}
echo "</tr>\n";
$cell_count = 0;
}
}
function end_group()
{
global $last_group;
if (strlen($last_group) > 0) {
end_row();
echo " </table>\n";
echo "</div>\n";
}
}
// If we are editing a transaction, get its ID and data.
$trow = $transid ? getTransById($transid) : array();
?>
<html>
<head>
<?php
html_header_show();
?>
<link rel='stylesheet' href="<?php
echo $css_header;
?>
" type="text/css">
<link rel="stylesheet" type="text/css" href="../../../library/js/fancybox/jquery.fancybox-1.2.6.css" media="screen" />
<style type="text/css">@import url(../../../library/dynarch_calendar.css);</style>
<script type="text/javascript" src="../../../library/dynarch_calendar.js"></script>
//STOP FAKE REGISTER GLOBALS
$fake_register_globals = false;
//
include_once "../../globals.php";
require_once "{$srcdir}/transactions.inc";
require_once "{$srcdir}/options.inc.php";
include_once "{$srcdir}/patient.inc";
$template_file = "{$webserver_root}/custom/referral_template.html";
$TEMPLATE_LABELS = array('label_clinic_id' => htmlspecialchars(xl('Clinic ID')), 'label_control_no' => htmlspecialchars(xl('Control No.')), 'label_date' => htmlspecialchars(xl('Date')), 'label_webpage_title' => htmlspecialchars(xl('Referral Form')), 'label_form1_title' => htmlspecialchars(xl('REFERRAL FORM')), 'label_name' => htmlspecialchars(xl('Name')), 'label_age' => htmlspecialchars(xl('Age')), 'label_gender' => htmlspecialchars(xl('Gender')), 'label_address' => htmlspecialchars(xl('Address')), 'label_postal' => htmlspecialchars(xl('Postal')), 'label_phone' => htmlspecialchars(xl('Phone')), 'label_ref_reason' => htmlspecialchars(xl('Reference Reason')), 'label_diagnosis' => htmlspecialchars(xl('Diagnosis')), 'label_ref_class' => htmlspecialchars(xl('Reference classification (risk level)')), 'label_dr_name_sig' => htmlspecialchars(xl('Doctor\'s name and signature')), 'label_refer_to' => htmlspecialchars(xl('Referred to')), 'label_clinic' => htmlspecialchars(xl('Health centre/clinic')), 'label_history_summary' => htmlspecialchars(xl('Client medical history summary')), 'label_bp' => htmlspecialchars(xl('Blood pressure')), 'label_ht' => htmlspecialchars(xl('Height')), 'label_wt' => htmlspecialchars(xl('Weight')), 'label_ref_name_sig' => htmlspecialchars(xl('Referer name and signature')), 'label_special_name_sig' => htmlspecialchars(xl('Specialist name and signature')), 'label_form2_title' => htmlspecialchars(xl('COUNTER REFERRAL FORM')), 'label_findings' => htmlspecialchars(xl('Findings')), 'label_final_diagnosis' => htmlspecialchars(xl('Final Diagnosis')), 'label_services_provided' => htmlspecialchars(xl('Services provided')), 'label_recommendations' => htmlspecialchars(xl('Recommendations and treatment')), 'label_scripts_and_referrals' => htmlspecialchars(xl('Prescriptions and other referrals')), 'label_subhead_clinic' => htmlspecialchars(xl('Clinic Copy')), 'label_subhead_patient' => htmlspecialchars(xl('Client Copy')), 'label_subhead_referred' => htmlspecialchars(xl('For Referred Organization/Practitioner')));
if (!is_file($template_file)) {
die("{$template_file} does not exist!");
}
$transid = empty($_REQUEST['transid']) ? 0 : $_REQUEST['transid'] + 0;
// if (!$transid) die("Transaction ID is missing!");
if ($transid) {
$trow = getTransById($transid);
$patient_id = $trow['pid'];
$refer_date = empty($trow['refer_date']) ? date('Y-m-d') : $trow['refer_date'];
} else {
if (empty($_REQUEST['patient_id'])) {
// If no transaction ID or patient ID, this will be a totally blank form.
$patient_id = 0;
$refer_date = '';
} else {
$patient_id = $_REQUEST['patient_id'] + 0;
$refer_date = date('Y-m-d');
}
$trow = array('id' => '', 'pid' => $patient_id, 'refer_date' => $refer_date);
}
if ($patient_id) {
$patdata = getPatientData($patient_id);
