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<?php session_start();
require_once("../patientmanager.php");
require_once("../DBManager.php");
include 'header.php';
include 'dashboarddocument.php';
if(isset($_POST['signup']))
{
PatientManager::preAssessmentSheet("$_POST[patientid]","$_POST[Information_Obtained_from]","$_POST[Date_of_Operative_procedure]","$_POST[Time_of_Operative_procedure]","$_POST[name_Surgeon]","$_POST[Name_of_Anesthetist]","$_POST[Pre_Operative_Diagnosis]","$_POST[Proposed_Surgery]","$_POST[Cough]","$_POST[Wheezing]","$_POST[Hypertension]","$_POST[Diabetes]","$_POST[Liverproblem]","$_POST[Previous_Operation]", "$_POST[Smoking]","$_POST[Migraine]","$_POST[Pregnancy]","$_POST[Bleeding_Disorder]","$_POST[SOB]","$_POST[Palpitation]","$_POST[Chest_Pain]","$_POST[Renal_Disease]","$_POST[Allergies]","$_POST[Alcohol]","$_POST[Anesthesia_Problem]","$_POST[Urination]","$_POST[Back_Neck_Pain]","$_POST[Arthritis]","$_POST[Blackouts]","$_POST[Muscie]","$_POST[Weight_Loss_Gain]","$_POST[hernia]","$_POST[Pacemaker]","$_POST[Artificial]","$_POST[Resp_System]","$_POST[CVS_status]","$_POST[Dentures_status]", "$_POST[Dentures_status_lower]","$_POST[Dentures_lower_note]","$_POST[Mouth_Opening]","$_POST[Neck_Mobility]","$_POST[Neck_Mobility_note]","$_POST[Venous_Access]","$_POST[Venous_Access_note]","$_POST[Nervous_System]","$_POST[Nervous_System_note]","$_POST[Abdomen_System]","$_POST[Intubation_Difficulty]","$_POST[Intubation_Difficulty_note]","$_POST[Special_Anesthesia_Problems]","$_POST[Special_Anesthesia_Problems_note]","$_POST[Thyromental_Distance]","$_POST[Metabolic_Score]","$_POST[Mallampati_Score]","$_POST[ASA_Gr]","$_POST[GA]","$_POST[Spinal]","$_POST[CSE]","$_POST[Epidural]","$_POST[Nerve_Block]","$_POST[Anesthesia_Consent]","$_POST[Missing]","$_POST[wardnursename]","$_POST[entered_by]");
}
?>
<!DOCTYPE html>
<html lang="en">
<head>
<style>
.switch {
position: relative;
display: inline-block;
width: 90px;
height: 34px;
}
.switch input {display:none;}
.slider {
position: absolute;
cursor: pointer;
top: 0;
left: 0;
right: 0;
bottom: 0;
background-color: #ca2222;
-webkit-transition: .4s;
transition: .4s;
border-radius: 34px;
}
.slider:before {
position: absolute;
content: "";
height: 26px;
width: 26px;
left: 4px;
bottom: 4px;
background-color: white;
-webkit-transition: .4s;
transition: .4s;
border-radius: 50%;
}
input:checked + .slider {
background-color: #2ab934;
}
input:focus + .slider {
box-shadow: 0 0 1px #2196F3;
}
input:checked + .slider:before {
-webkit-transform: translateX(26px);
-ms-transform: translateX(26px);
transform: translateX(55px);
}
/*------ ADDED CSS ---------*/
.slider:after
{
content:'No';
color: white;
display: block;
position: absolute;
transform: translate(-50%,-50%);
top: 50%;
left: 50%;
font-size: 10px;
font-family: Verdana, sans-serif;
}
input:checked + .slider:after
{
content:'Yes';
}
.center {
border: 1px solid grey;
text-align:;
}
</style>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1">
<link rel="stylesheet" href="https://www.w3schools.com/w3css/4/w3.css">
<title>Document</title>
<script>
function myFunction() {
var checkBox = document.getElementById("myCheck");
var text = document.getElementById("text");
if (checkBox.checked == true){
text.style.display = "block";
} else {
text.style.display = "none";
}
}
function myFunction2() {
var checkBox = document.getElementById("myCheck2");
var text = document.getElementById("text2");
if (checkBox.checked == true){
text.style.display = "block";
} else {
text.style.display = "none";
}
}
function myFunction3() {
var checkBox = document.getElementById("myCheck3");
var text = document.getElementById("text3");
if (checkBox.checked == true){
text.style.display = "block";
} else {
text.style.display = "none";
}
}
function myFunction4() {
var checkBox = document.getElementById("myCheck4");
var text = document.getElementById("text4");
if (checkBox.checked == true){
text.style.display = "block";
} else {
text.style.display = "none";
}
}
</script>
<style>
.center {
border: 1px solid grey;
text-align:;
}
</style>
</head>
<body>
<div class="content-wrapper">
<!-- Content Header (Page header) -->
<section class="content-header">
<form name="signup" method="post" >
<table id="example2" class="table table-bordered table-hover" border="1" width='100%'>
</table>
<table id="example2" class="table table-bordered table-hover">
<tr><td><span style="font-size: 20px">PALLOR </span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
</tr>
<tr>
<td><span style="font-size: 20px">ICTERUS</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
</tr>
<tr><td><span style="font-size: 20px">CYANOSIS </span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
</tr>
<tr><td><span style="font-size: 20px">LYMPHNODES </span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
</tr>
<tr>
<td><span style="font-size: 20px">JVP RAISED </span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
</tr>
<tr>
<td><span style="font-size: 20px">T.M.JOINT</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
</tr>
<tr>
<td><span style="font-size: 20px">DENTAL ABOUT REACTION </span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
</tr>
</table>
<table id="example2" class="table table-bordered table-hover">
<div class="center">
<h5 align="center">SYSTEMIC EXAMINATION </h5>
<h6>CARDIAO VASCULAR SYSTEM: RESPIRATORY SYSTEM: </h6>
<tr><td><span style="font-size: 20px">HISTORY OF CHEST PAIN
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">HISTORY OF PALPITATION </span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
</tr>
<tr><td><span style="font-size: 20px">HISTORY OF HYPERTENTION
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">S1 &S2 </span></h3></td><td>
<select name="S1 &S2">
<option value="" disabled selected>S1 &S2 </option>
<option value="NORMAL">NORMAL</option>
<option value="ABNORMAL">ABNORMAL </option>
</select>
</td>
</tr>
<tr>
<td><span style="font-size: 20px">MURMUR </span></h3></td><td>
<select name="MURMUR">
<option value="" disabled selected>MURMUR </option>
<option value="PRESENT">PRESENT</option>
<option value="ABSENT">ABSENT</option>
</select>
</td>
<td><span style="font-size: 20px">ECG REPORT</span></h3></td><td>
<select name="ECG REPORT">
<option value="" disabled selected>ECG REPORT </option>
<option value="PRESENT"> PRESENT </option>
<option value="ABSENT">ABSENT </option>
</select>
</td>
</tr>
<tr>
<td><span style="font-size: 20px">B/L AIR ENTER IN LUNGS </span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">CREPITATIONS / WHEEZ
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
</tr>
<tr>
<td><span style="font-size: 20px">HISTORY OF COUGH / BRONCHISOSM </span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">HISTORY OF BRONCHIAL ANTHMA
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
</tr>
<tr>
<td><span style="font-size: 20px">HISTORY OF REPAIRATORY DISEASES </span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">PULMONARY FUNCTION TEST
</span></td><td><select name="ECG REPORT">
<option value="" disabled selected>PULMONARY TEST </option>
<option value="PRESENT"> PRESENT </option>
<option value="ABSENT">ABSENT </option>
</select>
</td>
</tr>
</div>
</table>
<table id="example2" class="table table-bordered table-hover">
<p><tr><td><span style="font-size: 15px">CENTRAL NERVOUS SYSTEM </span> </td></tr></p>
</table>
<table id="example2" class="table table-bordered table-hover">
<tr><td><span style="font-size: 20px">HISTORY OF CONVULSION / FITS
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">HISTORY OF TREMOR </span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
</tr>
<tr><td><span style="font-size: 20px">HISTORY OF GI BLEEDING
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">HISTORY OF ANY NEUROLOGICAL DISEASE </span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
</tr>
</table>
<table id="example2" class="table table-bordered table-hover">
<p><tr><td><span style="font-size: 15px">GASTRO INTESTINAL SYSTEM </span> </td></tr></p>
</table>
<table id="example2" class="table table-bordered table-hover">
<tr><td><span style="font-size: 20px">H/O/ACIDITY / HEART BURN
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">HISTORY OF ANY OTHER DISEASE
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
</tr>
<tr><td><span style="font-size: 20px">HISTORY OF GI BLEEDING
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">LIVER FUNCTION TEST </span></h3></td><td><select name="LIVER_FUNCTION_TEST ">
<option value="" disabled selected>LIVER FUNCTION TEST</option>
<option value="PRESENT"> PRESENT </option>
<option value="ABSENT">ABSENT </option>
</select>
</td>
</tr>
</table>
<table id="example2" class="table table-bordered table-hover">
<p><tr><td><span style="font-size: 15px"> ENDOCRINE SYSTEM </span> </td></tr></p>
</table>
<table id="example2" class="table table-bordered table-hover">
<tr><td><span style="font-size: 20px">HISTORY OF DM
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">HISTORY OF HYPER / HYPO THYROIDISM
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
</tr>
<tr><td><span style="font-size: 20px">HISTORY OF ANY OTHER HARMONAL ABNORMALITY
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
</tr>
</table>
<table id="example2" class="table table-bordered table-hover">
<p><tr><td><span style="font-size: 15px"> GENITO URINARY SYSTEM </span> </td></tr></p>
</table>
<table id="example2" class="table table-bordered table-hover">
<tr><td><span style="font-size: 20px">HISTORY OF HAEMATURIA</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">HISTORY OF UTI </span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
</tr>
<tr>
<td><span style="font-size: 20px">HISTORY OF STD
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">HISTORY OF RENAL PROBLEM
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
</tr>
</table>
<h3 align="center">Take Vitals</h3>
<table id="example2" class="table table-bordered table-hover">
<thead>
<tr>
<td style="width:50%"><label><h4 align="center">Vitals</h2></label></td><td style="width:50%"><label><h4 align="center">Range</h2></label></td></tr>
<tr><td style="width:29%"><div><h5>Weight : </h5> </td></div><td style="width:46%"><div><input name="Wt" placeholder="In KG" type="text"></div></td></tr>
<td><div><h5>SPo2 : </h5> </td></div><td><div><input name="SPo2" placeholder="Oxygen saturation" type="text"></div></td></tr>
<tr><td><div><h5>RBS : </h5> </td></div><td><div><input placeholder="mg/dl" name="RBS" type="text"></div></td></tr>
<tr><td><div><h5>Temperature: </h5> </td></div><td><div><input placeholder="ьз╕C" name="Temp" type="text"></div></td></tr>
<tr><td><div><h5>Pulse: </h5> </td></div><td><div><input placeholder="Pulse" name="Pulse" type="text"></div></td></tr>
<tr><td><div><h5>Blood Pressure: </h5> </td></div><td><div><input placeholder="mmHg" name="BP" type="text"></div></td></tr>
</div>
</tr>
</tr>
</thead>
</tbody>
<tfoot>
</tfoot>
</table>
<h2 align="center">Risk Status </h2>
<table id="example2" class="table table-bordered table-hover" border="1" width='100%'>
<tr>
<td width='50%'>
<label>Plan of Action </label>
<textarea cols="110" row="3"></textarea>
</td>
</tr>
</table>
<table id="example2" class="table table-bordered table-hover" border="1" width='100%'>
<tr>
<td width='50%'>Arranged units of blood to be kept ready in BTO </td>
<td width='50%'><select name="blood">
<option value="" disabled selected>Number </option>
<option value="0">0</option>
<option value="1">1</option>
<option value="2">2 </option>
<option value="3">3 </option>
<option value="4">4 </option>
<option value="5">5 </option>
<option value="6">6 </option>
<option value="7">7 </option>
<option value="8">8 </option>
<option value="9">9 </option>
<option value="10">10 </option>
</select></td>
</tr>
</table> <table id="example2" class="table table-bordered table-hover" border="1" width='100%'>
<tr>
<td width='100%'>
<label> Anesthesia Consent </label>
</td>
</tr>
<tr><td><span style="font-size: 20px">Patient not accepted for anesthesia</span></td><td>
<label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td></tr>
<tr><td><span style="font-size: 20px">Patient accepted for anesthesia & explained</span></td><td>
<label class="switch">
<input id="myCheck3" onclick="myFunction3()" type="checkbox">
<span class="slider"></span>
</label>
</td> </tr></table> <div id="text3" style="display:none" >
<div class="checkbox"> <input name="GA" type="Radio"><span>GA </span>
</div>
<div class="checkbox"> <input name="Spinal" type="Radio"><span>Spinal </span>
</div>
<div class="checkbox"> <input name="CSE" type="Radio"><span>CSE (combined spinal epidural anesthesia) </span>
</div>
<div class="checkbox"> <input name="Epidural" type="Radio"><span>Epidural </span>
</div>
<div class="checkbox"> <input name="Nerve_Block" type="Radio"><span>Nerve Block </span>
</div>
<div class="checkbox"> <input name="Stand By" type="Radio"><span>Stand By </span>
</div>
</div>
<br>
<br>
<table id="example2" class="table table-bordered table-hover" border="1" width='100%'>
<tr>
<td width='50%'>
<span style="font-size: 20px"> Anesthesia Consent
</td>
<td width='50%'><select name='Dentures_status'>
<option value='' disabled selected>Unknown</option>
<option value='Present'>Present</option>
<option value='None'>Missing </option>
</select></td>
</tr>
<tr>
<td width='50%'><button>Download Consent</button></td>
<td width='50%'><label>Upload Consent</label><input type="file" value="Upload Consent" name="upload_Consent"></td>
</tr>
<tr>
<td width='50%'> <span style="font-size: 20px">Post Operation Analgesia Plan Explained: </span></td>
<td width='50%'><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</tr>
</table>
<br>
<Span>Name of ward nurse</Span><input type="text" name="wardnursename">
<br>
<input type="submit" name="sig" value="Save">
</form>
</div>
</div>
</body>
</html>