Updated Acknowledgments page
[openemr.git] / contrib / forms / phone_exam / new.php
blobaf6ad999581806cbd1efdb977044aec01bc00638
1 <?php
3 // file new.php
5 include_once("../../globals.php");
7 include_once("../../../library/api.inc");
9 formHeader("Phone Exam");
13 <html><head>
14 <?php html_header_show();?>
16 <link rel="stylesheet" href="<?php echo $css_header;?>" type="text/css">
18 </head>
20 <body class="body_top">
24 <br>
26 <form method='post' action="<?php echo $rootdir;?>/forms/phone_exam/save.php?mode=new" name='phone_exam_form' enctype="multipart/form-data">
28 <span class=title>Phone Exam</span>
30 <br>
34 <span class=text>Notes:</span><br>
36 <textarea name="notes" wrap="virtual" cols="45" rows="10"></textarea><br>
40 <!--REM note our nifty jscript submit -->
42 <input type="hidden" name="action" value="submit">
44 <a href="javascript:top.restoreSession();document.phone_exam_form.submit();" class="link_submit">[Save]</a>
46 <br>
50 <a href="<?php echo $GLOBALS['form_exit_url']; ?>" class="link" onclick="top.restoreSession()">[Don't Save]</a>
52 </form>
56 <?php
58 formFooter();