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Current File : /home/btiyawmy/public_html/login.easenup.in//eyefamily.php
<?php session_start();
require_once("../patientmanager.php");
require_once("../DBManager.php");
include 'header.php';
include 'dashboarddocument.php';
if(isset($_POST['signup'])) 
{
   PatientManager::admissionpatient("$_POST[patientid]","$_POST[Type_of_Admission]","$_POST[Reason_for_Admission]","$_POST[MLC]","$_POST[MLC_No]","$_POST[Upload_MLC_Slip]","$_POST[Information_Obtained_from]","$_POST[General_Consent_Signed]","$_POST[Upload_Consent]","$_POST[ID_Band_tied]","$_POST[Wt]","$_POST[SPo2]","$_POST[RBS]","$_POST[Temp]","$_POST[pulse]","$_POST[BP]","$_POST[Pain_Assessment]","$_POST[Chief_Complain]","$_POST[Admitted_Under]","$_POST[enteredby]");
}
?>
<!DOCTYPE html>
<html lang="en">
<head>
  <meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1">
 <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>
</head>
  
  <div class="content-wrapper">
    <!-- Content Header (Page header) -->
    <section class="content-header">
    <form name="signup" method="post" >
                  <p>
                 <div class="center">
           <table id="example2" class="table table-bordered table-hover">
                                                             <tr><p> <h5 align="center">Family History  </h5>  <td><span style="font-size: 20px">Glaucoma   </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">DM     </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">TB </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">Cataract    </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
</p>
<td><span style="font-size: 20px">HTN   </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">Visual loss     </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">CA  </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">RD   </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
</p>
<tr>
<td><span style="font-size: 20px">Parental Consanguinity   </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>

      </table>
      </div>
      <br>
      <br>
        <div class="center">
            <h4 align="center">Eye Surgeries </h4>
  <table id="example4" class="table table-bordered table-hover">
      <tr>
          <td><span style="font-size: 20px">Date                                              </span></h3></td><td>
  <input type="date">
</td>
<td><span style="font-size: 20px">Remark                          </span></h3></td><td>
  <input type="text">
</td>
</tr> 

          </table>
          </div>
          <br>
          <br>
          <div class="center">
           <table id="example4" class="table table-bordered table-hover">
               <tr>
     <td><span style="font-size: 20px">H/O Alcohol/Smoking     </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td></tr>
</table>
</div>
<br>
<br>
<div class="center">
    <h3 align="center">Systemic History
</h3>
<?php include('meditest.php');?>
</div>

 <div class="content-wrapper">
    <!-- Content Header (Page header) -->
    <section class="content-header">
        <div class="center">
 <table id="example2" class="table table-bordered table-hover">
                                                             <tr><p><td><span style="font-size: 20px">HTN  </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">DM     </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">Asthma </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">CAD    </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
</p>
 <tr><p><td><span style="font-size: 20px">TB </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">Malignancy
    </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">Other</span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
</p>


</table>
</div>
<br>
<br>
<div class="center">
<p><span style="font-size: 22px">External Examination</span><p>         
               <table id="example2" class="table table-bordered table-hover">
                                                             <tr><p>  <td><span style="font-size: 20px">Ocular Alignment & motility          </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">Lid/Adenexae
     </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">Sciera
 </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">Conjunctiva    </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
</p>

                                                             <tr><p>  <td><span style="font-size: 20px">Cornea   </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">Anterior Chamber
     </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">IRS/NVI/PXF
 </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">Pupil   </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
</p>
                                                     <tr><p>  <td><span style="font-size: 20px">Lens/IOL  </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">Cataract
     </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">Subluxated
 </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">Dislocated   </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
</p>


                                                     <tr><p>  <td><span style="font-size: 20px">Other  </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">Posterior Capsule
     </span></h3></td><td><label class="switch">
  <input type="checkbox">
  <span class="slider"></span>
</label>
</td>
</tr>
</p>
      </table>
      </div>
          <input type="submit" name="submit" value="Submit">

Anon7 - 2022
AnonSec Team