contrib/forms/ped_pain/new.php

   1 <?
   2 // file new.php
   3 // presents a blank form for evaluating pediatric pain
   4 // this file made by andres@paglayan.com on 2004-09-23
   5 // input designed by Lowell Gordon, MD lgordon@whssf.org
   6 // to max the billing complexity coding
   7
   8 include_once("../../globals.php");
   9 include_once("../../../library/api.inc");
  10 formHeader("Pediatric Pain Evaluation");
  11
  12 ?>
  13 <html><head>
  14 <link rel=stylesheet href="<?echo $css_header;?>" type="text/css">
  15 </head>
  16 <body <?echo $top_bg_line;?> topmargin=0 rightmargin=0 leftmargin=2 bottommargin=0 marginwidth=2 marginheight=0>
  17
  18 <!--REM note that every input method has the same name as a valid column, this will make things easier in save.php -->
  19
  20 <br>
  21 <form method='post' action="<?echo $rootdir;?>/forms/ped_pain/save.php?mode=new" name='ped_pain' target='Main' >
  22
  23 <!-- the form goes here -->
  24 <?php
  25         $obj=array(); // just to avoid undeclared var warning
  26         include ('form.php'); // to use a single file for both, empty and editing
  27 ?>
  28 <!-- the form ends here -->
  29
  30 <!--REM note our nifty jscript submit -->
  31 <a href="javascript:document.ped_pain.submit();" class="link_submit">[Save]</a>
  32 <br>
  33
  34 <a href="<?echo "$rootdir/patient_file/encounter/patient_encounter.php";?>" class="link">[Don't Save]</a>
  35 </form>
  36
  37
  38
  39 <?php
  40 formFooter();
  41 ?>