function form_consult_injury()
{
if (func_num_args() > 0) {
$arg_list = func_get_args();
$menu_id = $arg_list[0];
$post_vars = $arg_list[1];
$get_vars = $arg_list[2];
if ($get_vars["cid"] && $get_vars["injury_ts"]) {
$sql = "select injury_id, injury_mechanism, location_code, injury_date, injury_time, location_detail " . "from m_consult_injury " . "where consult_id = '" . $get_vars["cid"] . "' and injury_timestamp = '" . $get_vars["injury_ts"] . "'";
if ($result = mysql_query($sql)) {
if (mysql_num_rows($result)) {
$injury = mysql_fetch_array($result);
}
}
}
}
print "<table width='300'>";
print "<form action = '" . $_SERVER["SELF"] . "?page=" . $get_vars["page"] . "&menu_id=" . $get_vars["menu_id"] . "&consult_id=" . $get_vars["consult_id"] . "&ptmenu=" . $get_vars["ptmenu"] . "&module=" . $get_vars["module"] . "' name='form_consult_injury' method='post'>";
print "<tr valign='top'><td>";
print "<b>" . FTITLE_INJURY_DATA . "</b><br/><br/>";
print "</td></tr>";
print "<tr valign='top'><td>";
print "<span class='boxtitle'>" . LBL_INJURY_CODE . "</span><br> ";
print injury::show_injury_code($injury["injury_id"] ? $injury["injury_id"] : $post_vars["injury_id"]);
print "<br/></td></tr>";
print "<tr valign='top'><td>";
print "<span class='boxtitle'>" . LBL_INJURY_MECHANISM . "</span><br> ";
print "<textarea name='injury_mechanism' cols='36' rows='3' style='border: 1px solid black' class='tinylight'>" . stripslashes(nl2br($injury["injury_mechanism"] ? $injury["injury_mechanism"] : $post_vars["injury_mechanism"])) . "</textarea><br/>";
print "<small>" . INSTR_INJURY_MECHANISM . ".</small><br/>";
print "<br/></td></tr>";
print "<tr valign='top'><td>";
print "<span class='boxtitle'>" . LBL_INJURY_LOCATION . "</span><br> ";
print injury::show_injury_location($injury["location_code"] ? $injury["location_code"] : $post_vars["location_code"]);
print "</td></tr>";
print "<tr valign='top'><td>";
print "<span class='boxtitle'>" . LBL_INJURY_LOCATION_DETAILS . "</span><br> ";
print "<textarea name='location_detail' cols='36' rows='3' style='border: 1px solid black' class='tinylight'>" . stripslashes(nl2br($injury["location_detail"] ? $injury["location_detail"] : $post_vars["location_detail"])) . "</textarea><br/>";
print "<small>" . INSTR_INJURY_LOCATION_DETAILS . "</small><br/>";
print "<br/></td></tr>";
print "<tr valign='top'><td>";
print "<span class='boxtitle'>" . LBL_INJURY_DATE . "</span><br> ";
if ($injury["injury_date"]) {
list($year, $month, $day) = explode("-", $injury["injury_date"]);
$injury_date = "{$month}/{$day}/{$year}";
}
print "<input type='text' size='15' maxlength='10' class='textbox' name='injury_date' value='" . ($injury_date ? $injury_date : $post_vars["injury_date"]) . "' style='border: 1px solid #000000'> ";
print "<a href=\"javascript:show_calendar4('document.form_consult_injury.injury_date', document.form_consult_injury.injury_date.value);\"><img src='../images/cal.gif' width='16' height='16' border='0' alt='Click Here to Pick up the date'></a><br>";
print "<small>Click on the calendar icon to select date. Otherwise use MM/DD/YYYY format.</small><br>";
print "<br/></td></tr>";
print "<tr valign='top'><td>";
print "<span class='boxtitle'>" . LBL_INJURY_TIME . "</span><br> ";
list($hours, $minutes, $seconds) = explode(":", $injury["injury_time"]);
$injury_time = $hours . $minutes;
print module::show_military_time($injury_time ? $injury_time : $post_vars["injury_time"]);
print "<br/></td></tr>";
print "<tr><td>";
if ($get_vars["cid"] && $get_vars["injury_ts"]) {
print "<input type='hidden' name='cid' value='" . $get_vars["cid"] . "'>";
print "<input type='hidden' name='injury_ts' value='" . $get_vars["injury_ts"] . "'>";
if ($_SESSION["priv_update"]) {
print "<input type='submit' value = 'Update Injury Data' class='textbox' name='submitinjury' style='border: 1px solid #000000'> ";
}
if ($_SESSION["priv_delete"]) {
print "<input type='submit' value = 'Delete Injury Data' class='textbox' name='submitinjury' style='border: 1px solid #000000'> ";
}
} else {
if ($_SESSION["priv_add"]) {
print "<br><input type='submit' value = 'Add Injury Data' class='textbox' name='submitinjury' style='border: 1px solid #000000'><br> ";
}
}
print "</td></tr>";
print "</form>";
print "</table><br>";
}
