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<?php
session_start();
require_once('../DBManager.php');
require_once('../LoginManager.php');
require_once('../patientmanager.php');
include 'dashboarddocument.php';
include 'header.php';
if(isset($_POST['signup']))
{
PatientManager::bloodrequisition("$_POST[prescriptionid]","$_POST[patientid]","$_POST[abo_rh]","$_POST[units]","$_POST[blgroup]","$_POST[Address]","$_POST[Ref_Dr]","$_POST[entered_by]");
}
?>
<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>
<?php
$sql ="SELECT * FROM patient WHERE patientid='12704'";
$qsql = mysqli_query($con,$sql);
while($rs = mysqli_fetch_array($qsql))
{
echo "
<div class='content-wrapper'>
<!-- Content Header (Page header) -->
<section class='content-header'>
<div class='center'>
<table id='example2' class='table table-bordered table-hover' width='100%'>
<h3 align='center'>Blood Requisition Form</h3>
<tr>
<td width='50%'> Pt. Name: </td>
<td width='50%'>$rs[patientname]</td>
</tr>
<tr>
<td width='50%'> W/O,D/O,S/O. : </td>
<td width='50%'>$rs[HusbandName]</td>
</tr>
<tr>
<td width='50%'> DOB: </td>
<td width='50%'>$rs[dob]</td>
</tr>
<tr>
<td width='50%'> Sex : </td>
<td width='50%'>$rs[gendor]</td>
</tr>
";
echo "</td></tr>"; }
?>
<form name="signup" method="post">
<tr>
<td width='50%'> ABO & Rh: </td>
<td width='50%'><input type="text" placeholder="ABO & Rh" name="abo_rh"></td>
</tr>
<tr>
<td width='50%'> Advice: </td>
<td width='50%'>Please provide <input type='text' name='units'> Units <input type='text' name='group'> After grouping and cross matching </td>
</tr>
<tr>
<td width='50%'> Address: </td>
<td width='50%'><input type='text' placeholder='Address' name='address'></td>
</tr>
<tr>
<td width='50%'> Ref.by Dr: </td>
<td width='50%'><input type='text' placeholder='Ref.by Dr' name='Ref_Dr'></td>
</tr>
<?php
$sql ="SELECT * FROM addaspatient WHERE prescriptionid='$_GET[prescriptionid]' AND patientid='$_GET[patientid]'";
$qsql = mysqli_query($con,$sql);
while($rs = mysqli_fetch_array($qsql))
{
echo "
<input type='hidden' name='prescriptionid' value='$rs[prescriptionid]'>
<input type='hidden' name='patientid' value='$rs[patientid]'>
";
}
?>
<br>
</table>
<label>Nurse Name</label></td><td></td><input type="text" name='Nurse_Name' placeholder='Nurse Name'>
<br>
<br>
<tr>
<td width='50%'> Blood Bag Number: </td>
<td width='50%'><input type='text' placeholder='Blood Bag Number' name='Blood_Bag_Number'></td>
</tr>
<tr>
<td width='50%'> Product's Blood Group: </td>
<td width='50%'><input type='text' placeholder='Product Blood Group' name='Products_Blood_Group'></td>
</tr>
<tr>
<td width='50%'> Product's Name(PL. encircle): </td>
<td width='50%'><select name="product_name">
<option value="Whole Blood">Whole Blood</option>
<option value="RBC">RBC</option>
<option value="PRC">PRC</option>
<option value="FFP">FFP</option>
<option value="CPP">CPP</option>
<option value="Cryoprecipitate">Cryoprecipitate</option>
</select></td>
</tr>
<tr>
<td width='50%'> Name of the Blood Bank: </td>
<td width='50%'><input type='text' placeholder='Name of the Blood Bank' name='blood_bank_name'></td>
</tr>
<tr>
<td width='50%'> Date of expiry: </td>
<td width='50%'><input type='date' placeholder='Date of expiry' name='date_of_expiry'></td>
</tr>
<tr>
<td width='50%'> Blood Checked by the Doctor: </td>
<td width='50%'><input type='text' placeholder='Blood Checked by the Doctor' name='Blood_Checked_Doctor'></td>
</tr>
<tr>
<td width='50%'> Doctor ID No.: </td>
<td width='50%'><input type='text' placeholder='Doctor ID No.' name='doctor_id_no'></td>
</tr>
<input type="submit" name="signup" value="Submit">
</form>
<script>
n = new Date();
y = n.getFullYear();
m = n.getMonth() + 1;
d = n.getDate();
document.getElementById("date").innerHTML = m + "/" + d + "/" + y;
</script>