (Lnewcyl == "SPH") Lnewcyl = '';
 916                 }
 917
 918                 $("#OSSPH").val(Lnewsph);
 919                 $("#OSCYL").val(Lnewcyl);
 920                 $("#OSAXIS").val(Lnewaxis);
 921                 $('#OSAXIS').trigger('blur');
 922                 $('#OSSPH').trigger('blur');
 923                 $('#OSCYL').trigger('blur');
 924             }
 925         }
 926     </script>
 927 </head>
 928 <body>
 929 <?php echo report_header($pid, "web");  ?>
 930 <br/><br/>
 931 <?php
 932 if ($REFTYPE == "CTL") {
 933     $expir = date("Y-m-d", strtotime($CTL_expir, strtotime($data['date'])));
 934 } else {
 935     $expir = date("Y-m-d", strtotime($RX_expir, strtotime($data['date'])));
 936 }
 937     $expir_date = oeFormatShortDate($expir);
 938 ?>
 939 <p><b><?php echo xlt('Expiration Date'); ?>: </b>
 940     &nbsp;&nbsp;     <?php echo text($expir_date); ?>
 941
 942 <form method="post" action="<?php echo $rootdir; ?>/forms/<?php echo text($form_folder); ?>/SpectacleRx.php?mode=update"
 943       id="Spectacle" class="eye_mag pure-form" name="Spectacle" style="text-align:center;">
 944     <!-- start container for the main body of the form -->
 945     <input type="hidden" name="REFDATE" id="REFDATE" value="<?php echo attr($data['date']); ?>">
 946     <input type="hidden" name="RXTYPE" id="RXTYPE" value="<?php echo attr($RXTYPE); ?>">
 947     <input type="hidden" name="REFTYPE" value="<?php echo attr($REFTYPE); ?>"/>
 948     <input type="hidden" name="pid" id="pid" value="<?php echo attr($pid); ?>">
 949     <input type="hidden" name="id" id="id" value="<?php echo attr($insert_this_id); ?>">
 950     <input type="hidden" name="encounter" id="encounter" value="<?php echo $encounter; ?>">
 951
 952     <div style="width: 650px;">
 953
 954         <table style="margin: 0px auto;">
 955             <tr>
 956                 <td>
 957                     <?php
 958                     if ($REFTYPE != "CTL") { ?>
 959                         <table id="SpectacleRx" name="SpectacleRx" class="refraction bordershadow"
 960                                style="min-width:610px;top:0px;">
 961                             <tr style="font-weight:bold;text-align:center;">
 962                                 <td><i name="reverse" id="reverse" class="fa fa-gamepad fa-2x"></i></td>
 963                                 <td></td>
 964                                 <td><?php echo xlt('Sph{{Sphere}}'); ?></td>
 965                                 <td><?php echo xlt('Cyl{{Cylinder}}'); ?></td>
 966                                 <td><?php echo xlt('Axis{{Axis of a glasses prescription}}'); ?></td>
 967                                 <td rowspan="5" class="right bold" colspan="1" >
 968                                     <b class="bold underline"><?php echo xlt('Rx Type'); ?></b><br/><br/>
 969                                     <b id="SingleVision_span" name="SingleVision_span"><?php echo xlt('Single'); ?>
 970                                         <input type="radio"
 971                                                onclick="pick_rxType('Single','<?php echo attr(addslashes($insert_this_id)); ?>');"
 972                                                value="Single" id="RXTYPE" name="RXTYPE"
 973                                                class="input-helper--radio input-helper--radio" <?php echo attr($Single); ?>></b><br/>
 974                                     <b id="Bifocal_span" name="Bifocal_span"><?php echo xlt('Bifocal'); ?>
 975                                         <input type="radio"
 976                                                onclick="pick_rxType('Bifocal','<?php echo attr(addslashes($insert_this_id)); ?>');"
 977                                                value="Bifocal" id="RXTYPE" name="RXTYPE" <?php echo attr($Bifocal); ?>></b><br/>
 978                                     <b id="Trifocal_span" name="Trifocal_span"><?php echo xlt('Trifocal'); ?>
 979                                         <input type="radio"
 980                                                onclick="pick_rxType('Trifocal','<?php echo attr(addslashes($insert_this_id)); ?>');"
 981                                                value="Trifocal" id="RXTYPE"
 982                                                name="RXTYPE" <?php echo attr($Trifocal); ?>></b><br/>
 983                                     <b id="Progressive_span"><?php echo xlt('Prog.{{Progressive lenses}}'); ?>
 984                                         <input type="radio"
 985                                                onclick="pick_rxType('Progressive','<?php echo attr(addslashes($insert_this_id)); ?>');"
 986                                                value="Progressive" id="RXTYPE"
 987                                                name="RXTYPE" <?php echo attr($Progressive); ?>></b><br/>
 988                                 </td>
 989                                 <td></td>
 990                             </tr>
 991                             <tr class="center">
 992                                 <td rowspan="2" colspan="1" class="right bold"><?php echo xlt('Distance'); ?>: </td>
 993                                 <td class="right bold"><?php echo xlt('OD{{right eye}}'); ?></td>
 994                                 <td><input type=text id="ODSPH" name="ODSPH" value="<?php echo attr($ODSPH); ?>"></td>
 995                                 <td><input type=text id="ODCYL" name="ODCYL" value="<?php echo attr($ODCYL); ?>"></td>
 996                                 <td><input type=text id="ODAXIS" name="ODAXIS" value="<?php echo attr($ODAXIS); ?>">
 997                                 </td>
 998                             </tr>
 999                             <tr class="center">
1000                                 <td name="W_wide" class="right bold"><?php echo xlt('OS{{left eye}}'); ?></td>
1001                                 <td><input type=text id="OSSPH" name="OSSPH" value="<?php echo attr($OSSPH); ?>"></td>
1002                                 <td><input type=text id="OSCYL" name="OSCYL" value="<?php echo attr($OSCYL); ?>"></td>
1003                                 <td><input type=text id="OSAXIS" name="OSAXIS" value="<?php echo attr($OSAXIS); ?>">
1004                                 </td>
1005                             </tr>
1006                             <tr class="NEAR center">
1007                                 <td rowspan="2" colspan="1" nowrap class="right bold"><?php echo xlt('ADD'); ?>:<br/>
1008                                     <?php echo xlt("Mid{{Middle segment in a trifocal glasses prescription}}"); ?>
1009                                     /<?php echo xlt("Near"); ?></td>
1010                                 <td class="right bold"><?php echo xlt('OD{{right eye}}'); ?></td>
1011                                 <td name="COLADD1"><input type="text" id="ODMIDADD" name="ODMIDADD"
1012                                                           value="<?php echo attr($ODMIDADD); ?>"></td>
1013                                 <td class="WAdd2"><input type="text" id="ODADD2" name="ODADD2"
1014                                                          value="<?php echo attr($ODADD2); ?>"></td>
1015                             </tr>
1016                             <tr class="NEAR center">
1017                                 <td class="right bold"><?php echo xlt('OS{{left eye}}'); ?></td>
1018                                 <td name="COLADD1">
1019                                     <input type="text" id="OSMIDADD" name="OSMIDADD" value="<?php echo attr($OSMIDADD); ?>"></td>
1020                                 <td class="WAdd2">
1021                                     <input type="text" id="OSADD2" name="OSADD2" value="<?php echo attr($OSADD2); ?>"></td>
1022                             </tr>
1023                             <tr>
1024                                 <td colspan="2" class="center bold"><?php echo xlt('Comments'); ?>: </td>
1025                                 <td colspan="4">
1026                                     <textarea style="width:100%;height:3em;" id="CRCOMMENTS"
1027                                               name="CRCOMMENTS"><?php echo text($COMMENTS); ?></textarea>
1028                                 </td>
1029                             </tr>
1030                             <!-- start Dispense data -->
1031                             <tr class="header closeButton">
1032                                 <td colspan="9" class="right">
1033                                                 <span><?php
1034                                                 if ($ODHPD || $ODHBASE || $ODVPD || $ODVBASE || $ODSLABOFF || $ODVERTEXDIST ||
1035                                                         $OSHPD || $OSHBASE || $OSVPD || $OSVBASE || $OSSLABOFF || $OSVERTEXDIST ||
1036                                                         $ODMPDD || $ODMPDN || $OSMPDD || $OSMPDN || $BPDD || $BPDN ||
1037                                                         $LENS_MATERIAL || $LENS_TREATMENTS) {
1038                                                           $detailed = '1';
1039                                                         ?><i class="fa fa-minus-square-o"></i><?php
1040                                                 } else {
1041                                                     $detailed = '0';
1042                                                     ?><i class="fa fa-plus-square-o"></i><?php
1043                                                 }
1044                                                     ?>
1045                                                 </span>
1046
1047                                 </td>
1048                             </tr>
1049                             <tr>
1050                                 <td colspan="7">
1051                                     <hr/>
1052                                 </td>
1053                             </tr>
1054                             <tr class="dispense_data" style="font-weight:bold;text-align:center;">
1055                                 <td name="W_wide" colspan="1"></td>
1056                                 <td name="W_wide"
1057                                     title="<?php echo xla('Horizontal Prism Power'); ?>"><?php echo xlt('Horiz Prism{{abbreviation for Horizontal Prism Power}}'); ?></td>
1058                                 <td name="W_wide"
1059                                     title="<?php echo xla('Horizontal Prism Base'); ?>"><?php echo xlt('Horiz Base{{abbreviation for Horizontal Prism Base}}'); ?></td>
1060                                 <td name="W_wide"
1061                                     title="<?php echo xla('Vertical Prism Power'); ?>"><?php echo xlt('Vert Prism{{abbreviation for Vertical Prism Power}}'); ?></td>
1062                                 <td name="W_wide"
1063                                     title="<?php echo xla('Vertical Prism Base'); ?>"><?php echo xlt('Vert Base{{abbreviation for Vertical Prism Base}}'); ?></td>
1064                                 <td name="W_wide"
1065                                     title="<?php echo xla('Slab Off'); ?>"><?php echo xlt('Slab Off'); ?></td>
1066                                 <td name="W_wide"
1067                                     title="<?php echo xla('Vertex Distance'); ?>"><?php echo xlt('Vert Distance{{abbreviation for Vertex Distance}}'); ?></td>
1068                             </tr>
1069                             <tr class="dispense_data">
1070                                 <td name="W_wide" style="text-align:right;font-weight:bold;"
1071                                     colspan="1"><?php echo xlt('OD{{right eye}}'); ?></td>
1072                                 <td name="W_wide"><input type="text" class="prism" id="ODHPD" name="ODHPD"
1073                                                          value="<?php echo attr($ODHPD); ?>"></td>
1074                                 <td name="W_wide"><input type="text" class="prism" id="ODHBASE" name="ODHBASE"
1075                                                          value="<?php echo attr($ODHBASE); ?>"></td>
1076                                 <td name="W_wide"><input type="text" class="prism" id="ODVPD" name="ODVPD"
1077                                                          value="<?php echo attr($ODVPD); ?>"></td>
1078                                 <td name="W_wide"><input type="text" class="prism" id="ODVBASE" name="ODVBASE"
1079                                                          value="<?php echo attr($ODVBASE); ?>"></td>
1080                                 <td name="W_wide"><input type="text" class="prism" id="ODSLABOFF" name="ODSLABOFF"
1081                                                          value="<?php echo attr($ODSLABOFF); ?>"></td>
1082                                 <td name="W_wide"><input type="text" class="prism" id="ODVERTEXDIST" name="ODVERTEXDIST"
1083                                                          value="<?php echo attr($ODVERTEXDIST); ?>"></td>
1084                             </tr>
1085                             <tr class="dispense_data">
1086                                 <td name="W_wide" style="text-align:right;font-weight:bold;"
1087                                     colspan="1"><?php echo xlt('OS{{left eye}}'); ?></td>
1088                                 <td name="W_wide"><input type="text" class="prism" id="OSHPD" name="OSHPD"
1089                                                          value="<?php echo attr($OSHPD); ?>"></td>
1090                                 <td name="W_wide"><input type="text" class="prism" id="OSHBASE" name="OSHBASE"
1091                                                          value="<?php echo attr($OSHBASE); ?>"></td>
1092                                 <td name="W_wide"><input type="text" class="prism" id="OSVPD" name="OSVPD"
1093                                                          value="<?php echo attr($OSVPD); ?>"></td>
1094                                 <td name="W_wide"><input type="text" class="prism" id="OSVBASE" name="OSVBASE"
1095                                                          value="<?php echo attr($OSVBASE); ?>"></td>
1096                                 <td name="W_wide"><input type="text" class="prism" id="OSSLABOFF" name="OSSLABOFF"
1097                                                          value="<?php echo attr($OSSLABOFF); ?>"></td>
1098                                 <td name="W_wide"><input type="text" class="prism" id="OSVERTEXDIST" name="OSVERTEXDIST"
1099                                                          value="<?php echo attr($OSVERTEXDIST); ?>"></td>
1100                             </tr>
1101                             <tr class="dispense_data">
1102                                 <td colspan="7" class="center">
1103                                     <hr/>
1104                                 </td>
1105                             </tr>
1106                             <tr class="dispense_data" style="font-weight:bold;text-align:center;">
1107                                 <td></td>
1108                                 <td name="W_wide"
1109                                     title="<?php echo xla('Monocular Pupillary Diameter - Distance'); ?>"><?php echo xlt('MPD-D{{abbreviation for Monocular Pupillary Diameter - Distance}}'); ?></td>
1110                                 <td name="W_wide"
1111                                     title="<?php echo xla('Monocular Pupillary Diameter - Near'); ?>"><?php echo xlt('MPD-N{{abbreviation for Monocular Pupillary Diameter - Near}}'); ?></td>
1112                                 <td name="W_wide"
1113                                     title="<?php echo xla('Binocular Pupillary Diameter - Distance'); ?>"><?php echo xlt('BPD-D{{abbreviation for Binocular Pupillary Diameter - Distance}}'); ?></td>
1114                                 <td name="W_wide"
1115                                     title="<?php echo xla('Binocular Pupillary Diameter - Near'); ?>"><?php echo xlt('BPD-N{{abbreviation for Binocular Pupillary Diameter - Near}}'); ?></td>
1116
1117                                 <td colspan="2">Lens Material:</td>
1118                             </tr>
1119                             <tr>
1120                                 <td name="W_wide" style="text-align:right;font-weight:bold;"
1121                                     colspan="1"><?php echo xlt('OD{{right eye}}'); ?></td>
1122                                 <td name="W_wide"><input type="text" class="prism" id="ODMPDD" name="ODMPDD"
1123                                                          value="<?php echo attr($ODMPDD); ?>"></td>
1124                                 <td name="W_wide"><input type="text" class="prism" id="ODMPDN" name="ODMPDN"
1125                                                          value="<?php echo attr($ODMPDN); ?>"></td>
1126                                 <td name="W_wide" rowspan="2" style="vertical-align:middle;"><input type="text"
1127                                                                                                     class="prism"
1128                                                                                                     id="BPDD"
1129                                                                                                     name="BPDD"
1130                                                                                                     value="<?php echo attr($BPDD); ?>">
1131                                 </td>
1132                                 <td name="W_wide" rowspan="2" style="vertical-align:middle;"><input type="text"
1133                                                                                                     class="prism"
1134                                                                                                     id="BPDN"
1135                                                                                                     name="BPDN"
1136                                                                                                     value="<?php echo attr($BPDN); ?>">
1137                                 </td>
1138                                 <td colspan="2">   <?php
1139                                     echo generate_select_list("LENS_MATERIAL", "Eye_Lens_Material", "$LENS_MATERIAL", '', ' ', '', 'restoreSession;submit_form();', '', array('style' => 'width:120px'));
1140                                     ?>
1141                                 </td>
1142                             </tr>
1143                             <tr>
1144                                 <td name="W_wide" style="text-align:right;font-weight:bold;"
1145                                     colspan="1"><?php echo xlt('OS{{left eye}}'); ?></td>
1146                                 <td name="W_wide"><input type="text" class="prism" id="OSMPDD" name="OSMPDD"
1147                                                          value="<?php echo attr($OSMPDD); ?>"></td>
1148                                 <td name="W_wide"><input type="text" class="prism" id="OSMPDN" name="OSMPDN"
1149                                                          value="<?php echo attr($OSMPDN); ?>"></td>
1150                             </tr>
1151                             <tr style="font-weight:bold;text-align:center;">
1152                                 <td colspan="3"><?php echo xlt('Lens Treatments'); ?>
1153                                 </td>
1154                             </tr>
1155                             <tr style="text-align:left;vertical-align:top;">
1156                                 <td colspan="4" class="bold left">
1157                                     <?php echo generate_lens_treatments($W, $LENS_TREATMENTS); ?>
1158                                 </td>
1159                             </tr>
1160                         </table>&nbsp;<br/><br/><br/>
1161                         <?php
1162                     } else {
1163                         if (!empty($ODADD) || !empty($OSADD)) {
1164                             $adds =1;
1165                         } else {
1166                             $adds ='';
1167                         }
1168                         ?>
1169                         <table id="CTLRx" name="CTLRx" class="refraction bordershadow">
1170                             <tr class="bold center">
1171                                 <td class="right bold underline"><?php echo xlt('Right Lens'); ?></td>
1172                             </tr>
1173                            <tr>
1174                                 <td colspan="2" class="right bold text-uppercase"><?php echo xlt('Brand'); ?>:</td>
1175                                 <td colspan="4" class="left"><?php echo text($CTLBRANDOD); ?> <?php if ($CTLMANUFACTUREROD) {
1176                                     echo "(".text($CTLMANUFACTUREROD).")";} ?></td>
1177                             </tr>
1178                             <tr class="bold">
1179                                 <td><?php echo xlt('SPH{{Sphere}}'); ?></td>
1180                                 <td><?php echo xlt('CYL{{Cylinder}}'); ?></td>
1181                                 <td><?php echo xlt('AXIS{{Axis of a glasses prescription}}'); ?></td>
1182                                 <td><?php echo xlt('BC{{Base Curve}}'); ?></td>
1183                                 <td><?php echo xlt('DIAM{{Diameter}}'); ?></td>
1184                                 <?php
1185                                 if ($adds) {
1186                                 ?>
1187                                 <td><?php echo xlt('ADD{{Bifocal Add}}'); ?></td>
1188                                 <?php } ?>
1189                             </tr>
1190                             <tr>
1191                                 <td><input type=text id="CTLODSPH" name="CTLODSPH" value="<?php echo attr($ODSPH); ?>">
1192                                 </td>
1193                                 <td><input type=text id="CTLODCYL" name="CTLODCYL" value="<?php echo attr($ODCYL); ?>">
1194                                 </td>
1195                                 <td><input type=text id="CTLODAXIS" name="CTLODAXIS"
1196                                            value="<?php echo attr($ODAXIS); ?>"></td>
1197                                 <td><input type=text id="CTLODBC" name="CTLODBC" value="<?php echo attr($ODBC); ?>">
1198                                 </td>
1199                                 <td><input type=text id="CTLODDIAM" name="CTLODDIAM"
1200                                            value="<?php echo attr($ODDIAM); ?>"></td>
1201                                 <?php
1202                                 if ($adds) {
1203                                 ?>
1204                                 <td><input type=text id="CTLODADD" name="CTLODADD" value="<?php echo attr($ODADD); ?>">
1205                                 </td>
1206                                 <?php } ?>
1207                             </tr>
1208                             <tr>
1209                                 <td colspan="2" class="right bold text-uppercase"><?php echo xlt('Quantity:'); ?></td>
1210                                 <td colspan="4" class="left"><input id="CTLODQUANTITY" name="CTLODQUANTITY" value="<?php echo attr($CTLODQUANTITY); ?>" type="text" class="left" /></td>
1211                             </tr>
1212                             <tr>
1213                                 <td colspan="7">
1214                                     <hr />
1215                                 </td>
1216                             </tr>
1217                             <tr>
1218                                 <td class="right bold large underline"><?php echo xlt('Left Lens'); ?></td>
1219                             </tr>
1220                             <tr>
1221                                 <td colspan="2" class="right bold text-uppercase"><?php echo xlt('Brand'); ?>:</td>
1222                                 <td colspan="4" class="left"><?php echo text($CTLBRANDOS); ?> <?php if ($CTLMANUFACTUREROS) {
1223                                     echo "(".text($CTLMANUFACTUREROS).")";} ?></td>
1224                             </tr>
1225                             <tr class="bold" style="line-height:0.3em;font-size:0.6em;">
1226                                 <td><?php echo xlt('SPH{{Sphere}}'); ?></td>
1227                                 <td><?php echo xlt('CYL{{Cylinder}}'); ?></td>
1228                                 <td><?php echo xlt('AXIS{{Axis of a glasses prescription}}'); ?></td>
1229                                 <td><?php echo xlt('BC{{Base Curve}}'); ?></td>
1230                                 <td><?php echo xlt('DIAM{{Diameter}}'); ?></td>
1231                                 <?php
1232                                 if ($adds) {
1233                                 ?>
1234                                 <td><?php echo xlt('ADD{{Bifocal Add}}'); ?></td>
1235                                 <?php } ?>
1236                             </tr>
1237                             <tr>
1238                                 <td><input type=text id="CTLOSSPH" name="CTLOSSPH" value="<?php echo attr($OSSPH); ?>">
1239                                 </td>
1240                                 <td><input type=text id="CTLOSCYL" name="CTLOSCYL" value="<?php echo attr($OSCYL); ?>">
1241                                 </td>
1242                                 <td><input type=text id="CTLOSAXIS" name="CTLOSAXIS"
1243                                            value="<?php echo attr($OSAXIS); ?>"></td>
1244                                 <td><input type=text id="CTLOSBC" name="CTLOSBC" value="<?php echo attr($OSBC); ?>">
1245                                 </td>
1246                                 <td><input type=text id="CTLOSDIAM" name="CTLOSDIAM"
1247                                            value="<?php echo attr($OSDIAM); ?>"></td>
1248                                 <?php
1249                                 if ($adds) {
1250                                 ?>
1251                                 <td><input type=text id="CTLOSADD" name="CTLOSADD" value="<?php echo attr($OSADD); ?>"></td>
1252                                 <?php } ?>
1253                             </tr>
1254                             <tr>
1255                                 <td colspan="2" class="right bold text-uppercase"><?php echo xlt('Quantity:'); ?></td>
1256                                 <td colspan="4" class="left"><input id="CTLOSQUANTITY" name="CTLOSQUANTITY" value="<?php echo attr($CTLOSQUANTITY); ?>" type="text" class="left" /></td>
1257                             </tr>
1258
1259                             <?php if ($CTL_COMMENTS > '') { ?>
1260                                 <tr>
1261                                     <td colspan="7">
1262                                         <hr />
1263                                     </td>
1264                                 </tr>
1265                                 <tr>
1266                                     <td class="right bold red" colspan="2"
1267                                         style="vertical-align:top;"><?php echo xlt('Comments'); ?>:</u></td>
1268                                     <td colspan="4" class="left">
1269                                         <textarea cols="30" rows="4" id="COMMENTS" name="COMMENTS"><?php echo text($CTL_COMMENTS); ?></textarea>
1270                                     </td>
1271                                 </tr>
1272                             <?php } ?>
1273                         </table>
1274                         <?php
1275                     } ?>
1276                 </td>
1277             </tr>
1278             <tr>
1279                 <?php
1280                     $signature = $GLOBALS['fileroot'] . "/interface/forms/eye_mag/images/sign_" . attr($_SESSION['authUserID']) . ".jpg";
1281                 if (file_exists($signature)) {
1282                     ?>
1283                     <td class="center" style="margin:25px auto;">
1284                         <span style="position:relative;padding-left:40px;">
1285                             <img src='<?php echo $web_root; ?>/interface/forms/eye_mag/images/sign_<?php echo attr($_SESSION['authUserID']); ?>.jpg'
1286                                  style="width:240px;height:85px;border-block-end: 1pt solid black;margin:5px;"/>
1287                                 </span><br/>
1288
1289                         <?php
1290                 } else {
1291                     ?>
1292                     <td class="center">
1293                         <hr style="border:solid 1px black;width:50%;margin:0.5in auto 0;" />
1294                     <?php
1295                 } ?>
1296
1297                     <?php echo xlt('Provider'); ?>
1298                     : <?php echo text($prov_data['fname']); ?> <?php echo text($prov_data['lname']);
1299                     if ($prov_data['suffix']) {
1300                         echo ", " . $prov_data['suffix'];
1301                     } ?><br/>
1302                     <small><?php echo xlt('e-signed'); ?> <input type="checkbox" checked="checked"></small>
1303                 </td>
1304             </tr>
1305
1306
1307         </table>
1308     </div>
1309 </form>
1310
1311 </body>
1312 <script>
1313     $(document).ready(function () {
1314         $('.header').click(function () {
1315             var $this = $(this);
1316             $(this).nextUntil('tr.header').slideToggle(100).promise().done(function () {
1317                 $this.find('span').html(function (_, value) {
1318                     return value == '<i class="fa fa-plus-square-o"></i>' ? '<i class="fa fa-minus-square-o"></i>' : '<i class="fa fa-plus-square-o"></i>';
1319                 });
1320             });
1321         });
1322         <?php
1323         if (!$detailed) {
1324             echo "$('.header').trigger('click');";
1325         } ?>
1326
1327         $("input[name$='PD']").blur(function () {
1328             //make it all caps
1329             var str = $(this).val();
1330             str = str.toUpperCase();
1331             $(this).val(str);
1332         });
1333         $('input[name$="SPH"]').blur(function () {
1334             var mid = $(this).val();
1335             if (mid.match(/PLANO/i)) {
1336                 $(this).val('PLANO');
1337                 return;
1338             }
1339             if (mid.match(/^[\+\-]?\d{1}$/)) {
1340                 mid = mid + ".00";
1341             }
1342             if (mid.match(/\.[27]$/)) {
1343                 mid = mid + '5';
1344             }
1345             if (mid.match(/\.\d$/)) {
1346                 mid = mid + '0';
1347             }
1348             //if near is +2. make it +2.00
1349             if (mid.match(/\.$/)) {
1350                 mid = mid + '00';
1351             }
1352             if ((!mid.match(/\./)) && (mid.match(00 | 25 | 50 | 75))) {
1353                 var front = mid.match(/(\d{0,2})(00|25|50|75)/)[1];
1354                 var back = mid.match(/(\d{0,2})(00|25|50|75)/)[2];
1355                 if (front == '') front = '0';
1356                 mid = front + "." + back;
1357             }
1358             if (!mid.match(/\./)) {
1359                 var front = mid.match(/([\+\-]?\d{0,2})(\d{2})/)[1];
1360                 var back = mid.match(/(\d{0,2})(\d{2})/)[2];
1361                 if (front == '') front = '0';
1362                 if (front == '-') front = '-0';
1363                 mid = front + "." + back;
1364             }
1365             if (!mid.match(/^(\+|\-){1}/)) {
1366                 mid = "+" + mid;
1367             }
1368             $(this).val(mid);
1369         });
1370
1371         $("input[name$='ADD'],input[name$='ADD2']").blur(function () {
1372             var add = $(this).val();
1373             add = add.replace(/=/g, "+");
1374             //if add is one digit, eg. 2, make it +2.00
1375             if (add.match(/^\d{1}$/)) {
1376                 add = "+" + add + ".00";
1377             }
1378             //if add is '+'one digit, eg. +2, make it +2.00
1379             if (add.match(/^\+\d{1}$/)) {
1380                 add = add + ".00";
1381             }
1382             //if add is 2.5 or 2.0 make it 2.50 or 2.00
1383             if (add.match(/\.[05]$/)) {
1384                 add = add + '0';
1385             }
1386             //if add is 2.2 or 2.7 make it 2.25 or 2.75
1387             if (add.match(/\.[27]$/)) {
1388                 add = add + '5';
1389             }
1390             //if add is +2. make it +2.00
1391             if (add.match(/\.$/)) {
1392                 add = add + '00';
1393             }
1394             if ((!add.match(/\./)) && (add.match(/(0|25|50|75)$/))) {
1395                 var front = add.match(/([\+]?\d{0,1})(00|25|50|75)/)[1];
1396                 var back = add.match(/([\+]?\d{0,1})(00|25|50|75)/)[2];
1397                 if (front == '') front = '0';
1398                 add = front + "." + back;
1399             }
1400             if (!add.match(/^(\+)/) && (add.length > 0)) {
1401                 add = "+" + add;
1402             }
1403             $(this).val(add);
1404             if (this.id == "ODADD2") $('#OSADD2').val(add);
1405             if (this.id == "ODMIDADD") $('#OSMIDADD').val(add);
1406             if (this.id == "CTLODADD") $('#CTLOSADD').val(add);
1407         });
1408
1409         $("input[name$='AXIS']").blur(function () {
1410             // Make this a 3 digit leading zeros number.
1411             // we are not translating text to numbers, just numbers to
1412             // a 3 digit format with leading zeroes as needed.
1413             // assume the end user KNOWS there are only numbers presented and
1414             // more than 3 digits is a mistake...
1415             // (although this may change with topographic answer)
1416             var axis = $(this).val();
1417             var group = this.name.replace("AXIS", "CYL");
1418             ;
1419             var cyl = $("#" + group).val();
1420             if ((cyl > '') && (cyl != 'SPH')) {
1421                 if (!axis.match(/\d\d\d/)) {
1422                     if (!axis.match(/\d\d/)) {
1423                         if (!axis.match(/\d/)) {
1424                             axis = '0';
1425                         }
1426                         axis = '0' + axis;
1427                     }
1428                     axis = '0' + axis;
1429                 }
1430             } else {
1431                 axis = '';
1432             }
1433             $(this).val(axis);
1434         });
1435         $("[name$='CYL']").blur(function () {
1436             var mid = $(this).val();
1437             var group = this.name.replace("CYL", "SPH");
1438             ;
1439             var sphere = $("#" + group).val();
1440             if (((mid.length == 0) && (sphere.length > 0)) || (mid.match(/sph/i))) {
1441                 $(this).val('SPH');
1442                 var axis = this.name.replace("CYL", "AXIS");
1443                 $("#" + axis).val('');
1444                 return;
1445             } else if (sphere.length > 0) {
1446                 if (mid.match(/^[\+\-]?\d{1}$/)) {
1447                     mid = mid + ".00";
1448                 }
1449                 if (mid.match(/^(\d)(\d)$/)) {
1450                     mid = mid[0] + '.' + mid[1];
1451                 }
1452                 //if mid is 2.5 or 2.0 make it 2.50 or 2.00
1453                 if (mid.match(/\.[05]$/)) {
1454                     mid = mid + '0';
1455                 }
1456                 //if mid is 2.2 or 2.7 make it 2.25 or 2.75
1457                 if (mid.match(/\.[27]$/)) {
1458                     mid = mid + '5';
1459                 }
1460                 //if mid is +2. make it +2.00
1461                 if (mid.match(/\.$/)) {
1462                     mid = mid + '00';
1463                 }
1464                 if (mid.match(/([\+\-]?\d{0,2})\.?(00|25|50|75)/)) {
1465                     var front = mid.match(/([\+\-]?\d{0,2})\.?(00|25|50|75)/)[1];
1466                     var back = mid.match(/([\+\-]?\d{0,2})\.?(00|25|50|75)/)[2];
1467                     if (front == '') front = '0';
1468                     mid = front + "." + back;
1469                 }
1470                 if (!mid.match(/^(\+|\-){1}/) && (sphere.length > 0)) {
1471                     //Since it doesn't start with + or - then give it '+'
1472                     mid = "+" + mid;
1473                 }
1474                 $(this).val(mid);
1475             }
1476         });
1477         $("input,textarea,text,checkbox").change(function () {
1478             submit_form($(this));
1479         });
1480         $("#reverse").click(function () {
1481             //alert('Start');
1482             reverse_cylinder('');
1483             //alert('Finish');
1484
1485         });
1486         $("input[name$='SPH'],input[name$='CYL']").on('keyup', function (e) {
1487             if (e.keyCode == '61' || e.keyCode == '74') {
1488                 now = $(this).val();
1489                 now = now.replace(/=/g, "+").replace(/^j/g, "J");
1490                 $(this).val(now);
1491             }
1492         });
1493
1494     });
1495 </script>
1496 </html>
1497
1498 <?php
1499 $content = ob_get_clean();
1500 echo $content;
1501 exit;
1502 ?>