function getNewSpecimenForm($form_num, $pid, $dnum, $session_num, $doc="" ,$title ="Dr.")
{
# Returns HTML for new specimen form
LangUtil::setPageId("new_specimen");
$form_name = 'specimenform_'.$form_num;
$form_id = $form_name;
$form_class = 'specimenform_class';
$testbox_id = $form_id.'_testbox';
$stype_id = $form_id.'_stype';
$dnum_id = $form_id.'_dnum';
$time_id = $form_id.'_ctime';
$div_id = 'specimen_form_container_'.$form_num;
$dialog_id = $div_id."_dialog";
$specimen_id_div_id = 'specimen-id_'.$form_num;
$specimen_err_div_id = 'specimen_msg_'.$form_num;
$doc_row_id = 'doc_row_'.$form_num;
$ref_out_row_id = 'ref_out_row_'.$form_num;
$ref_out_check_id = 'ref_out_'.$form_num;
$lab_config = LabConfig::getById($_SESSION['lab_config_id']);
?>
<div id='<?php echo $div_id; ?>'>
<div class='pretty_box' style='width:530px;'>
<form name='<?php echo $form_name; ?>' id='<?php echo $form_id; ?>' action='ajax/specimen_add.php?session_num=<?php echo $session_num ?>' method='post'>
<input type='hidden' name='pid' value='<?php echo $pid; ?>' class='uniform_width'></input>
<?php /*<input type='hidden' name='session_num' value='<?php echo get_session_number(); ?>' class='uniform_width'></input> */ ?>
<table class='regn_form_table'>
<tbody>
<tr valign='top' <?php
if(is_numeric($_SESSION['dnum']) && $_SESSION['dnum'] == 0)
{
# Hide if daily num not in use
echo " style='display:none;' ";
}
?>
>
<td>
<label for='dnum'><?php echo LangUtil::$generalTerms['PATIENT_DAILYNUM']; ?><?php $this->getAsterisk(); ?></label>
</td>
<td> </td>
<td>
<input type="text" name="dnum" id="dnum" value=<?php echo $dnum; ?> size="20" class='uniform_width'> </input>
</td>
</tr>
<tr valign='top'>
<td>
<label for='stype'><?php echo LangUtil::$generalTerms['SPECIMEN_TYPE']; ?><?php $this->getAsterisk(); ?></label>
</td>
<td> </td>
<td>
<select
name='stype'
id='<?php echo $stype_id; ?>'
onchange="javascript:get_testbox('<?php echo $testbox_id; ?>', '<?php echo $stype_id; ?>');"
class='uniform_width'
>
option value="">-<?php echo LangUtil::$generalTerms['CMD_SELECT']; ?>-</option>
<?php $this->getSpecimenTypesSelect($_SESSION['lab_config_id']); ?>
</select>
</td>
</tr>
<tr valign='top'>
<td>
<label for='tests'><?php echo LangUtil::$generalTerms['TESTS']; ?> <?php $this->getAsterisk(); ?></label>
</td>
<td> </td>
<td>
<span id='<?php echo $testbox_id; ?>' class='uniform_width'>
-<?php echo LangUtil::$pageTerms['MSG_SELECT_STYPE']; ?>-
</span>
</td>
</tr>
<tr valign='top'<?php
//if($_SESSION['sid'] == 0)
if(true)
echo " style='display:none;' ";
?>>
<td>
<label for='sid'>DB Key
<?php if($_SESSION['sid'] == 2) $this->getAsterisk(); ?></label>
</td>
<td> </td>
<td>
<!--
<input type="text" name="specimen_id" id="<?php echo $specimen_id_div_id; ?>" value="" onblur="javascript:check_specimen_id('<?php echo $specimen_id_div_id; ?>', '<?php echo $specimen_err_div_id; ?>');" size="20" class='uniform_width'>
</input>
-->
<input type='text' name='specimen_id' id='specimen_id' value="<?php echo $form_num; ?>" readonly="readonly" class='uniform_width'>
</input>
<br><span id='<?php echo $specimen_err_div_id; ?>'></span>
</td>
</tr>
<tr valign='top' <?php
if($lab_config->specimenAddl == 0)
echo " style='display:none;' ";
?>>
<td>
<label for='addlid'><?php echo LangUtil::$generalTerms['SPECIMEN_ID']; ?><?php if($_SESSION['s_addl'] == 2) $this->getAsterisk(); ?> </label>
</td>
<td> </td>
<td>
<input type="text" name="addl_id" id="addl_id" value="" size="20" class='uniform_width'> </input>
</td>
</tr>
<tr valign='top' <?php
if($_SESSION['rdate'] == 0)
echo " style='display:none;' ";
?>>
<td>
<label><?php echo LangUtil::$generalTerms['R_DATE']; ?> <?php if($_SESSION['rdate'] == 2) $this->getAsterisk(); ?></label>
</td>
<td> </td>
<td>
<?php
$today = date("Y-m-d");
$today_array = explode("-", $today);
$name_list = array("receipt_yyyy", "receipt_mm", "receipt_dd");
$id_list = array($form_id."_receipt_yyyy", $form_id."_receipt_mm", $form_id."_receipt_dd");
$value_list = array($today_array[0], $today_array[1], $today_array[2]);
$this->getDatePicker($name_list, $id_list, $value_list, true);
?>
</td>
</tr>
<tr valign='top' style='display:none;'>
<td>
<label><?php echo LangUtil::$generalTerms['C_DATE']; ?></label>
</td>
<td> </td>
<td>
<?php
$today = date("Y-m-d");
$today_array = explode("-", $today);
$name_list = array("collect_yyyy", "collect_mm", "collect_dd");
$id_list = array($form_id."_collect_yyyy", $form_id."_collect_mm", $form_id."_collect_dd");
$value_list = array($today_array[0], $today_array[1], $today_array[2]);
$this->getDatePicker($name_list, $id_list, $value_list, false);
?>
</td>
</tr>
<tr valign='top' style='display:none;'>
<td>
<label><?php echo LangUtil::$generalTerms['C_TIME']; ?></label>
</td>
<td>
<select name='ctime_hh' autocomplete="OFF">
<?php
$time = date("H:i");
$time_parts = explode(":", $time);
for($i = 0; $i < 24; $i++)
{
if($i < 10)
$option = '0'.$i;
else
$option = $i;
echo "<option value='$option' ";
if($option == $time_parts[0])
//if($option == 9)
echo "selected ";
echo ">$option</option>";
}
?>
</select>
:
<select name='ctime_mm' autocomplete="OFF">
<?php
for($i = 0; $i < 60; $i++)
{
if($i < 10)
$option = '0'.$i;
else
$option = $i;
echo "<option value='$option' ";
if($option == $time_parts[1])
//if($option == "00")
echo "selected ";
echo ">$option</option>";
}
?>
</select>
hrs
</td>
</tr>
<tr valign='top'<?php
if($_SESSION['comm'] == 0)
echo " style='display:none;' ";
?>>
<td>
<label for='comments' valign='top'><?php echo LangUtil::$generalTerms['COMMENTS']; ?><?php if($_SESSION['comm'] == 2) $this->getAsterisk(); ?></label>
</td><td> </td>
<td>
<textarea name="comments" id="comments" class='uniform_width'></textarea>
</td>
</tr>
<tr valign='top' style='display:none' <?php ## Disabled for now ?>>
<td>
<label for='report_to' valign='top'>Report To</label>
</td>
<td> </td>
<td>
<select name='report_to' class='uniform_width'>
<?php
# Enable the following line if this field is to be used:
echo " onchange=\"javascript:checkandtoggle(this, '$doc_row_id');\" ";
?>
<option value='1'>Patient</option>
<option value='2'>Doctor/Hospital</option>
</select>
</td>
</tr>
<tr valign='top' id='<?php echo $doc_row_id; ?>' <?php
if($_SESSION['doctor'] == 0)
echo " style='display:none;' ";
?>>
<td><label for='doctor' valign='top'><?php echo LangUtil::$generalTerms['DOCTOR']; ?><?php if($_SESSION['doctor'] == 2) $this->getAsterisk(); ?></label></label>
</td>
<td>
<SELECT name='title' id='<?php echo $doc_row_id; ?>_title'>
<?php
$labtitlefieldoptions = get_custom_fields_labtitle(1);
$lab_titles = explode("/",$labtitlefieldoptions);
foreach($lab_titles as $option)
{
if(trim($option) == "")
continue;
echo "<option value='$option'";
if($option == $field_value)
{
echo " selected ";
}
echo " >$option</option>";
}
?>
</SELECT>
</td>
<td>
<input type='text' name='doctor' id='<?php echo $doc_row_id."_input"; ?>' value='<?php echo $doc; ?>' ></input>
</td>
</tr>
<?php
$custom_field_list = get_custom_fields_specimen();
foreach($custom_field_list as $custom_field)
{ if(($custom_field->flag)==NULL)
{
?>
<tr valign='top'>
<td><?php echo $custom_field->fieldName; ?></td>
<td></td>
<td><?php $this->getCustomFormField($custom_field); ?></td>
</tr>
<?php
}
}
?>
<tr valign='top'<?php
if($_SESSION['refout'] == 0)
echo " style='display:none;' ";
?>>
<td>
<label for='ref_out' valign='top'><?php echo LangUtil::$generalTerms['REF_OUT']; ?>? <?php if($_SESSION['refout'] == 2) $this->getAsterisk(); ?></label>
</td>
<td> </td>
<td>
<INPUT TYPE=RADIO NAME="ref_out" id='<?php echo $ref_out_check_id; ?>' VALUE="Y" onchange="javascript:checkandtoggle_ref('<?php echo $ref_out_check_id; ?>', '<?php echo $ref_out_row_id; ?>');"><?php echo LangUtil::$generalTerms['YES']; ?>
<INPUT TYPE=RADIO NAME="ref_out" onchange="javascript:checkandtoggle_ref('<?php echo $ref_out_check_id; ?>', '<?php echo $ref_out_row_id; ?>');" VALUE="N" checked><?php echo LangUtil::$generalTerms['NO']; ?>
</td>
</tr>
<tr valign='top' id='<?php echo $ref_out_row_id; ?>' style='display:none'>
<td><?php echo LangUtil::$generalTerms['REF_TO']; ?></td>
<td>
<input name='ref_out_name' class='uniform_width'></input>
</td>
</tr>
<?php
if($form_num != 1)
{
?>
<tr valign='top'>
<td>
<a href="javascript:show_dialog_box('<?php echo $div_id; ?>');"><?php echo LangUtil::$generalTerms['CMD_REMOVE']; ?></a>
</td>
<td>
<?php
$message = LangUtil::$pageTerms['MSG_SURETO_REMOVE'];
$ok_function = "remove_specimenbox('$div_id')";
$cancel_function = "hide_dialog_box('$div_id')";
$this->getConfirmDialog($dialog_id, $message, $ok_function, $cancel_function, $width=200);
?>
</td>
</tr>
<?php
}
?>
</tbody>
</table>
</form>
</div>
<small>
<span style='float:right'>
<?php $this->getAsteriskMessage(); ?>
</span>
</small>
<br>
</div>
<?php
}
function generate_doctors($doc_row_id, $doc=""){
/* $doc_array= getDoctorList();
$php_array= addslashes(implode("%", $doc_array));
echo '<script type="text/javascript">$(document).ready(function(){';
echo 'var data_string="'.$php_array;
echo 'var data=data_string.split("%");
$("#doc_row_1_input").autocomplete(data);
}</script>';
*/
if($_SESSION['user_level'] == 17) {
if($doc =="") {
$doc = $_SESSION['username'];
}
}
echo "<tr valign='top' id='";
echo $doc_row_id."'";
if($_SESSION['doctor'] == 0)
echo " style='display:none;' ";
echo ">
<td><label for='doctor' valign='top'>".LangUtil::$generalTerms['DOCTOR'];
if($_SESSION['doctor'] == 2)
$this->getAsterisk();
echo "</label></label>
</td>
<td>";
$labtitlefieldoptions = get_custom_fields_labtitle(1);
$lab_titles = explode("/",$labtitlefieldoptions);
echo "<SELECT name='title' id='".$doc_row_id."_title'>";
foreach($lab_titles as $option)
{
if(trim($option) == "")
continue;
echo "<option value='".$option."'";
if($option == $field_value)
{
echo " selected ";
}
echo " >".$option."</option>";
}
echo " </SELECT>
</td>
<td>
<input type='text' name='doctor' class ='doctors_auto' id='".$doc_row_id."_input' value='".$doc."' ></input>
</td>
</tr>";
}
