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<?php session_start(); include("dbconnection.php"); require_once("../patientmanager.php"); require_once("../DBManager.php"); if(isset($_POST[Surgeryprocedurerelatedva])) { PatientManager::Surgeryprocedurerelated("$_GET[prescriptionid]","$_GET[patientid]","$_POST[Surgeryprocedurerelated]","$_POST[Surgeryprocedurerelated_Native]","$_POST[Surgeryprocedurerelated_Corrective]","$_POST[entered_by]"); } ?> <!DOCTYPE html> <html lang="en"> <head> <meta charset="utf-8"> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <meta name="description" content=""> <meta name="author" content="Dashboard"> <meta name="keyword" content="Dashboard, Bootstrap, Admin, Template, Theme, Responsive, Fluid, Retina"> <title>Surgery procedure related</title> <body> <h3><i class="fa fa-angle-right"></i> Surgery procedure related </h3> <form name="Surgeryprocedurerelatedva" method="post"> <label for="address">Surgery procedure related</label> <select name="Surgeryprocedurerelated"> <option value="" disabled selected>Surgery procedure related</option> <option value="Incorrect site">Incorrect site</option> <option value="Site not marked">Site not marked </option><option value="Related material or consumable not available">Related material or consumable not available</option> <option value="Drugs not available">Drugs not available</option> <option value="Injury to patient during procedure">Injury to patient during procedure</option> </select> <label>Native description of Occurrence</label> <input type="text" name="Surgeryprocedurerelated_Native" placeholder="Native description of Occurrence"> <label>Corrective And Preventive Action Taken</label> <input type="text" name="Surgeryprocedurerelated_Corrective" placeholder="Corrective And Preventive Action Taken"> <br> <br> <br> <button style="float: right;" name="Surgeryprocedurerelatedva" type="submit"> Save</button> </form> <style> form{ margin: 20px 0; } form input, button{ padding: 5px; } table{ width: 100%; margin-bottom: 20px; border-collapse: collapse; } table, th, td{ border: 1px solid #cdcdcd; } table th, table td{ padding: 10px; text-align: left; } <style> table{ border: solid 1px gray; width: 100%; } </style> </head> <div id="container"> </div>