createTR($errorfax, 'fax', $LDFax, $fax, 2); } if (!$person_email_hide) { createTR($erroremail, 'email', $LDEmail, $email, 2); } if (!$person_citizenship_hide) { createTR($errorcitizen, 'citizenship', $LDCitizenship, $citizenship, 2); } if (!$person_sss_nr_hide) { createTR($errorsss, 'sss_nr', $LDSSSNr, $sss_nr, 2); } if (!$person_nat_id_nr_hide) { createTR($errornatid, 'nat_id_nr', $LDNatIdNr, $nat_id_nr, 2); } if (!$person_religion_hide) { createTR($errorreligion, 'religion', $LDReligion, $religion, 2); } if (!$person_ethnic_orig_hide) { /** Add by Jean-Philippe LIOT 13/05/2004 **/ ?> <tr> <td><FONT SIZE=-1 FACE="Arial"><?php if ($errortown) { echo "<font color=red>"; } echo $LDEthnicOrigin; ?> : </td> <td><input name="ethnic_orig_txt" type="text" size="35" value="<?php echo $ethnic_orig_txt;
<?php if (!$GLOBAL_CONFIG['person_name_2_hide']) { createTR($LDName2, $name_2); } if (!$GLOBAL_CONFIG['person_name_3_hide']) { createTR($LDName3, $name_3); } if (!$GLOBAL_CONFIG['person_name_middle_hide']) { createTR($LDNameMid, $name_middle); } if (!$GLOBAL_CONFIG['person_name_maiden_hide']) { createTR($LDNameMaiden, $name_maiden); } if (!$GLOBAL_CONFIG['person_name_others_hide']) { createTR($LDNameOthers, $name_others); } ?> <tr> <td bgColor="#eeeeee"><FONT SIZE=-1 FACE="Arial"><?php echo $LDBday; ?> : </td> <td bgcolor="#ffffee" ><FONT SIZE=-1 FACE="Arial" color="#990000"> <b><?php echo @formatDate2Local($date_birth, $date_format); ?> </b> </td>
</option> <?php # Generate discharge types while ($dis_type = $discharge_types->FetchRow()) { echo '<option value="' . $dis_type['nr'] . '">' . $dis_type['name'] . '</option>'; } ?> </select> </td> </tr> <?php createTR('discharged_by', 'Discharged By', $discharged_by); ?> <tr bgcolor="white"> <!--d.r. from merotech: Remove Bill Type from Archive form--> <!--<td background="<?php echo createBgSkin($root_path, 'tableHeaderbg3.gif'); ?> "> <?php echo $LDBillType; ?> :--> </td> <td colspan=2 bgcolor="#eeeeee"> <?php
createTR($errorcitizen, 'citizenship', $LDCitizenship, $citizenship, 2); } if (!$person_sss_nr_hide) { createTR($errorsss, 'sss_nr', $LDSSSNr, $sss_nr, 2); } if (!$person_nat_id_nr_hide) { createTR($errornatid, 'nat_id_nr', $LDNatIdNr, $nat_id_nr, 2); } if (!$person_religion_hide) { createTR($errorreligion, 'religion', $LDReligion, $religion, 2); } if (!$person_ethnic_orig_hide) { if (!$ethnic_orig) { $ethnic_orig = ''; } createTR($errorethnicorig, 'ethnic_orig', $LDEthnicOrigin, $ethnic_orig, 2); } ?> <tr> <td bgColor="#eeeeee"><FONT SIZE=-1 FACE="Arial" ><FONT SIZE=2 FACE="Arial"><?php echo $LDRegBy; ?> </td> <td colspan=2><FONT SIZE=-1 FACE="Arial"><nobr> <input name="user_id" type="text" value=<?php if ($user_id != '') { echo '"' . $user_id . '"'; } else { echo '"' . $_COOKIE[$local_user . $sid] . '"'; } ?>
$LD = $result['LD_var']; if (isset(${$LD}) && !empty(${$LD})) { echo ${$LD}; } else { echo $result['name']; } echo ' '; } } ?> </td> </tr> <?php createTR('insurance_nr', $LDInsuranceNr, $insurance_nr); createTR('insurance_firm_name', $LDInsuranceCo, $insurance_firm_name); ?> <?php //if (!$GLOBAL_CONFIG['patient_care_service_hide'] && $care_ok) if (!$GLOBAL_CONFIG['patient_service_care_hide']) { ?> <tr> <td background="<?php echo createBgSkin($root_path, 'tableHeaderbg3.gif'); ?> "><FONT SIZE=-1 FACE="Arial"><?php echo $LDCareServiceClass; ?> : </td>
if (!isset($nat_id_nr)) { $nat_id_nr = ''; } createTR('nat_id_nr', $LDNatIdNr, $nat_id_nr, 2); } if (!$GLOBAL_CONFIG['person_religion_hide']) { if (!isset($religion)) { $religion = ''; } createTR('religion', $LDReligion, $religion, 2); } if (!$GLOBAL_CONFIG['person_ethnic_orig_hide']) { if (!isset($ethnic_orig)) { $ethnic_orig = ''; } createTR('ethnic_orig', $LDEthnicOrigin, $ethnic_orig, 2); } /* if (!$GLOBAL_CONFIG['insurance_ID_hide']) { if(!isset($insurance_ID)) $insurance_ID=''; createTR('insurance_ID', $LDInsurance,$insurance_ID,2); } */ ?> </table> <p> <input type=hidden name="sid" value=<?php echo $sid;