interface/forms/vitals/templates/vitals/general_new.html.array

   1 <html>
   2 <head>
   3 {literal}
   4  <style type="text/css" title="mystyles" media="all">
   5 <!--
   6 td {
   7         font-size:12pt;
   8         font-family:helvetica;
   9 }
  10 li{
  11         font-size:11pt;
  12         font-family:helvetica;
  13         margin-left: 15px;
  14 }
  15 a {
  16         font-size:11pt;
  17         font-family:helvetica;
  18 }
  19 .title {
  20         font-family: sans-serif;
  21         font-size: 12pt;
  22         font-weight: bold;
  23         text-decoration: none;
  24         color: #000000;
  25 }
  26
  27 .form_text{
  28         font-family: sans-serif;
  29         font-size: 9pt;
  30         text-decoration: none;
  31         color: #000000;
  32 }
  33
  34 -->
  35 </style>
  36 {/literal}
  37 </head>
  38 <body bgcolor="{$STYLE.BGCOLOR2}">
  39 <p><span class="title">Vitals</span></p>
  40 <form name="vitals" method="post" action="{$FORM_ACTION}/interface/forms/vitals/save.php"
  41  onsubmit="return top.restoreSession()">
  42 <table>
  43         <tr><th align="left">Name</th><th align="left">Unit</th>
  44         {foreach item=vital from=$vitals}
  45                 <th align="left">{$vital->get_date()|date_format:"%m/%d/%y"}</th><tr>
  46         {/foreach}
  47         <tr><td>Height</td><td>in</td>
  48         {foreach item=vital from=$vitals}
  49                 <td><input type="text" width='5'
  50                 name="height" value="{$vital->get_height()}"/></td>
  51         {/foreach}
  52         <tr><td>Weight</td><td>lbs</td>
  53         {foreach item=vital from=$vitals}
  54                 <td><input type="text"
  55                         name="weight" value="{$vital->get_weight()}"/></td>
  56         {/foreach}
  57         <tr><td>BP Systolic</td><td>mm/hg</td>
  58         {foreach item=vital from=$vitals}
  59                 <td><input type="text"
  60                         name="bps" value="{$vital->get_bps()}"/></td>
  61         {/foreach}
  62         <tr><td>BP Diastolic</td><td>mm/hg</td>
  63         {foreach item=vital from=$vitals}
  64                 <td><input type="text"
  65                         name="bpd" value="{$vital->get_bpd()}"/></td>
  66         {/foreach}
  67         <tr><td>Pulse</td><td>per min</td>
  68         {foreach item=vital from=$vitals}
  69                         <td><input type="text"
  70                         name="pulse" value="{$vital->get_pulse()}"/></td>
  71         {/foreach}
  72         <tr><td>Respiration</td><td>per min</td>
  73         {foreach item=vital from=$vitals}
  74                 <td><input type="text"
  75                         name="respiration" value="{$vital->get_respiration()}"/></td>
  76         {/foreach}
  77         <tr><td>Temperature</td><td>F</td>
  78         {foreach item=vital from=$vitals}
  79                 <td><input type="text"
  80                         name="temperature" value="{$vital->get_temperature()}"/></td>
  81         {/foreach}
  82         <tr><td>Temp Location</td><td> </td>
  83                 <td><select name="temp_method">
  84
  85         </td></tr>
  86         <tr><td>Head Circumference</td><td>cm</td>
  87         {foreach item=vital from=$vitals}
  88                 <td><input type="text"
  89                         name="head_circ" value="{$vital->get_head_circ()}"/></td>
  90         {/foreach}
  91         <tr><td>BMI</td><td>%</td>
  92         {foreach item=vital from=$vitals}
  93                 <td><input type="text"
  94                         name="BMI" value="{$vital->get_BMI()}"/></td>
  95         {/foreach}
  96         <tr><td>BMI Status</td><td>Type</td>
  97         {foreach item=vital from=$vitals}
  98                 <td><input type="text"
  99                         name="BMI_status" value="{$vital->get_BMI_status()}"/></td>
 100         {/foreach}
 101
 102         <tr><td>Oxygen Saturation</td><td>%</td>
 103         {foreach item=vital from=$vitals}
 104                 <td><input type="text"
 105                         name="oxygen_saturation" value="{$vital->get_oxygen_saturation()}"/></td>
 106         {/foreach}
 107         <tr><td>Waist Circumference</td><td>in</td>
 108         {foreach item=vital from=$vitals}
 109                 <td><input type="text"
 110                         name="waist_circ" value="{$vital->get_waist_circ()}"/></td>
 111         {/foreach}
 112         </tr>
 113         <tr>
 114         <td><input type="submit" name="Submit" value="Save Form">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<a href="{$DONT_SAVE_LINK}" class="link">[Don't Save]</a></td>
 115 </tr>
 116 </table>
 117 {assign var="id" value=$vitals[0]->get_id()}
 118 {assign var="activity" value=$vitals[0]->get_activity()}
 119 {assign var="pid" value=$vitals[0]->get_pid()}
 120 <input type="hidden" name="id" value="{$id}" />
 121 <input type="hidden" name="activity" value="{$activity}">
 122 <input type="hidden" name="pid" value="{$pid}">
 123 <input type="hidden" name="process" value="true">
 124 </form>
 125 </body>
 126 </html>