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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($_POST['signup'])) { PatientManager::bloodtransfusion("$_POST[prescriptionid]","$_POST[patientid]","$_POST[blood]","$_POST[Diagnosis]","$_POST[Indications_Transfusion]","$_POST[blood_group]","$_POST[advers_reaction]","$_POST[Blood_Bag_Number]","$_POST[Products_Blood_Group]","$_POST[product_name]","$_POST[blood_bank_name]","$_POST[date_of_expiry]","$_POST[Blood_Checked_Doctor]","$_POST[doctor_id_no]","$_POST[Nurse_name]","$_POST[Nurse_Id_No]","$_POST[blood_start]","$_POST[blood_stop]","$_POST[entered_by]"); } ?> <style> .center { border: 1px solid grey; text-align:; } </style> <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"; } } </script> <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> <div class='content-wrapper'> <section class='content-header'> <?php $sql ="SELECT * FROM patient WHERE patientid='$_GET[patientid]'"; $qsql = mysqli_query($con,$sql); while($rs = mysqli_fetch_array($qsql)) { $sql1 ="SELECT * FROM request_for_admission_ipd WHERE patientid='$rs[patientid]' AND prescriptionid='$_GET[prescriptionid]'"; $qsql1 = mysqli_query($con,$sql1); while($rsr = mysqli_fetch_array($qsql1)) { echo " <div class='center'> <table id='example2' class='table table-bordered table-hover' width='100%'> <h3 align='center'>Surgical Site Infection Reporting Form</h3> <tr> <td width='50%'> Ward: </td> <td width='50%'>$rsr[Ward]</td> </tr> <tr> <td width='50%'> Date of Admission: </td> <td width='50%'>$rsr[created_at]</td> </tr> <tr> <td width='50%'> Doctor: </td> <td width='50%'>$rsr[Admitted_Under]</td> </tr> <tr> <td width='50%'> Operation: </td> <td width='50%'>$rsr[created_at]</td> </tr> <tr> <td width='50%'> Pt. Name: </td> <td width='50%'>$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%'>$rs[gendor]</td> </tr> <form name='signup' method='post'> <tr> <td width='50%'> Diagnosis: </td> <td width='50%'><input type='text' placeholder='Diagnosis' name='Diagnosis'></td> </tr> <tr> <td width='50%'> Indications of Transfusion: </td> <td width='50%'><input type='text' placeholder='Indications of Transfusion' name='Indications_Transfusion'></td> </tr> <tr> <td width='50%'> Patient Blood Group: </td> <td width='50%'>$rs[bloodgroup]</td> <input type='hidden' name='blood_group' value='$rs[bloodgroup]'> </tr> </table> "; echo "</td></tr>"; } } ?> <div class="checkbox"> <input type="checkbox" id="myCheck" onclick="myFunction()" name="Wound_Class"><span style="font-size: 17px;"> History of Previous BT</span> </div> <p id="text" style="display:none"> <label>Adverse Reaction During Previous Transfusion & its Nature</label> <input type="text" placeholder="Adverse Reaction During" name="advers_reaction"></p> <?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 id='example2' class='table table-bordered table-hover' width='100%'> <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> <tr> <td width='50%'> Nurse: </td> <td width='50%'><input type='text' placeholder='Nurse' name='Nurse_name'></td> </tr> <tr> <td width='50%'> Nurse Id No.: </td> <td width='50%'><input type='text' placeholder=' Nurse Id No.' name=' Nurse_Id_No'></td> </tr> <tr> <td width='50%'> Blood Started at: </td> <td width='50%'><input type='datetime-local' name='blood_start'></td> </tr> <tr> <td width='50%'> Blood End at: </td> <td width='50%'><input type='datetime-local' name='blood_stop'></td> </tr> </table> <br> <br> <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>