function writeTemplateLine($selector, $dosage, $period, $quantity, $refills, $prices, $taxrates)
{
global $tmpl_line_no;
++$tmpl_line_no;
echo " <tr>\n";
echo " <td class='tmplcell drugsonly'>";
echo "<input type='text' name='form_tmpl[{$tmpl_line_no}][selector]' value='{$selector}' size='8' maxlength='100'>";
echo "</td>\n";
echo " <td class='tmplcell drugsonly'>";
echo "<input type='text' name='form_tmpl[{$tmpl_line_no}][dosage]' value='{$dosage}' size='6' maxlength='10'>";
echo "</td>\n";
echo " <td class='tmplcell drugsonly'>";
generate_form_field(array('data_type' => 1, 'field_id' => 'tmpl[' . $tmpl_line_no . '][period]', 'list_id' => 'drug_interval', 'empty_title' => 'SKIP'), $period);
echo "</td>\n";
echo " <td class='tmplcell drugsonly'>";
echo "<input type='text' name='form_tmpl[{$tmpl_line_no}][quantity]' value='{$quantity}' size='3' maxlength='7'>";
echo "</td>\n";
echo " <td class='tmplcell drugsonly'>";
echo "<input type='text' name='form_tmpl[{$tmpl_line_no}][refills]' value='{$refills}' size='3' maxlength='5'>";
echo "</td>\n";
foreach ($prices as $pricelevel => $price) {
echo " <td class='tmplcell'>";
echo "<input type='text' name='form_tmpl[{$tmpl_line_no}][price][{$pricelevel}]' value='{$price}' size='6' maxlength='12'>";
echo "</td>\n";
}
$pres = sqlStatement("SELECT option_id FROM list_options " . "WHERE list_id = 'taxrate' ORDER BY seq");
while ($prow = sqlFetchArray($pres)) {
echo " <td class='tmplcell'>";
echo "<input type='checkbox' name='form_tmpl[{$tmpl_line_no}][taxrate][" . $prow['option_id'] . "]' value='1'";
if (strpos(":{$taxrates}", $prow['option_id']) !== false) {
echo " checked";
}
echo " /></td>\n";
}
echo " </tr>\n";
}
<div class="tab_title sr" data-role="tab" data-value="sr">Srpski</div>
<div class="tab_title en" data-role="tab" data-value="en">English</div>
<div class="tab sr_tab">
<?php
generate_form_field("text", "title_sr", "Naziv", "", $errors, "Naziv usluge");
?>
<?php
generate_form_field("textarea", "body_sr", "Opis usluge", "", $errors);
?>
</div>
<div class="tab en_tab">
<?php
generate_form_field("text", "title_en", "Title", "", $errors, "Title of the page");
?>
<?php
generate_form_field("textarea", "body_en", "Description", "", $errors);
?>
</div>
</div>
<div class="form-field">
<label for="published">Status:</label>
<select id="published" name="published">
<option value="false">Skrivena</option>
<option value="true">Objavljena</option>
</select>
</div>
<div class="form-field">
<input type="submit" name="submit" value="Sačuvaj">
</div>
</form>
</section>
?>
</td>
</tr>
<?php
}
// end of if has admin access
?>
<tr id="nameRow">
<td width='1%' nowrap><b><?php
xl('Name', 'e');
?>
:</b></td>
<td>
<?php
generate_form_field(array('data_type' => 1, 'field_id' => 'title', 'list_id' => 'titles', 'empty_title' => ' '), $row['title']);
?>
<b><?php
xl('Last', 'e');
?>
:</b><input type='text' size='10' name='form_lname' class='inputtext'
maxlength='50' value='<?php
echo htmlspecialchars($row['lname'], ENT_QUOTES);
?>
'/>
<b><?php
xl('First', 'e');
?>
:</b> <input type='text' size='10' name='form_fname' class='inputtext'
maxlength='50' value='<?php
echo htmlspecialchars($row['fname'], ENT_QUOTES);
<span class="title"><?php
xl('Advance Directives', 'e');
?>
</span>
<br><br>
<form action='advancedirectives.php' method='post' onsubmit='return validate(this)' enctype="multipart/form-data">
<table border=0 cellpadding=1 cellspacing=1>
<?php
echo "<tr><td class='required'>";
xl('Completed', 'e');
echo ":</td><td width=10></td><td class='text'>";
generate_form_field(array('data_type' => 1, 'field_id' => 'yesno', 'list_id' => 'yesno', 'empty_title' => 'SKIP'), $form_completedad);
echo "</td></tr><tr><td class='required'>";
xl('Last Reviewed', 'e');
echo ":</td><td width=10></td><td class='text'>";
generate_form_field(array('data_type' => 4, 'field_id' => 'adreviewed'), $form_adreviewed);
echo "<script language='JavaScript'>Calendar.setup({inputField:'form_adreviewed', ifFormat:'%Y-%m-%d', button:'img_adreviewed'});</script>";
echo "</td></tr>";
echo "<tr><td class=text colspan=2><br><input type=submit id=create value='" . xl('Save') . "' /> <input type=button id=cancel value='" . xl('Cancel') . "' /></td></tr>";
?>
</table></form>
<div>
<?php
$query = "SELECT id FROM categories WHERE name='Advance Directive'";
$myrow2 = sqlQuery($query);
if ($myrow2) {
$parentId = $myrow2['id'];
$query = "SELECT id, name FROM categories WHERE parent='{$parentId}'";
$resNew1 = sqlStatement($query);
while ($myrows3 = sqlFetchArray($resNew1)) {
$categoryId = $myrows3['id'];
(<?php
xl('leave blank if still active', 'e');
?>
)
</td>
</tr>
<tr id='row_occurrence'>
<td valign='top' nowrap><b><?php
xl('Occurrence', 'e');
?>
:</b></td>
<td>
<?php
// Modified 6/2009 by BM to incorporate the occurrence items into the list_options listings
generate_form_field(array('data_type' => 1, 'field_id' => 'occur', 'list_id' => 'occurrence', 'empty_title' => 'SKIP'), $irow['occurrence']);
?>
</td>
</tr>
<tr id='row_classification'>
<td valign='top' nowrap><b><?php
xl('Classification', 'e');
?>
:</b></td>
<td>
<select name='form_classification'>
<?php
foreach ($ISSUE_CLASSIFICATIONS as $key => $value) {
echo " <option value='{$key}'";
if ($key == $irow['classification']) {
:</b></td>
<td>
<?php
generate_form_field(array('data_type' => 1, 'field_id' => 'laterality', 'list_id' => 'proc_lat', 'description' => xl('Laterality of this procedure, if applicable')), $row['laterality']);
?>
</td>
</tr>
<tr class='resonly'>
<td width='1%' nowrap><b><?php
echo xlt('Default Units');
?>
:</b></td>
<td>
<?php
generate_form_field(array('data_type' => 1, 'field_id' => 'units', 'list_id' => 'proc_unit', 'description' => xl('Optional default units for manual entry of results')), $row['units']);
?>
</td>
</tr>
<tr class='resonly'>
<td nowrap><b><?php
echo xlt('Default Range');
?>
:</b></td>
<td>
<input type='text' size='40' name='form_range' maxlength='255'
value='<?php
echo htmlspecialchars($row['range'], ENT_QUOTES);
?>
'
echo $result3["subscriber_postal_code"];
?>
">
<span class='required'<?php
if ($GLOBALS['omit_employers']) {
echo " style='display:none'";
}
?>
>
<?php
xl('Country', 'e');
?>
: </span>
<?php
// Modified 7/2009 by BM to incorporate data types
generate_form_field(array('data_type' => $GLOBALS['country_data_type'], 'field_id' => 'i' . $i . 'subscriber_country', 'list_id' => $GLOBALS['country_list'], 'fld_length' => '10', 'max_length' => '63', 'edit_options' => 'C'), $result3['subscriber_country']);
?>
<br />
<span class=bold><?php
xl('Subscriber Phone', 'e');
?>
:
<input type='text' size='20' name='i<?php
echo $i;
?>
subscriber_phone' value='<?php
echo $result3["subscriber_phone"];
?>
' onkeyup='phonekeyup(this,mypcc)' />
</span><br />
<span class=bold><?php
echo " <td class='bold'>" . xlt('DOB') . ":</td>\n";
echo " <td class='text'>" . text($row['DOB']) . "</td>\n";
echo " </tr>\n";
echo " <tr>\n";
echo " <td class='bold'>" . xlt('SSN') . ":</td>\n";
echo " <td class='text'>" . text($row['ss']) . "</td>\n";
echo " </tr>\n";
echo " <tr>\n";
echo " <td class='bold'>" . xlt('Current Location') . ":</td>\n";
// Note that $current_location has already been html escaped
echo " <td class='text'>{$current_location}</td>\n";
echo " </tr>\n";
echo " <tr>\n";
echo " <td class='bold'>" . xlt('Check In To') . ":</td>\n";
echo " <td class='text'>";
generate_form_field(array('data_type' => 1, 'field_id' => 'newloc', 'list_id' => 'chartloc', 'empty_title' => ''), '');
echo " </td>\n";
echo " </tr>\n";
echo " <tr>\n";
echo " <td class='bold'>" . xlt('Or Out To') . ":</td>\n";
echo " <td class='text'><select name='form_newuser' onchange='userSelect()'>\n";
echo " <option value=''></option>";
$ures = sqlStatement("SELECT id, fname, mname, lname FROM users " . "WHERE username != '' AND active = 1 ORDER BY lname, fname, mname");
while ($urow = sqlFetchArray($ures)) {
echo " <option value='" . attr($urow['id']) . "'";
echo ">" . text($urow['lname']) . ', ' . text($urow['fname']) . ' ' . text($urow['mname']) . "</option>\n";
}
echo " </select></td>\n";
echo " </tr>\n";
echo " <tr>\n";
echo " <td> </td>\n";
<br>
<form action='patient_data.php' name='patient_data' method='post' onsubmit='return top.restoreSession()'>
<table border=0 cellpadding=1 cellspacing=1>
<?php
echo "<tr><td class='required'>";
echo xlt('Date/Time');
echo ":</td><td class='text'>";
echo "<input type='text' size='16' name='form_date' id='form_date' " . "value='" . attr($form_date) . "' " . "onkeyup='datekeyup(this,mypcc)' onblur='dateblur(this,mypcc)' " . "title='" . xla('yyyy-mm-dd hh:mm:ss') . "' />";
echo "<img src='../../pic/show_calendar.gif' align='absbottom' width='24' height='22'" . "id='img_date' border='0' alt='[?]' style='cursor:pointer'" . "title='" . xla('Click here to choose a date') . "' />";
echo "<script language='JavaScript'>Calendar.setup({inputField:'form_date', ifFormat:'%Y-%m-%d %H:%M:%S', button:'img_date', showsTime:'true'});</script>";
echo "</td></tr>";
echo "<tr><td class='required'>";
echo xlt('Completed');
echo ":</td><td class='text'>";
generate_form_field(array('data_type' => 1, 'field_id' => 'complete', 'list_id' => 'yesno', 'empty_title' => 'SKIP'), $form_complete ? $form_complete : "YES");
echo "</td></tr>";
echo "<tr><td class='bold'>";
echo xlt('Results/Details');
echo ":</td><td class='text'>";
echo "<textarea name='form_result' cols='40' rows='3'>";
echo attr($form_result);
echo "</textarea>";
echo "</td></tr>";
echo "</table>";
echo "<input type='hidden' name='form_category' value='" . attr($category) . "' />";
echo "<input type='hidden' name='form_item' value='" . attr($item) . "' />";
if (isset($entryID)) {
echo "<input type='hidden' name='form_entryID' value='" . attr($entryID) . "' />";
}
?>
align='absbottom' width='24' height='22' id='img_to_date'
border='0' alt='[?]' style='cursor: pointer'
title='<?php
echo xlt('Click here to choose a date');
?>
'></td>
</tr>
<tr>
<td class='label'><?php
echo xlt('Status');
# status code drop down creation
?>
:</td>
<td><?php
generate_form_field(array('data_type' => 1, 'field_id' => 'apptstatus', 'list_id' => 'apptstat', 'empty_title' => 'All'), $_POST['form_apptstatus']);
?>
</td>
<td><?php
echo xlt('Category');
?>
:</td>
<td>
<select id="form_apptcat" name="form_apptcat">
<?php
$categories = fetchAppointmentCategories();
echo "<option value='ALL'>" . xlt("All") . "</option>";
while ($cat = sqlFetchArray($categories)) {
echo "<option value='" . attr($cat['id']) . "'";
if ($cat['id'] == $_POST['form_apptcat']) {
echo " selected='true' ";
<select name='form_reviewed'>
<?php
foreach (array('1' => xl('All'), '2' => xl('Reviewed'), '3' => xl('Received, not reviewed'), '4' => xl('Sent, not received'), '5' => xl('Not sent')) as $key => $value) {
echo "<option value='{$key}'";
if ($key == $form_reviewed) {
echo " selected";
}
echo ">" . text($value) . "</option>\n";
}
?>
</select>
<?php
generate_form_field(array('data_type' => 10, 'field_id' => 'provider', 'empty_title' => '-- All Providers --'), $form_provider);
?>
</td>
</tr>
<tr>
<td class='text' align='center'>
<input type='checkbox' name='form_patient' value='1'
<?php
if ($form_patient) {
echo 'checked ';
}
?>
/>Current Patient Only
<span title='<?php
</tr>
<?php
foreach ($l_arr as $layout_entry) {
?>
<tr>
<td style="width:180px;">
<span class=text><?php
echo text(xl_layout_label($layout_entry['title']));
?>
: </span>
</td>
<td style="width:270px;">
<?php
$entry_data = sqlQuery("SELECT `field_value` FROM `facility_user_ids` " . "WHERE `uid` = ? AND `facility_id` = ? AND `field_id` = ?", array($user_info['id'], $fac_info['id'], $layout_entry['field_id']));
echo "<td><span class='text'>" . generate_form_field($layout_entry, $entry_data['field_value']) . " </td>";
?>
</td>
</tr>
<?php
}
?>
</table>
</form>
<!-- include support for the list-add selectbox feature -->
<?php
include $GLOBALS['fileroot'] . "/library/options_listadd.inc";
?>
Calendar.setup({inputField:'dates', ifFormat:'%Y-%m-%d %H:%M:%S',
button:'img_date', showsTime:true});
</script>
</tr>
<tr>
<td><span class=text><?php
echo htmlspecialchars(xl('Type of Disclosure'), ENT_NOQUOTES);
?>
: </span></TD>
<td><?php
if ($editlid) {
//To incorporate the disclosure types into the list_options listings
generate_form_field(array('data_type' => 1, 'field_id' => 'disclosure_type', 'list_id' => 'disclosure_type', 'fld_length' => '10', 'max_length' => '63', 'empty_title' => 'SKIP'), $app_event);
} else {
//To incorporate the disclosure types into the list_options listings
generate_form_field(array('data_type' => 1, 'field_id' => 'disclosure_type', 'list_id' => 'disclosure_type', 'fld_length' => '10', 'max_length' => '63', 'empty_title' => 'SKIP'), $title);
}
?>
</td>
</tr>
<tr>
<td><span class=text><?php
echo htmlspecialchars(xl('Recipient of the Disclosure'), ENT_NOQUOTES);
?>
:
</span></td>
<td class='text'>
<?php
if ($editlid) {
?>
<input type=entry name=recipient_name size=20 value="<?php
:</b></td>
<td valign='top'>
<?php
generate_form_field(array('data_type' => 1, 'field_id' => 'order_priority', 'list_id' => 'ord_priority'), $row['order_priority']);
?>
</td>
</tr>
<tr>
<td width='1%' valign='top' nowrap><b><?php
xl('Status', 'e');
?>
:</b></td>
<td valign='top'>
<?php
generate_form_field(array('data_type' => 1, 'field_id' => 'order_status', 'list_id' => 'ord_status'), $row['order_status']);
?>
</td>
</tr>
<tr>
<td width='1%' valign='top' nowrap><b><?php
xl('Clinical History', 'e');
?>
:</b></td>
<td valign='top'>
<input type='text' maxlength='255' name='form_clinical_hx' style='width:100%'
class='inputtext' value='<?php
echo attr($row['clinical_hx']);
?>
' />
<?php
xl('Specialty', 'e');
?>
:
<input type='text' name='form_specialty' size='10' value='<?php
echo htmlspecialchars(strip_escape_custom($_POST['form_specialty']), ENT_QUOTES);
?>
'
class='inputtext' title='<?php
xl("Any part of the desired specialty", "e");
?>
' />
<?php
echo xl('Type') . ": ";
// Generates a select list named form_abook_type:
generate_form_field(array('data_type' => 1, 'field_id' => 'abook_type', 'list_id' => 'abook_type', 'empty_title' => 'All'), strip_escape_custom($_REQUEST['form_abook_type']));
?>
<input type='checkbox' name='form_external' value='1'<?php
if ($form_external) {
echo ' checked';
}
?>
title='<?php
xl("Omit internal users?", "e");
?>
' />
<?php
xl('External Only', 'e');
?>
<input type='submit' class='button' name='form_search' value='<?php
public static function batch_despatch($var, $func, $data_credentials)
{
global $pid;
if (UserService::valid($data_credentials)) {
require_once "../../library/invoice_summary.inc.php";
require_once "../../library/options.inc.php";
require_once "../../library/acl.inc";
require_once "../../library/patient.inc";
if ($func == 'ar_responsible_party') {
$patient_id = $pid;
$encounter_id = $var['encounter'];
$x['ar_responsible_party'] = ar_responsible_party($patient_id, $encounter_id);
return UserService::function_return_to_xml($x);
} elseif ($func == 'getInsuranceData') {
$type = $var['type'];
$given = $var['given'];
$x = getInsuranceData($pid, $type, $given);
return UserService::function_return_to_xml($x);
} elseif ($func == 'generate_select_list') {
$tag_name = $var['tag_name'];
$list_id = $var['list_id'];
$currvalue = $var['currvalue'];
$title = $var['title'];
$empty_name = $var['empty_name'];
$class = $var['class'];
$onchange = $var['onchange'];
$x['generate_select_list'] = generate_select_list($tag_name, $list_id, $currvalue, $title, $empty_name, $class, $onchange);
return UserService::function_return_to_xml($x);
} elseif ($func == 'xl_layout_label') {
$constant = $var['constant'];
$x['xl_layout_label'] = xl_layout_label($constant);
return UserService::function_return_to_xml($x);
} elseif ($func == 'generate_form_field') {
$frow = $var['frow'];
$currvalue = $var['currvalue'];
ob_start();
generate_form_field($frow, $currvalue);
$x['generate_form_field'] = ob_get_contents();
ob_end_clean();
return UserService::function_return_to_xml($x);
} elseif ($func == 'getInsuranceProviders') {
$i = $var['i'];
$provider = $var['provider'];
$insurancei = getInsuranceProviders();
$x = $insurancei;
return $x;
} elseif ($func == 'get_layout_form_value') {
$frow = $var['frow'];
$_POST = $var['post_array'];
$x['get_layout_form_value'] = get_layout_form_value($frow);
return UserService::function_return_to_xml($x);
} elseif ($func == 'updatePatientData') {
$patient_data = $var['patient_data'];
$create = $var['create'];
updatePatientData($pid, $patient_data, $create);
$x['ok'] = 'ok';
return UserService::function_return_to_xml($x);
} elseif ($func == 'updateEmployerData') {
$employer_data = $var['employer_data'];
$create = $var['create'];
updateEmployerData($pid, $employer_data, $create);
$x['ok'] = 'ok';
return UserService::function_return_to_xml($x);
} elseif ($func == 'newHistoryData') {
newHistoryData($pid);
$x['ok'] = 'ok';
return UserService::function_return_to_xml($x);
} elseif ($func == 'newInsuranceData') {
$_POST = $var[0];
foreach ($var as $key => $value) {
if ($key >= 3) {
$var[$key] = formData($value);
}
if ($key >= 1) {
$parameters[$key] = $var[$key];
}
}
$parameters[12] = fixDate($parameters[12]);
$parameters[27] = fixDate($parameters[27]);
call_user_func_array('newInsuranceData', $parameters);
$x['ok'] = 'ok';
return UserService::function_return_to_xml($x);
} elseif ($func == 'generate_layout_validation') {
$form_id = $var['form_id'];
ob_start();
generate_layout_validation($form_id);
$x = ob_get_clean();
return $x;
}
} else {
throw new SoapFault("Server", "credentials failed");
}
}
function display_layout_tabs_data_editable($formtype, $result1, $result2 = '')
{
global $item_count, $cell_count, $last_group, $CPR;
$fres = sqlStatement("SELECT distinct group_name FROM layout_options " . "WHERE form_id = ? AND uor > 0 " . "ORDER BY group_name, seq", array($formtype));
$first = true;
while ($frow = sqlFetchArray($fres)) {
$this_group = $frow['group_name'];
$group_name = substr($this_group, 1);
$group_name_esc = htmlspecialchars($group_name, ENT_QUOTES);
$titlecols = $frow['titlecols'];
$datacols = $frow['datacols'];
$data_type = $frow['data_type'];
$field_id = $frow['field_id'];
$list_id = $frow['list_id'];
$currvalue = '';
$group_fields_query = sqlStatement("SELECT * FROM layout_options " . "WHERE form_id = ? AND uor > 0 AND group_name = ? " . "ORDER BY seq", array($formtype, $this_group));
?>
<div class="tab <?php
echo $first ? 'current' : '';
?>
" id="tab_<?php
echo $group_name_esc;
?>
" >
<table border='0' cellpadding='0'>
<?php
while ($group_fields = sqlFetchArray($group_fields_query)) {
$titlecols = $group_fields['titlecols'];
$datacols = $group_fields['datacols'];
$data_type = $group_fields['data_type'];
$field_id = $group_fields['field_id'];
$list_id = $group_fields['list_id'];
$currvalue = '';
if ($formtype == 'DEM') {
if ($GLOBALS['athletic_team']) {
// Skip fitness level and return-to-play date because those appear
// in a special display/update form on this page.
if ($field_id === 'fitness' || $field_id === 'userdate1') {
continue;
}
}
if (strpos($field_id, 'em_') === 0) {
// Skip employer related fields, if it's disabled.
if ($GLOBALS['omit_employers']) {
continue;
}
$tmp = substr($field_id, 3);
if (isset($result2[$tmp])) {
$currvalue = $result2[$tmp];
}
} else {
if (isset($result1[$field_id])) {
$currvalue = $result1[$field_id];
}
}
} else {
if (isset($result1[$field_id])) {
$currvalue = $result1[$field_id];
}
}
// Handle a data category (group) change.
if (strcmp($this_group, $last_group) != 0) {
$group_name = substr($this_group, 1);
// totally skip generating the employer category, if it's disabled.
if ($group_name === 'Employer' && $GLOBALS['omit_employers']) {
continue;
}
$last_group = $this_group;
}
// Handle starting of a new row.
if ($titlecols > 0 && $cell_count >= $CPR || $cell_count == 0) {
disp_end_row();
echo "<tr>";
}
if ($item_count == 0 && $titlecols == 0) {
$titlecols = 1;
}
// Handle starting of a new label cell.
if ($titlecols > 0) {
disp_end_cell();
$titlecols_esc = htmlspecialchars($titlecols, ENT_QUOTES);
echo "<td class='label' colspan='{$titlecols_esc}' ";
echo ">";
$cell_count += $titlecols;
}
++$item_count;
// Added 5-09 by BM - Translate label if applicable
if ($group_fields['title']) {
echo htmlspecialchars(xl_layout_label($group_fields['title']), ENT_NOQUOTES) . ":";
} else {
echo " ";
}
// Handle starting of a new data cell.
if ($datacols > 0) {
disp_end_cell();
$datacols_esc = htmlspecialchars($datacols, ENT_QUOTES);
echo "<td class='text data' colspan='{$datacols_esc}'";
echo ">";
$cell_count += $datacols;
}
++$item_count;
echo generate_form_field($group_fields, $currvalue);
}
?>
</table>
</div>
<?php
$first = false;
}
}
echo ">" . text($value) . "</option>\n";
}
?>
</select>
</td>
</tr>
<tr id='row_distributor'>
<td valign='top' nowrap><b><?php
echo xlt('Distributor');
?>
:</b></td>
<td>
<?php
// Address book entries for distributors.
generate_form_field(array('data_type' => 14, 'field_id' => 'distributor_id', 'list_id' => '', 'edit_options' => 'R', 'description' => xl('Address book entry for the distributor')), '');
?>
</td>
</tr>
<tr id='row_sale_date'>
<td valign='top' nowrap><b><?php
echo xlt('Date');
?>
:</b></td>
<td>
<input type='text' size='10' name='form_sale_date' id='form_sale_date'
value='<?php
echo attr(date('Y-m-d'));
?>
'
?>
:</b></td>
<td valign='top'>
<?php
generate_form_field(array('data_type' => 1, 'field_id' => 'order_status', 'list_id' => 'ord_status'), $row['order_status']);
?>
</td>
</tr>
<tr>
<td width='1%' valign='top' nowrap><b><?php
xl('History order', 'e');
?>
:</b>
<td valign='top'>
<?php
generate_form_field(array('data_type' => 1, 'field_id' => 'history_order', 'list_id' => 'boolean'), $row['history_order']);
?>
</td>
</tr>
<tr>
<td width='1%' valign='top' nowrap><b><?php
xl('Clinical History', 'e');
?>
:</b></td>
<td valign='top'>
<input type='text' maxlength='255' name='form_clinical_hx' style='width:100%'
class='inputtext' value='<?php
echo attr($row['clinical_hx']);
?>
' />
</td>
?>
' />
<input type='hidden' name='reply_to' id='reply_to' value='<?php
echo htmlspecialchars($reply_to, ENT_QUOTES);
?>
' />
<b><?php
echo htmlspecialchars(xl('Status'), ENT_NOQUOTES);
?>
:</b>
<?php
if ($form_message_status == "") {
$form_message_status = 'New';
}
generate_form_field(array('data_type' => 1, 'field_id' => 'message_status', 'list_id' => 'message_status', 'empty_title' => 'SKIP', 'order_by' => 'title'), $form_message_status);
?>
</td>
</tr>
<tr>
<td class='text'>
<b><?php
echo htmlspecialchars(xl('To'), ENT_QUOTES);
?>
:</b>
<input type='textbox' name='assigned_to_text' id='assigned_to_text' size='40' readonly='readonly'
value='<?php
echo htmlspecialchars(xl("Select Users From The Dropdown List"), ENT_QUOTES);
?>
' >
<input type='hidden' name='assigned_to' id='assigned_to' >
echo " ";
}
echo "</b>";
// Handle starting of a new data cell.
if ($datacols > 0) {
end_cell();
$datacols_esc = htmlspecialchars($datacols, ENT_QUOTES);
echo "<td valign='top' colspan='{$datacols_esc}' class='text'";
if ($cell_count > 0) {
echo " style='padding-left:5pt'";
}
echo ">";
$cell_count += $datacols;
}
++$item_count;
generate_form_field($frow, $currvalue);
echo "</div>";
}
end_group();
?>
</div></div>
</form>
</div>
<p>
<div id='otherdiv' style='display:none'>
<span class='bold'><?php
echo htmlspecialchars(xl('Details'), ENT_NOQUOTES);
?>
:</span><br>
<textarea name='body' rows='6' cols='40' wrap='virtual'><?php
echo htmlspecialchars($body, ENT_NOQUOTES);
function display_layout_tabs_data_editable($formtype, $result1, $result2='') {
global $item_count, $cell_count, $last_group, $CPR,$condition_str;
$fres = sqlStatement("SELECT distinct group_name FROM layout_options " .
"WHERE form_id = ? AND uor > 0 " .
"ORDER BY group_name, seq", array($formtype) );
$first = true;
while ($frow = sqlFetchArray($fres)) {
$this_group = $frow['group_name'];
$group_name = substr($this_group, 1);
$group_name_esc = htmlspecialchars( $group_name, ENT_QUOTES);
$titlecols = $frow['titlecols'];
$datacols = $frow['datacols'];
$data_type = $frow['data_type'];
$field_id = $frow['field_id'];
$list_id = $frow['list_id'];
$currvalue = '';
if (substr($this_group,1,8) === 'Employer' && $GLOBALS['omit_employers']) continue;
$group_fields_query = sqlStatement("SELECT * FROM layout_options " .
"WHERE form_id = ? AND uor > 0 AND group_name = ? " .
"ORDER BY seq", array($formtype,$this_group) );
?>
<div class="tab <?php echo $first ? 'current' : '' ?>" id="tab_<?php echo str_replace(' ', '_',$group_name_esc)?>" >
<table border='0' cellpadding='0'>
<?php
while ($group_fields = sqlFetchArray($group_fields_query)) {
$titlecols = $group_fields['titlecols'];
$datacols = $group_fields['datacols'];
$data_type = $group_fields['data_type'];
$field_id = $group_fields['field_id'];
$list_id = $group_fields['list_id'];
$backup_list = $group_fields['list_backup_id'];
$condition_str = get_conditions_str($condition_str,$group_fields);
$currvalue = '';
if ($formtype == 'DEM') {
if (strpos($field_id, 'em_') === 0) {
// Skip employer related fields, if it's disabled.
if ($GLOBALS['omit_employers']) continue;
$tmp = substr($field_id, 3);
if (isset($result2[$tmp])) $currvalue = $result2[$tmp];
}
else {
if (isset($result1[$field_id])) $currvalue = $result1[$field_id];
}
}
else {
if (isset($result1[$field_id])) $currvalue = $result1[$field_id];
}
// Handle a data category (group) change.
if (strcmp($this_group, $last_group) != 0) {
$group_name = substr($this_group, 1);
// totally skip generating the employer category, if it's disabled.
if ($group_name === 'Employer' && $GLOBALS['omit_employers']) continue;
$last_group = $this_group;
}
// Handle starting of a new row.
if (($titlecols > 0 && $cell_count >= $CPR) || $cell_count == 0) {
disp_end_row();
echo "<tr>";
}
if ($item_count == 0 && $titlecols == 0) {
$titlecols = 1;
}
// Handle starting of a new label cell.
if ($titlecols > 0) {
disp_end_cell();
$titlecols_esc = htmlspecialchars( $titlecols, ENT_QUOTES);
$field_id_label = 'label_'.$group_fields['field_id'];
echo "<td class='label' colspan='$titlecols_esc' id='$field_id_label' ";
echo ">";
$cell_count += $titlecols;
}
++$item_count;
// Added 5-09 by BM - Translate label if applicable
if ($group_fields['title']) echo (htmlspecialchars( xl_layout_label($group_fields['title']), ENT_NOQUOTES).":"); else echo " ";
// Handle starting of a new data cell.
if ($datacols > 0) {
disp_end_cell();
$datacols_esc = htmlspecialchars( $datacols, ENT_QUOTES);
$field_id = 'text_'.$group_fields['field_id'];
echo "<td class='text data' colspan='$datacols_esc' id='$field_id'";
echo ">";
$cell_count += $datacols;
}
++$item_count;
echo generate_form_field($group_fields, $currvalue);
}
?>
</table>
</div>
<?php
$first = false;
}
}
<?php
if (!$useCVX) {
?>
<tr>
<td align="right">
<span class=text>
<?php
echo htmlspecialchars(xl('Immunization'), ENT_NOQUOTES);
?>
</span>
</td>
<td>
<?php
// Modified 7/2009 by BM to incorporate the immunization items into the list_options listings
generate_form_field(array('data_type' => 1, 'field_id' => 'immunization_id', 'list_id' => 'immunizations', 'empty_title' => 'SKIP'), $immunization_id);
?>
</td>
</tr>
<?php
} else {
?>
<tr>
<td align="right" valign="top" style="padding-top:4px;">
<span class=text>
<?php
echo htmlspecialchars(xl('Immunization'), ENT_NOQUOTES);
?>
(<?php
echo htmlspecialchars(xl('CVX Code'), ENT_NOQUOTES);
?>
<?php
}
?>
</td>
</tr>
<tr>
<td><?php
echo xlt('Category');
?>
:</td>
<td></td>
<td>
<?php
generate_form_field(array('data_type' => 1, 'field_id' => 'superbill', 'list_id' => 'superbill'), $superbill);
?>
<input type='checkbox' title='<?php
echo xlt("Syndromic Surveillance Report");
?>
' name='reportable' value='1'<?php
if (!empty($reportable)) {
echo ' checked';
}
?>
/>
<?php
echo xlt('Diagnosis Reporting');
?>
<tr>
<td nowrap>
<span id='title_apptstatus'><b><?php
echo htmlspecialchars($GLOBALS['athletic_team'] ? xl('Session Type') : xl('Status'));
?>
:</b></span>
<span id='title_prefcat' style='display:none'><b><?php
xl('Pref Cat', 'e');
?>
:</b></span>
</td>
<td nowrap>
<?php
generate_form_field(array('data_type' => 1, 'field_id' => 'apptstatus', 'list_id' => 'apptstat', 'empty_title' => 'SKIP'), $row['pc_apptstatus']);
?>
<!--
The following list will be invisible unless this is an In Office
event, in which case form_apptstatus (above) is to be invisible.
-->
<select name='form_prefcat' style='width:100%;display:none' title='<?php
xl('Preferred Event Category', 'e');
?>
'>
<?php
echo $prefcat_options;
?>
</select>
</td>
<div class="tab_title sr" data-role="tab" data-value="sr">Srpski</div>
<div class="tab_title en" data-role="tab" data-value="en">English</div>
<div class="tab sr_tab">
<?php
generate_form_field("text", "title_sr", "Naslov", $page->title_sr, $errors, "Naslov stranice");
?>
<?php
generate_form_field("textarea", "body_sr", "Sadržaj stranice", $page->body_sr, $errors);
?>
</div>
<div class="tab en_tab">
<?php
generate_form_field("text", "title_en", "Title", $page->title_en, $errors, "Title of the page");
?>
<?php
generate_form_field("textarea", "body_en", "Content", $page->body_en, $errors);
?>
</div>
</div>
<div class="form-field">
<label for="published">Status:</label>
<select id="published" name="published">
<option value="false" <?php
echo !$page->published ? "selected" : "";
?>
>Skrivena</option>
<option value="true"<?php
echo $page->published ? "selected" : "";
?>
>Objavljena</option>
</select>
onclick='return divclick(this,"div_note");' />
<b><?php
xl('Create Patient Note', 'e');
?>
</b>
<div id='div_note' class='section' style='display:none;margin-top:0.5em;'>
<table>
<tr>
<td class='itemtitle' width='1%' nowrap><?php
xl('Type', 'e');
?>
</td>
<td>
<?php
// Added 6/2009 by BM to incorporate the patient notes into the list_options listings
generate_form_field(array('data_type' => 1, 'field_id' => 'note_type', 'list_id' => 'note_type', 'empty_title' => 'SKIP'), '');
?>
</td>
</tr>
<tr>
<td class='itemtitle' width='1%' nowrap>To</td>
<td>
<select name='form_note_to' style='width:100%'>
<?php
while ($urow = sqlFetchArray($ures)) {
echo " <option value='" . $urow['username'] . "'";
echo ">" . $urow['lname'];
if ($urow['fname']) {
echo ", " . $urow['fname'];
}
echo "</option>\n";
echo ">" . text($value) . "\n";
}
?>
</select>
</td>
</tr>
<!-- Reaction For Medication Allergy -->
<tr id='row_severity'>
<td valign='top' nowrap><b><?php
echo xlt('Severity');
?>
:</b></td>
<td><?php
$severity = $irow['severity_al'];
generate_form_field(array('data_type' => 1, 'field_id' => 'severity_id', 'list_id' => 'severity_ccda', 'empty_title' => 'SKIP'), $severity);
?>
</td>
</tr>
<tr id='row_reaction'>
<td valign='top' nowrap><b><?php
echo xlt('Reaction');
?>
:</b></td>
<td>
<?php
echo generate_select_list('form_reaction', 'reaction', $irow['reaction'], '', '', '', '');
?>
</td>
</tr>
$currvalue = $ptrow[$field_id];
}
/*****************************************************************
$newvalue = '';
if (isset($result['fields'][$reskey])) $newvalue = $result['fields'][$reskey];
//// Zero-length input means nothing will change.
// if ($newvalue === '') $newvalue = $currvalue;
// $newvalue = trim($newvalue);
$newvalue = cms_field_to_lbf($newvalue, $data_type, $field_id);
*****************************************************************/
$newvalue = cms_field_to_lbf($data_type, $reskey, $result['fields']);
echo " <tr class='detail'>\n";
echo " <td class='bold'>" . text($field_title) . "</td>\n";
echo " <td>" . generate_display_field($lorow, $currvalue) . "</td>\n";
echo " <td>";
generate_form_field($lorow, $newvalue);
echo "</td>\n";
echo " </tr>\n";
}
}
$field_id = 'cmsportal_login';
if (empty($ptrow[$field_id])) {
if ($result['post']['user'] !== '') {
// Registered in portal but still need to record that in openemr.
echo "</table>\n";
echo "<input type='hidden' name='form_{$field_id}' value='" . attr($result['post']['user']) . "' />\n";
} else {
// Portal registration is needed.
$newvalue = isset($result['fields']['email']) ? trim($result['fields']['email']) : '';
echo " <tr class='detail'>\n";
echo " <td class='bold' style='color:red;'>" . xlt('New Portal Login') . "</td>\n";
function issue_ippf_con_form($issue, $thispid)
{
global $pprow, $item_count, $cell_count, $last_group;
$shrow = getHistoryData($thispid);
if ($issue) {
$pprow = sqlQuery("SELECT * FROM lists_ippf_con WHERE id = '{$issue}'");
} else {
$pprow = array();
}
echo "<div id='ippf_con' style='display:none'>\n";
$fres = sqlStatement("SELECT * FROM layout_options " . "WHERE form_id = 'CON' AND uor > 0 " . "ORDER BY group_name, seq");
$last_group = '';
$cell_count = 0;
$item_count = 0;
$display_style = 'block';
while ($frow = sqlFetchArray($fres)) {
$this_group = $frow['group_name'];
$titlecols = $frow['titlecols'];
$datacols = $frow['datacols'];
$data_type = $frow['data_type'];
$field_id = $frow['field_id'];
$list_id = $frow['list_id'];
$currvalue = '';
if ($frow['edit_options'] == 'H') {
// This data comes from static history
if (isset($shrow[$field_id])) {
$currvalue = $shrow[$field_id];
}
} else {
if (isset($pprow[$field_id])) {
$currvalue = $pprow[$field_id];
}
}
// Handle a data category (group) change.
if (strcmp($this_group, $last_group) != 0) {
end_group();
$group_seq = 'con' . substr($this_group, 0, 1);
$group_name = substr($this_group, 1);
$last_group = $this_group;
echo "<br /><span class='bold'><input type='checkbox' name='form_cb_{$group_seq}' value='1' " . "onclick='return divclick(this,\"div_{$group_seq}\");'";
if ($display_style == 'block') {
echo " checked";
}
echo " /><b>{$group_name}</b></span>\n";
echo "<div id='div_{$group_seq}' class='section' style='display:{$display_style};'>\n";
echo " <table border='0' cellpadding='0' width='100%'>\n";
$display_style = 'none';
}
// Handle starting of a new row.
if ($titlecols > 0 && $cell_count >= $CPR || $cell_count == 0) {
end_row();
echo " <tr>";
}
if ($item_count == 0 && $titlecols == 0) {
$titlecols = 1;
}
// Handle starting of a new label cell.
if ($titlecols > 0) {
end_cell();
echo "<td valign='top' colspan='{$titlecols}' width='1%' nowrap";
echo $frow['uor'] == 2 ? " class='required'" : " class='bold'";
if ($cell_count == 2) {
echo " style='padding-left:10pt'";
}
echo ">";
$cell_count += $titlecols;
}
++$item_count;
echo "<b>";
if ($frow['title']) {
echo $frow['title'] . ":";
} else {
echo " ";
}
echo "</b>";
// Handle starting of a new data cell.
if ($datacols > 0) {
end_cell();
echo "<td valign='top' colspan='{$datacols}' class='text'";
if ($cell_count > 0) {
echo " style='padding-left:5pt'";
}
echo ">";
$cell_count += $datacols;
}
++$item_count;
if ($frow['edit_options'] == 'H') {
echo generate_display_field($frow, $currvalue);
} else {
generate_form_field($frow, $currvalue);
}
}
end_group();
echo "</div>\n";
}
