<?php include "../../../myDatabase.php"; $ro = new database(); $ro->coconutDesign(); echo "<Br><br><br><br><br>"; echo "<center><font size=3> Pag-ibig Monthly Report</font></center>"; $ro->coconutFormStart("post", "pagibigMonthlyReport.php"); $ro->coconutBoxStart("400", "120"); echo "<br>"; echo "<table border=0>"; echo "<tr>"; echo "<Td> From </tD>"; echo "<td>"; $ro->coconutComboBoxStart_short("fromYear"); echo "<option value=''>YYYY</option>"; for ($x = 2013; $x > 1999; $x--) { echo "<option value='{$x}'>{$x}</option>"; } $ro->coconutComboBoxStop(); echo "-"; $ro->coconutComboBoxStart_short("fromMonth"); echo "<option value='MM'>MM</option>"; echo "<option value='01'>01</option>"; echo "<option value='02'>02</option>"; echo "<option value='03'>03</option>"; echo "<option value='04'>04</option>"; echo "<option value='05'>05</option>"; echo "<option value='06'>06</option>"; echo "<option value='07'>07</option>"; echo "<option value='08'>08</option>";
$remarks = $_GET['remarks']; $url = $_GET['url']; $ro = new database(); $ro->coconutDesign(); if ($title == "OT" || $title == "ST") { $ro->coconutFormStart("get", "http://" . $ro->getMyUrl() . "/COCONUT/patientProfile/therapyCharges.php"); echo "<br><br>"; $ro->coconutBoxStart("500", "100"); echo "<Br>"; echo "<font color=red>{$description}</font>"; echo "<br>"; echo "<table border=0>"; echo "<tr>"; echo "<Td>Date Charge </td>"; echo "<Td>"; $ro->coconutComboBoxStart_short("month"); echo "<option value='" . date("m") . "'>" . date("M") . "</option>"; echo "<option value='01'>Jan</option>"; echo "<option value='02'>Feb</option>"; echo "<option value='03'>Mar</option>"; echo "<option value='04'>Apr</option>"; echo "<option value='05'>May</option>"; echo "<option value='06'>Jun</option>"; echo "<option value='07'>Jul</option>"; echo "<option value='08'>Aug</option>"; echo "<option value='09'>Sep</option>"; echo "<option value='10'>Oct</option>"; echo "<option value='11'>Nov</option>"; echo "<option value='12'>Dec</option>"; $ro->coconutComboBoxStop(); echo "-";
$ro->coconutFormStart("get", "editMisc.php"); $ro->coconutHidden("id", $id); $ro->coconutHidden("username", $username); echo "<table border=0>"; echo "<tr>"; echo "<td>" . $ro->coconutText("Function") . "</td>"; echo "<td><input type='text' name='function' value='{$function}' class='txtBox' readonly></td>"; echo "</tr>"; echo "<tr>"; echo "<td>" . $ro->coconutText("Description") . "</td>"; echo "<td><textarea class='txtArea' name='description'>{$description}</textarea></td>"; echo "</tr>"; echo "<tr>"; echo "<td>" . $ro->coconutText("Value") . "</td>"; if ($function == "anotherPrice") { echo "<Td>"; $ro->coconutComboBoxStart_short("val"); echo "<option value='{$value}'>{$value}</option>"; echo "<option value='IPD'>IPD</option>"; echo "<option value='OPD'>OPD</option>"; $ro->coconutComboBoxStop(); echo "</td>"; } else { echo "<td><input type='text' name='val' value='{$value}' class='txtBox'></td>"; } echo "</tr>"; echo "</table>"; echo "<br>"; $ro->coconutButton("Proceed"); $ro->coconutFormStop(); $ro->coconutBoxStop();
echo "<option value='" . $ro->getPatientRecord_civilStatus() . "'>" . $ro->getPatientRecord_civilStatus() . "</option>"; $ro->showCivilStatus(); echo "</select></td>"; echo "</tr>"; echo "<tr>"; echo "<td>Gender </td>"; echo "<td>\n<select name='gender' class='comboBox'>"; echo "<option value='" . $ro->getPatientRecord_gender() . "'>" . $ro->getPatientRecord_gender() . "</option>"; echo "<option value='male'>male</option>"; echo "<option value='female'>female</option>"; echo "</select></td>"; echo "</tr>"; echo "<tr>"; echo "<td>Birth Date </td>"; echo "<Td>"; $ro->coconutComboBoxStart_short("bdayMonth"); echo "<option value='" . $bday[1] . "'>" . $bday[1] . "</option>"; echo "<option value='01'>Jan</option>"; echo "<option value='02'>Feb</option>"; echo "<option value='03'>Mar</option>"; echo "<option value='04'>Apr</option>"; echo "<option value='05'>May</option>"; echo "<option value='06'>Jun</option>"; echo "<option value='07'>Jul</option>"; echo "<option value='08'>Aug</option>"; echo "<option value='09'>Sep</option>"; echo "<option value='10'>Oct</option>"; echo "<option value='11'>Nov</option>"; echo "<option value='12'>Dec</option>"; $ro->coconutComboBoxStop(); echo "-";
<?php include "../../myDatabase.php"; $username = $_GET['username']; $ro = new database(); $ro->coconutDesign(); $ro->coconutFormStart("get", "transmitted.php"); $ro->coconutBoxStart("600", "170"); echo "<Br>"; echo "<table border=0>"; echo "<tr>"; echo "<td>" . $ro->coconutText("From Date") . "</td>"; echo "<td>"; $ro->coconutComboBoxStart_short("fromMonth"); echo "<option value='01'>Jan</option>"; echo "<option value='02'>Feb</option>"; echo "<option value='03'>Mar</option>"; echo "<option value='04'>Apr</option>"; echo "<option value='05'>May</option>"; echo "<option value='06'>Jun</option>"; echo "<option value='07'>Jul</option>"; echo "<option value='08'>Aug</option>"; echo "<option value='09'>Sep</option>"; echo "<option value='10'>Oct</option>"; echo "<option value='11'>Nov</option>"; echo "<option value='12'>Dec</option>"; $ro->coconutComboBoxStop(); echo "</td>"; echo "<td>"; $ro->coconutComboBoxStart_short("fromDay"); for ($x = 1; $x < 32; $x++) {
echo " <select name='toTime_seconds' class='comboBoxShort'>"; for ($x = 0; $x <= 60; $x++) { if ($x < 10) { echo "<option value='0{$x}'>0{$x}</option>"; } else { echo "<option name='{$x}'>{$x}</option>"; } } echo "</select>"; echo "</td>"; echo "</tr>"; if ($username == "cris") { echo "<tr>"; echo "<tD>Show All: </tD>"; echo "<Td>"; $ro->coconutComboBoxStart_short("username"); echo "<option value='{$username}'>No</option>"; echo "<option value='smch'>Yes</option>"; $ro->coconutComboBoxStop(); echo "</td>"; echo "</tr>"; echo "<tr>"; echo "<tD>Show Cut-off: </tD>"; echo "<Td>"; $ro->coconutComboBoxStart_short("cutoff"); echo "<option value='no'>No</option>"; echo "<option value='yes'>Yes</option>"; $ro->coconutComboBoxStop(); echo "</td>"; echo "</tr>"; } else {
<?php include "../../../myDatabase.php"; $ro = new database(); $ro->coconutDesign(); $ro->coconutFormStart("get", "pf_ipd.php"); $ro->coconutBoxStart("500", "100"); echo "<br>"; echo "<table border=0>"; echo "<tr>"; echo "<td>" . $ro->coconutText("From Date") . "</td>"; echo "<td>"; $ro->coconutComboBoxStart_short("fromDate_month"); echo "<option value='Jan'>Jan</option>"; echo "<option value='Feb'>Feb</option>"; echo "<option value='Mar'>Mar</option>"; echo "<option value='Apr'>Apr</option>"; echo "<option value='May'>May</option>"; echo "<option value='Jun'>Jun</option>"; echo "<option value='Jul'>Jul</option>"; echo "<option value='Aug'>Aug</option>"; echo "<option value='Sep'>Sep</option>"; echo "<option value='Oct'>Oct</option>"; echo "<option value='Nov'>Nov</option>"; echo "<option value='Dec'>Dec</option>"; $ro->coconutComboBoxStop(); echo " - "; $ro->coconutComboBoxStart_short("fromDate_day"); for ($x = 1; $x < 32; $x++) { if ($x < 9) { echo "<option value='0{$x}'>0{$x}</option>";
echo "<tr>"; echo "<td><font class='labelz'>To Date </font></td>"; echo "<td>\n<select name='toMonth' class='comboBoxShort'> \n<option value='01'>Jan</option>\n<option value='02'>Feb</option>\n<option value='03'>Mar</option>\n<option value='04'>Apr</option>\n<option value='05'>May</option>\n<option value='06'>Jun</option>\n<option value='07'>Jul</option>\n<option value='08'>Aug</option>\n<option value='09'>Sep</option>\n<option value='10'>Oct</option>\n<option value='11'>Nov</option>\n<option value='12'>Dec</option>\n</select>"; echo " <select name='toDay' class='comboBoxShort'>"; for ($x = 1; $x < 32; $x++) { if ($x < 10) { echo "<option value='0{$x}'>0{$x}</option>"; } else { echo "<option value='{$x}'>{$x}</option>"; } } echo "</select>"; echo " <input type=text name='toYear' class='shortField' value='" . date("Y") . "'>"; echo "</td>"; echo "</tr>"; echo "<tr>"; echo "<td> </td>"; echo "</tr>"; echo "<tr>"; echo "<Td>" . $ro->coconutText("Type") . "</td>"; echo "<td>"; $ro->coconutComboBoxStart_short("type"); echo "<option value='OPD'>OPD</option>"; echo "<option value='IPD'>IPD</option>"; $ro->coconutComboBoxStop(); echo "</td>"; echo "</tr>"; echo "</table>"; echo "<br><input type=submit value='Proceed' style='border:1px solid #000; background-color:#3b5998; color:white;' >"; echo "</div>"; echo "</form>";
<?php include "../../myDatabase.php"; $ro = new database(); $ro->coconutDesign(); echo "<br><Br><br><br>"; $ro->coconutBoxStart("600", "130"); echo "<center><br>"; $ro->coconutFormStart("get", "admissionKit1.php"); echo $ro->coconutText("From Date: "); $ro->coconutComboBoxStart_short("month"); echo "<option value='01'>Jan</option>"; echo "<option value='02'>Feb</option>"; echo "<option value='03'>Mar</option>"; echo "<option value='04'>Apr</option>"; echo "<option value='05'>May</option>"; echo "<option value='06'>Jun</option>"; echo "<option value='07'>Jul</option>"; echo "<option value='08'>Aug</option>"; echo "<option value='09'>Sep</option>"; echo "<option value='10'>Oct</option>"; echo "<option value='11'>Nov</option>"; echo "<option value='12'>Dec</option>"; $ro->coconutComboBoxStop(); echo " "; $ro->coconutComboBoxStart_short("day"); for ($x = 1; $x <= 31; $x++) { if ($x < 10) { echo "<option value='0{$x}'>0{$x}</option>"; } else { echo "<option value='{$x}'>{$x}</option>";
echo "<td><font class='labelz'>Cash Rate </font></td>"; echo "<td><input type=text name='cashAmount' class='shortField'></td>"; echo "</tr>"; echo "<tr>"; echo "<td><font class='labelz'>Company Rate </font></td>"; echo "\n<td>\n<select name='companyRate' class='comboBoxShort'>\n<option value='rate1'>rate1</option>\n<option value='rate2'>rate2</option>\n<option value='rate3'>rate3</option>\n<option value='rate4'>rate4</option>\n<option value='rate5'>rate5</option>\n</select>\n</td>"; echo "</tr>"; echo "<tr>"; echo "<td><font class='labelz'>PF Sharing </font></td>"; echo "<td><input type=text name='doctorShare' class='shortField'> <font size=2>Ex:</font> <font size=2 color=red>.60 = 60%</font></td>"; echo "</tr>"; echo "<tr>"; echo "<td><font class='labelz'>Discount </font></td>"; echo "<td><input type=text name='discount' class='shortField'> </td>"; echo "</tr>"; echo "<tr>"; echo "<Td><font class='labelz'>PhilHealth</font></tD>"; echo "<TD>"; $ro->coconutComboBoxStart_short("phic"); echo "<option value='yes'>yes</option>"; echo "<option value='no'>no</option>"; $ro->coconutComboBoxStop(); echo "</td>"; echo "</tr>"; echo "<tr><Td> </tD></tR>"; echo "<tr>"; echo "<td> </td><td><input type=submit value='Proceed' style='border:1px solid #000; background-color:#3b5998; color:white' ></td>"; echo "</tr>"; echo "</table>"; echo "</div>"; echo "</form>";
echo "<option value='" . date("d") . "'>" . date("d") . "</option>"; for ($x = 1; $x < 32; $x++) { if ($x < 10) { echo "<option value='0{$x}'>0{$x}</option>"; } else { echo "<option value='{$x}'>{$x}</option>"; } } echo "</select>"; echo " <input type=text name='year' class='shortField' value='" . date("Y") . "'>"; echo "</td>"; echo "</tr>"; echo "<Tr>"; echo "<Td>From Time</td>"; echo "<tD>"; $ro->coconutComboBoxStart_short("fromTime_hours"); for ($x = 0; $x <= 24; $x++) { if ($x < 10) { echo "<option value='0{$x}'>0{$x}</option>"; } else { echo "<option value='{$x}'>{$x}</option>"; } } $ro->coconutComboBoxStop(); echo "-"; $ro->coconutComboBoxStart_short("fromTime_minutes"); for ($x = 0; $x <= 24; $x++) { if ($x < 10) { echo "<option value='0{$x}'>0{$x}</option>"; } else { echo "<option value='{$x}'>{$x}</option>";
$cashPaid = $_GET['cashPaid']; $batchNo = $_GET['batchNo']; $username = $_GET['username']; $inventoryFrom = $_GET['inventoryFrom']; $ro = new database(); $ro->coconutDesign(); echo "\n<style type='text/css'>\n.qty {\n\tborder: 1px solid #000;\n\tcolor: #000;\n\theight:25px;\n\twidth: 100px;\n\tpadding:4px 4px 4px 10px;\n}\n\n</style>\n\n"; //addCharges.php echo "<br><Br><Br><center><font color=blue>Ambulance</font>"; echo "<form method='get' action='http://" . $ro->getMyUrl() . "/COCONUT/availableMisc/addCharges_ambulance.php'>"; echo "<center><div style='border:1px solid #000000; width:400px; height:100px;\t'>"; echo "<br><table border=0 cellpadding=0 cellspacing=0>"; echo "<tr>"; echo "<td><font size=3 color=red>Additional 10%?</font> </td>"; echo "<td>"; $ro->coconutComboBoxStart_short("additional"); echo "<option value='no'>No</option>"; echo "<option value='yes'>Yes</option>"; $ro->coconutComboBoxStop(); echo "</td>"; echo "</tr>"; echo "<tr><td> </td></tr>"; echo "<tr>"; echo "<td><input type='button' class='button' value=' Back '\nonClick='javascript: history.go(-1)' style='border:1px solid #000000; background-color:transparent;'></td>"; echo "<td> </td>"; echo "<td><input type=submit value='Proceed' style='border:1px solid #000000; background-color:transparent; color:red; height:20px;'></td>"; echo "<input type=hidden name='status' value='{$status}'>"; echo "<input type=hidden name='registrationNo' value='{$registrationNo}'>"; echo "<input type=hidden name='chargesCode' value='{$chargesCode}'>"; echo "<input type=hidden name='description' value='{$description}'>"; echo "<input type=hidden name='sellingPrice' value='{$sellingPrice}'>";