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120 lines
3.6 KiB
120 lines
3.6 KiB
<?php |
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/* |
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* Work/School Note Form new.php |
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* |
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* @package OpenEMR |
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* @link http://www.open-emr.org |
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* @author Nikolai Vitsyn |
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* @author Brady Miller <brady.g.miller@gmail.com> |
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* @copyright Copyright (c) 2004-2005 Nikolai Vitsyn |
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* @copyright Copyright (c) Open Source Medical Software |
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* @copyright Copyright (c) 2019 Brady Miller <brady.g.miller@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__ . "/../../globals.php"); |
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require_once("$srcdir/api.inc"); |
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use OpenEMR\Common\Csrf\CsrfUtils; |
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use OpenEMR\Core\Header; |
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formHeader("Form: note"); |
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$returnurl = 'encounter_top.php'; |
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$provider_results = sqlQuery("select fname, lname from users where username=?", array($_SESSION["authUser"])); |
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/* name of this form */ |
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$form_name = "note"; |
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?> |
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<html><head> |
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<?php Header::setupHeader('datetime-picker'); ?> |
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<script> |
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// required for textbox date verification |
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var mypcc = <?php echo js_escape($GLOBALS['phone_country_code']); ?>; |
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</script> |
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</head> |
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<body class="body_top"> |
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<?php echo text(date("F d, Y", time())); ?> |
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<form method=post action="<?php echo $rootdir . "/forms/" . $form_name . "/save.php?mode=new";?>" name="my_form" id="my_form"> |
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<input type="hidden" name="csrf_token_form" value="<?php echo attr(CsrfUtils::collectCsrfToken()); ?>" /> |
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<span class="title"><?php echo xlt('Work/School Note'); ?></span><br /><br /> |
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<div style="margin: 10px;"> |
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<input type="button" class="save" value=" <?php echo xla('Save'); ?> "> |
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<input type="button" class="dontsave" value="<?php echo xla('Don\'t Save'); ?>"> |
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</div> |
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<select name="note_type"> |
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<option value="WORK NOTE"><?php echo xlt('WORK NOTE'); ?></option> |
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<option value="SCHOOL NOTE"><?php echo xlt('SCHOOL NOTE'); ?></option> |
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</select> |
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<br /> |
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<b><?php echo xlt('MESSAGE:'); ?></b> |
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<br /> |
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<textarea name="message" id="message" rows="7" cols="47"></textarea> |
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<br /> |
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<?php |
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// commented out below private field, because no field in database, and causes error. |
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?> |
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<!-- |
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<input type="checkbox" name="private" id="private"><label for="private">This note is private</label> |
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<br /> |
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--> |
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<br /> |
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<b><?php echo xlt('Signature:'); ?></b> |
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<br /> |
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<table> |
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<tr><td> |
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<?php echo xlt('Doctor:'); ?> |
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<input type="text" name="doctor" id="doctor" value="<?php echo attr($provider_results["fname"]) . ' ' . attr($provider_results["lname"]); ?>"> |
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</td> |
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<td> |
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<span class="text"><?php echo xlt('Date'); ?></span> |
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<input type='text' size='10' class='datepicker' name='date_of_signature' id='date_of_signature' |
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value='<?php echo attr(date('Y-m-d', time())); ?>' |
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title='<?php echo xla('yyyy-mm-dd'); ?>' /> |
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</td> |
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</tr> |
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</table> |
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<div style="margin: 10px;"> |
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<input type="button" class="save" value=" <?php echo xla('Save'); ?> "> |
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<input type="button" class="dontsave" value="<?php echo xla('Don\'t Save'); ?>"> |
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</div> |
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</form> |
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</body> |
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<script> |
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// jQuery stuff to make the page a little easier to use |
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$(function () { |
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$(".save").click(function() { top.restoreSession(); $('#my_form').submit(); }); |
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$(".dontsave").click(function() { parent.closeTab(window.name, false); }); |
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//$("#printform").click(function() { PrintForm(); }); |
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$('.datepicker').datetimepicker({ |
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<?php $datetimepicker_timepicker = false; ?> |
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<?php $datetimepicker_showseconds = false; ?> |
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<?php $datetimepicker_formatInput = false; ?> |
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<?php require($GLOBALS['srcdir'] . '/js/xl/jquery-datetimepicker-2-5-4.js.php'); ?> |
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<?php // can add any additional javascript settings to datetimepicker here; need to prepend first setting with a comma ?> |
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}); |
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}); |
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</script> |
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</html>
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