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126 lines
5.0 KiB
126 lines
5.0 KiB
<?php |
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/** |
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* For various specialty forms to call from dialog using the |
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* Ajax, iFrame, Alert, Confirm or HTML modes. Just follow |
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* the example patient previous names history form pattern shown below. |
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* |
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* @package OpenEMR |
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* @link https://www.open-emr.org |
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* @author Jerry Padgett <sjpadgett@gmail.com> |
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* @copyright Copyright (c) 2021 Jerry Padgett <sjpadgett@gmail.com> |
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* @license https://github.com/openemr/openemr/blob/master/LICENSE GNU General Public License 3 |
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*/ |
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require_once(__DIR__ . "/../interface/globals.php"); |
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use OpenEMR\Common\Csrf\CsrfUtils; |
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use OpenEMR\Core\Header; |
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if (!CsrfUtils::verifyCsrfToken($_GET["csrf_token_form"])) { |
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CsrfUtils::csrfNotVerified(); |
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} |
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$form = trim($_GET['form_handler']); |
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echo "<script>var form=" . js_escape($form) . "</script>"; |
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?> |
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<!DOCTYPE html> |
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<html> |
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<head> |
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<title><?php echo xlt("Specialty Form"); ?></title> |
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<meta name="viewport" content="width=device-width, initial-scale=1.0"> |
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<?php Header::setupHeader(['opener', 'datetime-picker']); ?> |
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<script> |
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$(function () { |
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$("#names_form").submit(function(event) { |
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event.preventDefault(); |
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const url = top.webroot_url + '/library/ajax/specialty_form_ajax.php'; |
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return fetch( |
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url, |
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{ |
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method: 'POST', |
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body: new FormData(this) |
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} |
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).then(data => data.json()) |
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.then(data => { |
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let ele = opener.document.getElementById('form_name_history'); |
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if (data !== false) { |
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let newOption = new Option(data.name, data.id, true, true); |
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ele.append(newOption); |
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} else { |
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let message = xl("Previous name history already exist. Try again or Cancel."); |
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dialog.alert(message); |
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} |
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}).then(() => { |
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dlgclose(); |
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}); |
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}); |
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$("#form_cancel").click(function(){ |
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dlgclose(); |
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}); |
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$('.datepicker').datetimepicker({ |
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<?php $datetimepicker_timepicker = false; ?> |
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<?php $datetimepicker_showseconds = false; ?> |
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<?php $datetimepicker_formatInput = true; ?> |
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<?php require($GLOBALS['srcdir'] . '/js/xl/jquery-datetimepicker-2-5-4.js.php'); ?> |
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}); |
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}); |
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</script> |
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</head> |
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<body> |
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<?php if ($form === 'name_history') { ?> |
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<div class="container-fluid"> |
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<form class="form" id="names_form"> |
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<input type="hidden" name="csrf_token_form" value="<?php echo attr(CsrfUtils::collectCsrfToken()); ?>" /> |
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<input type="hidden" name="pid" value="<?php echo attr($pid); ?>" /> |
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<input type="hidden" name="task_name_history" value="save" /> |
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<div class="col"> |
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<p class="small text-center"><?php echo xlt("Patient previous names history. Ensure to add the date the name was last used if known."); ?></p> |
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<div class="col"> |
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<div class="form-group"> |
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<input type="text" name="previous_name_prefix" id="previous_name_prefix" class="form-control" /> |
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<label class="form-label" for="previous_name_prefix"><?php echo xlt("Title"); ?></label> |
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</div> |
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</div> |
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<div class="col"> |
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<div class="form-group"> |
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<input type="text" name="previous_name_first" id="previous_name_first" class="form-control" /> |
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<label class="form-label" for="previous_name_first"><?php echo xlt("First name"); ?></label> |
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</div> |
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</div> |
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<div class="col"> |
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<div class="form-group"> |
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<input type="text" name="previous_name_middle" id="previous_name_middle" class="form-control" /> |
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<label class="form-label" for="previous_name_middle"><?php echo xlt("Middle name"); ?></label> |
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</div> |
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</div> |
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<div class="col"> |
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<div class="form-group"> |
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<input type="text" name="previous_name_last" id="previous_name_last" class="form-control" /> |
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<label class="form-label" for="previous_name_last"><?php echo xlt("Last name"); ?></label> |
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</div> |
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</div> |
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<div class="col"> |
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<div class="form-group"> |
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<input type="text" name="previous_name_suffix" id="previous_name_suffix" class="form-control" /> |
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<label class="form-label" for="previous_name_suffix"><?php echo xlt("Suffix"); ?></label> |
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</div> |
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</div> |
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<div class="col"> |
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<div class="form-group"> |
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<input type="text" name="previous_name_enddate" id="previous_name_enddate" class="form-control datepicker" /> |
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<label class="form-label" for="previous_name_enddate"><?php echo xlt("End Date"); ?></label> |
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</div> |
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</div> |
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</div> |
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<div class="col-12 text-center"> |
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<div class="form-group"> |
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<button type='submit' class='btn btn-primary' name='form_save' id='form_save' value="save"><?php echo xlt('Save'); ?></button> |
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<button type='button' class='btn btn-secondary' name='form_cancel' id='form_cancel'><?php echo xlt('Cancel'); ?></button> |
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</div> |
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</div> |
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</form> |
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</div> |
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<?php } ?> |
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</body> |
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</html>
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