contrib/forms/xmlformgen/urinary_soap.xml

   1 <?xml version="1.0" encoding="ISO-8859-1"?>
   2 <!-- Generated by Hand -->
   3 <form>
   4   <table type="form">form_urinary_soap</table>
   5   <RealName>Urinary Symptoms</RealName>
   6   <safename>urinary_soap</safename>
   7   <style cells_per_row="2">layout</style>
   8   <acl table="patients">med</acl>
   9
  10   <manual>
  11
  12     <section name="subjective" label="Subjective">
  13         <field name="urinary_complaints" label="Urinary Complaints" type="checkbox_combo_list" list="Urinary_Complaints" size="140" maxlength="255" labelcols="1" cols="1"/>
  14         <field name="previous_cultures" label="Previous Cultures" type="textfield" size="151" maxlength="255" labelcols="1" cols="1"/>
  15         <field name="other" label="Other" type="textarea" columns="151" labelcols="1" cols="1"/>
  16         <field name="duration" label="Duration" type="textfield" size="140" maxlength="255" labelcols="1" cols="1"/>
  17     </section>
  18
  19    <section name="objective" label="Objective">
  20                 <field name="exam" label="Exam" type="checkbox_combo_list" list="Urinary_Exam" size="140" labelcols="1" cols="1"/>
  21     </section>
  22
  23     <section name="assessment" label="Assessment">
  24         <field name="diagnosis" label="Diagnosis" type="checkbox_combo_list" list="Urinary_Diagnosis" size="140" labelcols="1" cols="1"/>
  25     </section>
  26
  27     <section name="plan" label="Plan">
  28                 <field name="plan" label="Plan" type="checkbox_combo_list" list="Urinary_Plans" size="140" labelcols="1" cols="1"/>
  29     </section>
  30
  31   </manual>
  32
  33   <list id="Urinary_Complaints" name="Urinary_Complaints" label="Urinary Complaints" type="standard" import="yes">
  34       <listitem id='1' label="Frequency" order='1'>Frequency</listitem>
  35       <listitem id='2' label="Urgency" order='2'>Urgency</listitem>
  36       <listitem id='3' label="Incontinence" order='3'>Incontinence</listitem>
  37       <listitem id='4' label="Dysuria" order='4'>Dysuria</listitem>
  38       <listitem id='5' label="Other" order='5'>Other</listitem>
  39   </list>
  40
  41   <list id="Urinary_Exam" name="Urinary_Exam" label="Urinary Exam"
  42                 type="standard" import="yes">
  43                 <listitem id='1' label="Vulvar" order="1">"Vulvar"</listitem>
  44                 <listitem id='2' label="Vaginal" order="2">Vaginal</listitem>
  45                 <listitem id='3' label="Cervix" order="3">Cervix</listitem>
  46                 <listitem id='4' label="Uterus" order="4">Uterus</listitem>
  47                 <listitem id='5' label="Adnexae" order="5">Adnexae</listitem>
  48                 <listitem id='6' label="Rectal" order="6">Rectal</listitem>
  49                 <listitem id='7' label="Other" order="7">Other</listitem>
  50         </list>
  51
  52   <list id="Urinary_Diagnosis" name="Urinary_Diagnosis" label="Urinary Diagnosis" type="standard" import="yes">
  53       <listitem id='1' label="UTI" order="1">UTI</listitem>
  54       <listitem id='2' label="Hematuria" order="2">Hematuria</listitem>
  55       <listitem id='3' label="Chronic/Recurrent Cystitis" order="3">Chronic/Recurrent Cystitis</listitem>
  56       <listitem id='4' label="Duration" order="4">Duration</listitem>
  57       <listitem id='5' label="OAB (Overactive Bladder)" order="5">OAB (Overactive Bladder)</listitem>
  58       <listitem id='6' label="Other" order="6">Other</listitem>
  59   </list>
  60
  61     <list id="Urinary_Plans" name="Urinary_Plans" label="Urinary Plans" type="standard" import="yes">
  62       <listitem id='1' label="Antibiotics" order ="1">Antibiotics</listitem>
  63       <listitem id='2' label="Urine Cultire and Sensitivity" order ="2">Urine Cultire and Sensitivity</listitem>
  64       <listitem id='3' label="Cystoscopy and Cystometrogram" order ="3">Cystoscopy and Cystometrogram</listitem>
  65       <listitem id='4' label="Anticholinergic" order ="4">Anticholinergic</listitem>
  66       <listitem id='5' label="Behavior Modification" order ="5">Behavior Modification</listitem>
  67       <listitem id='6' label="Other" order ="6">Other</listitem>
  68   </list>
  69 </form>