interface/new/new.php

   1 <?php
   2 /**
   3  * new.php
   4  *
   5  * @package   OpenEMR
   6  * @link      http://www.open-emr.org
   7  * @author    Brady Miller <brady.g.miller@gmail.com>
   8  * @copyright Copyright (c) 2018 Brady Miller <brady.g.miller@gmail.com>
   9  * @license   https://github.com/openemr/openemr/blob/master/LICENSE GNU General Public License 3
  10  */
  11
  12
  13 require_once("../globals.php");
  14
  15 if ($GLOBALS['full_new_patient_form']) {
  16     require("new_comprehensive.php");
  17     exit;
  18 }
  19
  20 // For a layout field return 0=unused, 1=optional, 2=mandatory.
  21 function getLayoutUOR($form_id, $field_id)
  22 {
  23     $crow = sqlQuery("SELECT uor FROM layout_options WHERE " .
  24     "form_id = ? AND field_id = ? LIMIT 1", array($form_id, $field_id));
  25     return 0 + $crow['uor'];
  26 }
  27
  28 // Determine if the registration date should be requested.
  29 $regstyle = getLayoutUOR('DEM', 'regdate') ? "" : " style='display:none'";
  30
  31 $form_pubpid    = $_POST['pubpid'   ] ? trim($_POST['pubpid'   ]) : '';
  32 $form_title     = $_POST['title'    ] ? trim($_POST['title'    ]) : '';
  33 $form_fname     = $_POST['fname'    ] ? trim($_POST['fname'    ]) : '';
  34 $form_mname     = $_POST['mname'    ] ? trim($_POST['mname'    ]) : '';
  35 $form_lname     = $_POST['lname'    ] ? trim($_POST['lname'    ]) : '';
  36 $form_refsource = $_POST['refsource'] ? trim($_POST['refsource']) : '';
  37 $form_sex       = $_POST['sex'      ] ? trim($_POST['sex'      ]) : '';
  38 $form_refsource = $_POST['refsource'] ? trim($_POST['refsource']) : '';
  39 $form_dob       = $_POST['DOB'      ] ? trim($_POST['DOB'      ]) : '';
  40 $form_regdate   = $_POST['regdate'  ] ? trim($_POST['regdate'  ]) : date('Y-m-d');
  41 ?>
  42 <html>
  43
  44 <head>
  45 <?php html_header_show(); ?>
  46 <link rel="stylesheet" href="<?php echo $css_header; ?>" type="text/css">
  47 <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery-datetimepicker/build/jquery.datetimepicker.min.css">
  48
  49 <script type="text/javascript" src="../../library/textformat.js?v=<?php echo $v_js_includes; ?>"></script>
  50 <script type="text/javascript" src="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery/dist/jquery.min.js"></script>
  51 <script type="text/javascript" src="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery-datetimepicker/build/jquery.datetimepicker.full.min.js"></script>
  52
  53 <?php include_once("{$GLOBALS['srcdir']}/options.js.php"); ?>
  54
  55 <script LANGUAGE="JavaScript">
  56
  57  function validate() {
  58   var f = document.forms[0];
  59 <?php if ($GLOBALS['inhouse_pharmacy']) { ?>
  60   if (f.refsource.selectedIndex <= 0) {
  61    alert('Please select a referral source!');
  62    return false;
  63   }
  64 <?php } ?>
  65 <?php if (getLayoutUOR('DEM', 'sex') == 2) { ?>
  66   if (f.sex.selectedIndex <= 0) {
  67    alert('Please select a value for sex!');
  68    return false;
  69   }
  70 <?php } ?>
  71 <?php if (getLayoutUOR('DEM', 'DOB') == 2) { ?>
  72   if (f.DOB.value.length == 0) {
  73    alert('Please select a birth date!');
  74    return false;
  75   }
  76 <?php } ?>
  77   top.restoreSession();
  78   return true;
  79  }
  80
  81 $(document).ready(function(){
  82     $('.datepicker').datetimepicker({
  83         <?php $datetimepicker_timepicker = false; ?>
  84         <?php $datetimepicker_showseconds = false; ?>
  85         <?php $datetimepicker_formatInput = true; ?>
  86         <?php require($GLOBALS['srcdir'] . '/js/xl/jquery-datetimepicker-2-5-4.js.php'); ?>
  87         <?php // can add any additional javascript settings to datetimepicker here; need to prepend first setting with a comma ?>
  88     });
  89     $('.datetimepicker').datetimepicker({
  90         <?php $datetimepicker_timepicker = true; ?>
  91         <?php $datetimepicker_showseconds = false; ?>
  92         <?php $datetimepicker_formatInput = true; ?>
  93         <?php require($GLOBALS['srcdir'] . '/js/xl/jquery-datetimepicker-2-5-4.js.php'); ?>
  94         <?php // can add any additional javascript settings to datetimepicker here; need to prepend first setting with a comma ?>
  95     });
  96 });
  97
  98 </script>
  99
 100 </head>
 101
 102 <body class="body_top" onload="javascript:document.new_patient.fname.focus();">
 103
 104 <form name='new_patient' method='post' action="new_patient_save.php"
 105  onsubmit='return validate()'>
 106 <input type="hidden" name="csrf_token_form" value="<?php echo attr(collectCsrfToken()); ?>" />
 107
 108 <span class='title'><?php echo xlt('Add Patient Record'); ?></span>
 109
 110 <br><br>
 111
 112 <center>
 113
 114 <?php if ($GLOBALS['omit_employers']) { ?>
 115    <input type='hidden' name='title' value='' />
 116 <?php } ?>
 117
 118 <table border='0'>
 119
 120 <?php if (!$GLOBALS['omit_employers']) { ?>
 121  <tr>
 122   <td>
 123    <span class='bold'><?php echo xlt('Title'); ?>: </span>
 124   </td>
 125   <td>
 126    <select name='title'>
 127 <?php
 128 $ores = sqlStatement("SELECT option_id, title FROM list_options " .
 129   "WHERE list_id = 'titles' AND activity = 1 ORDER BY seq");
 130 while ($orow = sqlFetchArray($ores)) {
 131     echo "    <option value='" . attr($orow['option_id']) . "'";
 132     if ($orow['option_id'] == $form_title) {
 133         echo " selected";
 134     }
 135
 136     echo ">" . text($orow['title']) . "</option>\n";
 137 }
 138 ?>
 139    </select>
 140   </td>
 141  </tr>
 142 <?php } ?>
 143
 144  <tr>
 145   <td>
 146    <span class='bold'><?php echo xlt('First Name'); ?>: </span>
 147   </td>
 148   <td>
 149    <input type='entry' size='15' name='fname' value='<?php echo attr($form_fname); ?>'>
 150   </td>
 151  </tr>
 152
 153  <tr>
 154   <td>
 155    <span class='bold'><?php echo xlt('Middle Name'); ?>: </span>
 156   </td>
 157   <td>
 158    <input type='entry' size='15' name='mname' value='<?php echo attr($form_mname); ?>'>
 159   </td>
 160  </tr>
 161
 162  <tr>
 163   <td>
 164    <span class='bold'><?php echo xlt('Last Name'); ?>: </span>
 165   </td>
 166   <td>
 167    <input type='entry' size='15' name='lname' value='<?php echo attr($form_lname); ?>'>
 168   </td>
 169  </tr>
 170
 171  <tr>
 172   <td>
 173    <span class='bold'><?php echo xlt('Sex'); ?>: </span>
 174   </td>
 175   <td>
 176    <select name='sex'>
 177     <option value=''>Unassigned</option>
 178 <?php
 179 $ores = sqlStatement("SELECT option_id, title FROM list_options " .
 180   "WHERE list_id = 'sex' AND activity = 1 ORDER BY seq");
 181 while ($orow = sqlFetchArray($ores)) {
 182     echo "    <option value='" . attr($orow['option_id']) . "'";
 183     if ($orow['option_id'] == $form_sex) {
 184         echo " selected";
 185     }
 186
 187     echo ">" . text($orow['title']) . "</option>\n";
 188 }
 189 ?>
 190    </select>
 191   </td>
 192  </tr>
 193
 194 <?php if ($GLOBALS['inhouse_pharmacy']) { ?>
 195  <tr>
 196   <td>
 197    <span class='bold'><?php echo xlt('Referral Source'); ?>: </span>
 198   </td>
 199   <td>
 200    <select name='refsource'>
 201     <option value=''>Unassigned</option>
 202 <?php
 203 $ores = sqlStatement("SELECT option_id, title FROM list_options " .
 204   "WHERE list_id = 'refsource' AND activity = 1 ORDER BY seq");
 205 while ($orow = sqlFetchArray($ores)) {
 206     echo "    <option value='" . attr($orow['option_id']) . "'";
 207     if ($orow['option_id'] == $form_refsource) {
 208         echo " selected";
 209     }
 210
 211     echo ">" . text($orow['title']) . "</option>\n";
 212 }
 213 ?>
 214    </select>
 215   </td>
 216  </tr>
 217 <?php } ?>
 218
 219  <tr>
 220   <td>
 221    <span class='bold'><?php echo xlt('Birth Date'); ?>: </span>
 222   </td>
 223   <td>
 224    <input type='text' size='10' class='datepicker' name='DOB' id='DOB'
 225     value='<?php echo attr($form_dob); ?>' />
 226   </td>
 227  </tr>
 228
 229  <tr<?php echo $regstyle ?>>
 230   <td>
 231    <span class='bold'><?php echo xlt('Registration Date'); ?>: </span>
 232   </td>
 233   <td>
 234    <input type='text' size='10' class='datepicker' name='regdate' id='regdate'
 235     value='<?php echo attr($form_regdate); ?>' />
 236   </td>
 237  </tr>
 238
 239  <tr>
 240   <td>
 241    <span class='bold'><?php echo xlt('Patient Number'); ?>: </span>
 242   </td>
 243   <td>
 244    <input type='entry' size='5' name='pubpid' value='<?php echo attr($form_pubpid); ?>'>
 245    <span class='text'><?php echo xlt('omit to autoassign'); ?> &nbsp; &nbsp; </span>
 246   </td>
 247  </tr>
 248
 249  <tr>
 250   <td colspan='2'>
 251    &nbsp;<br>
 252    <input type='submit' name='form_create' value='<?php echo xla('Create New Patient'); ?>' />
 253   </td>
 254   <td>
 255   </td>
 256  </tr>
 257
 258 </table>
 259 </center>
 260 </form>
 261 <script language="Javascript">
 262 <?php
 263 if ($form_pubpid) {
 264     echo "alert(" . xlj('This patient ID is already in use!') . ");\n";
 265 }
 266 ?>
 267 </script>
 268
 269 </body>
 270 </html>