Exemplo n.º 1
0
echo "</tr>";
echo "<tr>";
echo "<td><b>Name:</b></td>";
echo "<td><input type='text' class='linez' value='" . $ro->getPatientRecord_lastName() . ", " . $ro->getPatientRecord_firstName() . " " . $ro->getPatientRecord_middleName() . "'></td>";
echo "<td><b>Age/Sex:</b></td>";
echo "<td><input type='text' class='linez' value='" . $ro->getPatientRecord_age() . "/" . $ro->getPatientRecord_gender() . "'></td>";
echo "</tr>";
echo "<tr>";
echo "<Td><b>Date of Birth:</td>";
echo "<td></b><input type='text' class='linez' value='" . $ro->getPatientRecord_birthDate() . "'></tD>";
echo "<td><b>Status:</td>";
echo "<td></b><input type='text' class='linez' value='" . $ro->getPatientRecord_civilStatus() . "'></tD>";
echo "</tr>";
echo "<tr>";
echo "<Td><b>Physician:</b></td>";
echo "<td><input type='text' class='linez' value='" . $ro->getAttendingDoc($registrationNo, "ATTENDING") . "'></tD>";
echo "<Td><b>Room:</b></td>";
echo "<td> <input type='text' class='linez' value='" . $ro->getRegistrationDetails_room() . "'></tD>";
echo "</tr>";
echo "</table>";
echo "</center>";
echo "<Br>";
echo "<center>";
echo $ro->ENCRYPT_DECRYPT($ro->doubleSelectNow_notDeleted("labSavedResult", "result", "itemNo", $itemNo, "registrationNo", $registrationNo));
echo "</center>";
if ($ro->selectNow("labSavedResult", "morphology", "itemNo", $itemNo) != "") {
    echo "<b>Morphology:&nbsp;</b>" . $ro->selectNow("labSavedResult", "morphology", "itemNo", $itemNo);
} else {
}
echo "<Br>";
if ($ro->selectNow("labSavedResult", "remarks", "itemNo", $itemNo) != "") {
Exemplo n.º 2
0
echo "<td><font size=2>THIS HOSPITAL FROM <input type=text class='underLine2' value='" . $ro->getRegistrationDetails_dateRegistered() . "'></font>\n<font size=2>TO</font>\n<input type=text class='underLine2' value='" . $ro->getRegistrationDetails_dateUnregistered() . "' >\n</td>";
echo "</tr>";
echo "<tr>";
echo "<td><font size=2>WITH THE FOLLOWING FINDINGS AND OR DIAGNOSIS:</font><input type='text' name='d1' class='underline2'></td>";
echo "</tr>";
echo "</table>";
echo "<input type=text name='d2' class='underLine3'>";
echo "<br>";
echo "<input type=text name='d3' class='underLine3'>";
echo "<br><Br>";
echo "<table border=0>";
echo "<tr>";
echo "<td><font size=2>THE CERTIFICATION IS ISSUED UPON REQUEST OF</font> <input type=text class='underLine'> </td>";
echo "</tr>";
echo "<tr>";
echo "<td><font size=2>FOR</font> <input type=text class='underLine3'> </td>";
echo "</tr>";
echo "</table>";
echo "<br><br>";
echo "<table border=0>";
echo "<tr>";
echo "<td width='25%'>&nbsp;</td>";
echo "<td width='10%'><input type='text' class='underLine4'  value='" . $ro->getAttendingDoc($registrationNo, "Attending") . "'><br>&nbsp;&nbsp;<font size=2>ATTENDING PHYSICIAN</font></td>";
echo "</tr>";
echo "</table>";
$ro->coconutHidden("registrationNo", $registrationNo);
$ro->coconutButton("Printable Version");
$ro->coconutFormStop();
?>
</div>
Exemplo n.º 3
0
$ro = new database1();
$ro->getPatientProfile($registrationNo);
echo "<center><b><font size=5>" . $ro->getReportInformation("hmoSOA_name") . "</font></b></center>";
echo "<center><font size=3>" . $ro->getReportInformation("hmoSOA_address") . "</font></center>";
echo "<center><font size=2>Tel No. (062) 2143237</font></center>";
echo "<br>";
echo "<center>CONSENT FOR ADMISSION</center>";
echo "<br><br><br>";
echo "<Table border=0 width='100%'>";
echo "<tr>";
echo "<td width='70%'></td>";
echo "<td width='85%'>Date:&nbsp;" . date("M d, Y") . "</td>";
echo "</tr>";
echo "</table>";
echo "<br>";
echo "&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;I&nbsp;&nbsp;, _________________________________________________ hereby voluntarily and willingly authorized <br> &nbsp; Dr. <b><u>__" . $ro->getAttendingDoc($registrationNo, "ATTENDING") . "__</u></b>&nbsp; to treat and to admit __<b><u>" . $ro->getPatientRecord_lastName() . ", " . $ro->getPatientRecord_firstName() . "</u></b>__ <br>&nbsp; at PAGADIAN CITY MEDICAL CENTER.";
echo "<br><br>";
echo "<Table border=0 width='100%'>";
echo "<tr>";
echo "<td width='70%'></td>";
echo "<td width='85%'>_________________________________________<br><font size=2>Signature Over Printed Name</font></td>";
echo "</tr>";
echo "<tr>";
echo "<td width='70%'></td>";
echo "<td width='85%'></td>";
echo "</tr>";
echo "<tr>";
echo "<td width='70%'></td>";
echo "<td width='85%'></td>";
echo "</tr>";
echo "<tr>";