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<?php session_start();
require_once("../patientmanager.php");
require_once("../DBManager.php");
include 'header.php';
include 'dashboarddocument.php';
if(isset($_POST['signup']))
{
PatientManager::admissionpatient("$_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">
<link rel="stylesheet" href="https://www.w3schools.com/w3css/4/w3.css">
<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>
<h3 align="center">Pre Anesthetic Assessment </h3>
<table width='100%' id="example2" class="table table-bordered table-hover">
<tr><td width='50%'>
UHID:
</td>
<td>12345
</td>
</tr>
<tr><td>
Name of patient: </td>
<td>Pavan Kumar singh
</td>
</tr>
<tr><td>
DOB: </td>
<td>19-03-1994
</td>
</tr>
<tr><td>
Gender </td>
<td>Male
</td>
</tr>
<tr><td>
Weight </td>
<td>71
</td>
</tr>
<tr><td>
Name of Operative Procedure: </td>
<td>Dr Surendra singh
</td>
</tr>
</table>
<br>
<div><input type="button" onclick="harila('Demo')" value="Known Allergies"></div>
<div id="Demo" class="w3-container w3-hide">
<table id="example2" class="table table-bordered table-hover">
<thead>
<tr>
<div class='card-header d-flex p-0'>
<ul class='nav nav-pills ml-auto p-2'>
<th><strong>Allergies</strong></th>
<th><strong>Category</strong></th>
<th><strong>Edit</strong></th>
</tr>
</thead>
<?php
$sql ="SELECT * FROM allergy WHERE patientid='GET[patientid]'";
$qsql = mysqli_query($con,$sql);
while($rs = mysqli_fetch_array($qsql))
{
echo " <tbody>
<tr> <td> $rs[Allergen]</td>
<td> $rs[Category]</td>
<td><a href='edit_alg.php?patientid=$rs[patientid]&medicalcoid=$rs[medicalcoid]'>Edit</a></td>
</tr>
";
}
?> </tr>
</thead>
</tbody>
<tfoot>
</tfoot>
</table> <button style="height:40px;width:100px"><a href="Allergies.php">Add More</a></button>
</div>
<script>
function harila(id) {
var x = document.getElementById(id);
if (x.className.indexOf("w3-show") == -1) {
x.className += " w3-show";
} else {
x.className = x.className.replace(" w3-show", "");
}
}
</script>
<br>
<div><input type="button" onclick="family('familya')" value="Family History"></div>
<div id="familya" class="w3-container w3-hide">
<table id="example2" class="table table-bordered table-hover">
<thead>
<tr>
<div class='card-header d-flex p-0'>
<ul class='nav nav-pills ml-auto p-2'>
<th><strong>Diabetes</strong></th>
<th><strong>Thyroid</strong></th>
<th><strong>Heart</strong></th>
<th><strong>Hypertension</strong></th>
<th><strong>Depression</strong></th>
<th><strong>Anemia</strong></th>
<th><strong>Thalassemia</strong></th>
<th><strong>HIV</strong></th>
</tr>
</thead>
<?php
$sql ="SELECT * FROM medicalcon WHERE patientid='$_GET[patientid]' AND fmNone=''";
$qsql = mysqli_query($con,$sql);
while($rs = mysqli_fetch_array($qsql))
{
echo " <tbody>
<thead>
<tr>
<td> $rs[fmDiabetes] </td>
<td> $rs[fmThyroid]</td>
<td> $rs[fmHeart]
<td> $rs[fmHypertension]</td>
<td> $rs[fmDepression]</td>
<td> $rs[fmAnemia]</td>
<td> $rs[fmThalassemia]</td>
<td> $rs[fmHIV]</td>
";
}
?>
</tr>
</tbody>
</thead>
<tfoot>
</tfoot>
</table>
<script>
function family(id) {
var x = document.getElementById(id);
if (x.className.indexOf("w3-show") == -1) {
x.className += " w3-show";
} else {
x.className = x.className.replace(" w3-show", "");
}
}
</script>
</div>
<br>
<div><input type="button" onclick="myFunction('Demo1')" value="History of illness: (Medical Condition)"></div>
<div id="Demo1" class="w3-container w3-hide">
<table id="example2" class="table table-bordered table-hover">
<thead>
<tr>
<div class='card-header d-flex p-0'>
<ul class='nav nav-pills ml-auto p-2'>
<th><strong>Medical Condition</strong></th>
<th><strong>Status</strong></th>
<th><strong>Edit</strong></th>
</tr>
</thead>
<?php
$sql ="SELECT * FROM medi_condition_final WHERE patientid='patientid]'";
$qsql = mysqli_query($con,$sql);
while($rs = mysqli_fetch_array($qsql))
{
echo " <tbody>
<tr> <td> $rs[medicalcon]</td>
<td> $rs[Status]</td>
<td><a href='edit_medicalcon.php?patientid=$rs[patientid]&medicalcoid=$rs[medicalcoid]'>Edit</a></td>
</tr>
";
}
?> </tr>
</thead>
</tbody>
<tfoot>
</tfoot>
</table>
<script>
function myFunction(id) {
var x = document.getElementById(id);
if (x.className.indexOf("w3-show") == -1) {
x.className += " w3-show";
} else {
x.className = x.className.replace(" w3-show", "");
}
}
</script>
<button style="height:40px;width:100px"><a href="medicalcon_nurse.php">Add More</a></button> <br>
<div>
<label>Dependency</label>
<select name="Dependency">
<option value="" disabled selected>Dependency </option>
<option value="Independent">Independent</option>
<option value="Partially Dependent">Partially Dependent</option>
<option value="Completely Dependent">Completely Dependent </option>
</select>
</div>
<div>
<label>Mode of Movement </label>
<select name="Modn">
<option value="" disabled selected>Mode of Movement </option>
<option value="Independent">Ambulatory</option>
<option value="Wheel chair">Wheel chair</option>
<option value="Stretcher">Stretcher </option>
<option value="Physical Support">Physical Support </option>
</select>
</div>
<div>
<label>Level of Consciousness </label>
<select name="Level">
<option value="" disabled selected>Level of Consciousness </option>
<option value="Conscious">Conscious</option>
<option value="Semi Conscious">Semi Conscious</option>
<option value="Un-conscious ">Un-conscious </option>
</select>
</div></div>
<div><input type="button" onclick="Disease('Diseasey')" value="History of Any Systemic Disease"></div>
<div id="Diseasey" class="w3-container w3-hide">
<table id="example2" class="table table-bordered table-hover">
<tr><td><span style="font-size: 20px">History of Any Systemic Disease </span></td><td>
<label class="switch">
<input type="checkbox" checked>
<span class="slider"></span>
</label>
</td></tr>
</table>
<script>
function Disease(id) {
var x = document.getElementById(id);
if (x.className.indexOf("w3-show") == -1) {
x.className += " w3-show";
} else {
x.className = x.className.replace(" w3-show", "");
}
}
</script>
</div>
<br>
<div><input type="button" onclick="Events('Eventsy')" value="History of Anesthesia Events "></div>
<div id="Eventsy" class="w3-container w3-hide">
<table id="example2" class="table table-bordered table-hover">
<tr><td><span style="font-size: 20px">History of Anesthesia Events </span></td><td>
<label class="switch">
<input type="checkbox" checked>
<span class="slider"></span>
</label>
</td></tr>
</table>
<script>
function Events(id) {
var x = document.getElementById(id);
if (x.className.indexOf("w3-show") == -1) {
x.className += " w3-show";
} else {
x.className = x.className.replace(" w3-show", "");
}
}
</script>
</div>
<br>
<div><input type="button" onclick="Operations('Operationsy')" value="History of Operations"></div>
<div id="Operationsy" class="w3-container w3-hide">
Comming Soon
<script>
function Operations(id) {
var x = document.getElementById(id);
if (x.className.indexOf("w3-show") == -1) {
x.className += " w3-show";
} else {
x.className = x.className.replace(" w3-show", "");
}
}
</script>
</div>
<br>
<div><input type="button" onclick="drugsalg('drugsalgy')" value="History of Adverse Drugs Reaction"></div>
<div id="drugsalgy" class="w3-container w3-hide">
<table id="example2" class="table table-bordered table-hover">
<thead>
<tr>
<div class='card-header d-flex p-0'>
<ul class='nav nav-pills ml-auto p-2'>
<th><strong>Allergen</strong></th>
<th><strong>Category</strong></th>
<th><strong>Severity</strong></th>
<th><strong>Reaction</strong></th>
<th><strong>Reaction Type</strong></th>
<th><strong>Reaction Date</strong></th>
</tr>
</thead>
<?php
$sql ="SELECT * FROM allergy WHERE patientid='patientid'";
$qsql = mysqli_query($con,$sql);
while($rs = mysqli_fetch_array($qsql))
{
echo " <tbody>
<tr> <td> $rs[Allergen]</td>
<td> $rs[Category]</td>
<td> $rs[Severity]</td>
<td> $rs[Reaction]</td>
<td> $rs[Reactiontype]</td>
<td> $rs[Reactionstdate]</td>
</tr>
";
}
?> </tr>
</thead>
</tbody>
<tfoot>
</tfoot>
</table>
<script>
function drugsalg(id) {
var x = document.getElementById(id);
if (x.className.indexOf("w3-show") == -1) {
x.className += " w3-show";
} else {
x.className = x.className.replace(" w3-show", "");
}
}
</script>
</div>
<br>
<div class="center">
<h3 align="center"> PRE - ASSESSMENT </h3>
<table id="example2" class="table table-bordered table-hover" width="100%"> <tr>
<td width="50%">PHYSICAL STATUS </td><td width="50%"><select name="Dependency">
<option value="" disabled selected>Physical Status </option>
<option value="ASA I">ASA I</option>
<option value="ASA II">ASA II</option>
<option value="ASA III">ASA III</option>
<option value="IV">IV</option>
<option value="V">V</option>
</select>
</td>
</tr>
<tr>
<td width="50%">MALLAMPATI SCORE CLASS </td><td width="50%"><select name="Dependency">
<option value="" disabled selected>MALLAMPATI SCORE CLASS </option>
<option value="I">I</option>
<option value="II">II</option>
<option value="III">III</option>
</select>
</td>
</tr>
</table>
<h3 align="center">Vitals</h3>
<table id="example2" class="table table-bordered table-hover">
<th><strong> P.R.O </strong></th>
<th><strong> Date Time </strong></th>
<th><strong>BP (mmhg) </strong></th>
<th><strong>Temp(c) </strong></th>
<th><strong> RR(Breaths/min) </strong></th>
<th><strong>SPo2(%) </strong></th>
<th><strong>HR(bpm) </strong></th>
</tr>
</thead>
<tr><?php
$sql ="SELECT * FROM Request_for_Admission WHERE patientid='$_GET[patientid]'";
$qsql = mysqli_query($con,$sql);
while($rs = mysqli_fetch_array($qsql))
{
echo " <tbody>
<tr> <td> $rs[Wt]</td>
<td> $rs[SPo2]</td>
<td> $rs[RBS]</td>
<td> $rs[Temp]</td>
<td> $rs[Pulse]</td>
<td> $rs[BP]</td>
";
}
?>
</tr>
</table>
</div>
<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>
<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>
<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">MOUTH OPENING </span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">NECK MOVEMENT </span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
</tr>
<tr><td><span style="font-size: 20px">ARTIFICIAL DENTURE </span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<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">NECK</span></h3></td><td>
<select name="NECK">
<option value="" disabled selected>NECK </option>
<option value="SHORT">SHORT</option>
<option value="LONG">LONG</option>
<option value="NORMAL">NORMAL </option>
</select>
</td>
<td><span style="font-size: 20px">ADDICTION </span></h3></td><td>
<select name="ADDICTION ">
<option value="" disabled selected>ADDICTION </option>
<option value="SMOKING">SMOKING</option>
<option value="PAN">PAN</option>
<option value="TOBACCO">TOBACCO </option>
</select>
</td>
</tr>
<tr>
</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>
</table>
<br><br><br>
<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">H/O CHEST PAIN
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">H/O 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">H/O 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>
<tr>
<td><span style="font-size: 20px">H/O COUGH / BRONCHISOSM </span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">H/O 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">H/O 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>
<br><br><br>
<table id="example2" class="table table-bordered table-hover">
<p><tr><td><span style="font-size: 15px">CENTRAL NERVOUS SYSTEM </span> </td><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 CONVULSION / FITS
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">H/O 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">H/O SPINAL TRAUMA
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">H/O ANY NEUROLOGICAL 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">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">H/O 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">H/O SPINAL TRAUMA
</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>
<br><br><br>
<table id="example2" class="table table-bordered table-hover">
<p><tr><td><span style="font-size: 15px"> ENDOCRINE SYSTEM </span> </td><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">H/O DM
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">H/O HAEMATURIA</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
</tr>
<tr><td><span style="font-size: 20px">H/O HYPER / HYPO THYROIDISM
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">H/O 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">H/O ANY OTHER HARMONAL ABNORMALITY
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td><span style="font-size: 20px">H/O STD
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
</tr>
<tr><td></td><td></td><td><span style="font-size: 20px">H/O RENAL PROBLEM
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<tr>
</table>
<br><br><br>
<table id="example2" class="table table-bordered table-hover">
<div class="center">
<h5 align="center">Others respiration </h5>
<tr><td><span style="font-size: 20px">WRITTEN CONSENT </span></h3></td><td><select name="LIVER_FUNCTION_TEST ">
<option value="" disabled selected>WRITTEN CONSENT</option>
<option value="PRESENT"> PRESENT </option>
<option value="ABSENT">ABSENT </option>
</select>
</td>
<td><span style="font-size: 20px">XYLOCAINE SENSITIVITY </span></h3></td><td><select name="XYLOCAINE_SENSITIVITY">
<option value="" disabled selected>XYLOCAINE SENSITIVITY </option>
<option value="PRESENT"> PRESENT </option>
<option value="ABSENT">ABSENT </option>
</select>
</td>
</tr>
<tr><td><span style="font-size: 20px">Food Intake </span></h3></td><td><select name="Food_Intake ">
<option value="" disabled selected>Food Intake </option>
<option value="PRESENT"> Nil By Mouth </option>
<option value="ABSENT">By Mouth </option>
</select>
</td>
<td><span style="font-size: 20px">REMOVE NAIL POLISH </span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
</tr>
<tr><td><span style="font-size: 20px">SPECTACLES
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td> <span style="font-size: 20px">LENSE
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label> </td>
</tr>
<tr><td><span style="font-size: 20px">ORNAMENT
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label>
</td>
<td> <span style="font-size: 20px">DENTURES (ARTIFICIAL)
</span></h3></td><td><label class="switch">
<input type="checkbox">
<span class="slider"></span>
</label> </td>
</tr>
</div>
</table>
<br>
<br>
<h5 align="center">PRE-MEDICATION </h5>
<table id="example2" class="table table-bordered table-hover">
<tr>
<td>Prepare for GA-NILL orally after </td>
<td>day before surgery</td>
</tr>
<tr>
<td>Stop/continuous drugs </td>
<td></td>
</tr>
<tr>
<td>Arranged units of blood to be kept ready in BTO </td>
<td><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>
<lable>Other Advice(if any)</lable><input type="text" name="note">
<label>Name of Anesthetist </label> <input type="text" name="wardnursename">
<label>Name of Surgeon </label> <input type="text" name="wardnursename">
<br>
<input type="submit" name="submit" value="Submit">
<script src="../plugins/jquery/jquery.min.js"></script>
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<script>
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$('.select2').select2()
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$('.select2bs4').select2({
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$('#datemask').inputmask('dd/mm/yyyy', { 'placeholder': 'dd/mm/yyyy' })
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$('#datemask2').inputmask('mm/dd/yyyy', { 'placeholder': 'mm/dd/yyyy' })
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$('[data-mask]').inputmask()
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$('#reservationdate').datetimepicker({
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});
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$('#reservation').daterangepicker()
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$('#reservationtime').daterangepicker({
timePicker: true,
timePickerIncrement: 30,
locale: {
format: 'MM/DD/YYYY hh:mm A'
}
})
//Date range as a button
$('#daterange-btn').daterangepicker(
{
ranges : {
'Today' : [moment(), moment()],
'Yesterday' : [moment().subtract(1, 'days'), moment().subtract(1, 'days')],
'Last 7 Days' : [moment().subtract(6, 'days'), moment()],
'Last 30 Days': [moment().subtract(29, 'days'), moment()],
'This Month' : [moment().startOf('month'), moment().endOf('month')],
'Last Month' : [moment().subtract(1, 'month').startOf('month'), moment().subtract(1, 'month').endOf('month')]
},
startDate: moment().subtract(29, 'days'),
endDate : moment()
},
function (start, end) {
$('#reportrange span').html(start.format('MMMM D, YYYY') + ' - ' + end.format('MMMM D, YYYY'))
}
)
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$('#timepicker').datetimepicker({
format: 'LT'
})
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$('.duallistbox').bootstrapDualListbox()
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$('.my-colorpicker1').colorpicker()
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$('.my-colorpicker2').colorpicker()
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$('.my-colorpicker2 .fa-square').css('color', event.color.toString());
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$("input[data-bootstrap-switch]").each(function(){
$(this).bootstrapSwitch('state', $(this).prop('checked'));
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</script>