| Şuanki Dizin: /home/wwwdreamtechnolo/public_html/kitchenfoodrecipes.com/disha/disha-foundation-old/ |
| Şuanki Dosya : /home/wwwdreamtechnolo/public_html/kitchenfoodrecipes.com/disha/disha-foundation-old/example.php |
<?php
require_once("lib/function.php");
$db = new login_function();
if(isset($_GET['update_id']))
{
$up_id = $_GET['update_id'];
$_SESSION['current_update_id'] = $up_id;
}
else if(isset($_SESSION['current_update_id']))
{
$up_id = $_SESSION['current_update_id'];
}
?>
<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>Home</title>
<link rel="stylesheet" href="D:\style.css">
<style type="text/css">
.Admission_form{
text-align:center;
}
.text_1{
margin-left:10px;
}
.strikethough {
width:70%;
text-align:left;
border-bottom: 1px solid #bcbcbc;
overflow: inherit;
margin:0px 0 30px;
font-size: 16px;
color:#757575;
}
.strikethough span {
background:#fff;
padding:0 20px 0px 0px;
position: relative;
top: 10px;
}
.strikethough_1{
width:500%;
text-align:left;
border-bottom: 1px solid #bcbcbc;
overflow: inherit;
margin:0px 0 30px;
font-size: 16px;
}
.strikethough_2{
width:100%;
text-align:left;
border-bottom: 1px solid #bcbcbc;
overflow: inherit;
margin:0px 0 30px;
font-size: 16px;
}
.strikethough_3{
width:50%;
text-align:left;
border-bottom: 1px solid #bcbcbc;
overflow: inherit;
margin:0px 0 30px;
font-size: 16px;
}
.strikethough_4{
width:70%;
text-align:left;
border-bottom: 1px solid #bcbcbc;
overflow: inherit;
margin:0px 0 30px;
font-size: 16px;
}
.strikethough_5{
width:70%;
text-align:left;
border-bottom: 1px solid #bcbcbc;
overflow: inherit;
margin:0px 0 30px;
font-size: 16px;
}
.strikethough_6{
width:20%;
text-align:left;
border-bottom: 1px solid #bcbcbc;
overflow: inherit;
margin:0px 0 30px;
font-size: 16px;
}
.strikethough_7{
width:20%;
text-align:left;
border-bottom: 1px solid #bcbcbc;
overflow: inherit;
margin:0px 0 30px;
font-size: 16px;
}
.strikethough_8{
width:20%;
text-align:left;
border-bottom: 1px solid #bcbcbc;
overflow: inherit;
margin:0px 0 30px;
font-size: 16px;
}
.strikethough_9{
width:20%;
text-align:left;
border-bottom: 1px solid #bcbcbc;
overflow: inherit;
margin:0px 0 30px;
font-size: 16px;
}
.strikethough_10{
width:20%;
text-align:left;
border-bottom: 1px solid #bcbcbc;
overflow: inherit;
margin:0px 0 30px;
font-size: 16px;
}
.strikethough_11{
width:20%;
text-align:left;
border-bottom: 1px solid #bcbcbc;
overflow: inherit;
margin:0px 0 30px;
font-size: 16px;
}
.strikethough_12{
width:20%;
text-align:left;
border-bottom: 1px solid #bcbcbc;
overflow: inherit;
margin:0px 0 30px;
font-size: 16px;
}
.strikethough_13{
width:20%;
text-align:left;
border-bottom: 1px solid #bcbcbc;
overflow: inherit;
margin:0px 0 30px;
font-size: 16px;
}
.strikethough_14{
width:100%;
text-align:left;
border-bottom: 1px solid #bcbcbc;
overflow: inherit;
margin:0px 0 30px;
font-size: 16px;
}
.strikethough_18{
width:100%;
text-align:left;
border-bottom: 1px solid #bcbcbc;
overflow: inherit;
margin:0px 0 30px;
font-size: 16px;
}
.strikethough_19{
width:100%;
text-align:left;
border-bottom: 1px solid #bcbcbc;
overflow: inherit;
margin:0px 0 30px;
font-size: 16px;
}
.bottom-textbox{
border:none;
margin-left:20px;
border-bottom:2px solid black;
outline:none;
}
..bottom-border-textbox:focus{
border-bottom-color:blue;
}
</style>
</head>
<body>
<?php
$report_details = $db->get_all_admission_report();
if(!empty($report_details)) {
$counter =0;
foreach($report_details as $record)
{
$id = $report_details[$counter][0];
$date_of_admission = $report_details[$counter][1];
$center = $report_details[$counter][2];
$name_patient = $report_details[$counter][3];
$gender = $report_details[$counter][4];
$address = $report_details[$counter][5];
$is_rural = $report_details[$counter][6];
$city = $report_details[$counter][7];
$state = $report_details[$counter][8];
$pin = $report_details[$counter][9];
$phone = $report_details[$counter][10];
$mobile = $report_details[$counter][11];
$email = $report_details[$counter][12];
$date_of_birth = $report_details[$counter][13];
$age = $report_details[$counter][14];
$religion = $report_details[$counter][15];
$education_qualification = $report_details[$counter][16];
$occupation = $report_details[$counter][17];
$incone_per_month = $report_details[$counter][18];
$family = $report_details[$counter][19];
$marital_status = $report_details[$counter][20];
$living_arrangements = $report_details[$counter][21];
$name_family_member = $report_details[$counter][22];
$address_family_mem = $report_details[$counter][23];
$phone_family = $report_details[$counter][24];
$mobile_family = $report_details[$counter][25];
$email_family = $report_details[$counter][26];
$referred_by = $report_details[$counter][27];
$reason_of_addiction = $report_details[$counter][28];
$type_addiction = $report_details[$counter][29];
$jaundice = $report_details[$counter][30];
$malena = $report_details[$counter][31];
$malenamalena = $report_details[$counter][32];
$convulsion = $report_details[$counter][33];
$ascitis = $report_details[$counter][34];
$chronic_pedal_oedems = $report_details[$counter][35];
$psychiatric_problem = $report_details[$counter][36];
$heart_attack = $report_details[$counter][37];
$shock = $report_details[$counter][38];
$tia = $report_details[$counter][39];
$kochs = $report_details[$counter][40];
$ht = $report_details[$counter][41];
$dm = $report_details[$counter][42];
$aadhar_no = $report_details[$counter][43];
$pratidnya_name = $report_details[$counter][44];
$pratidnya_address = $report_details[$counter][45];
$pratidnya_mobile = $report_details[$counter][46];
$pratidnya_age = $report_details[$counter][47];
$date = $report_details[$counter][48];
$time = $report_details[$counter][49];
$status = $report_details[$counter][50];
$totalamount = $report_details[$counter][51];
$doctor_name = $report_details[$counter][52];
$discharge_date = $report_details[$counter][53];
$samupdaykl_name = $report_details[$counter][54];
?>
<div class="Admission_form">
<b><u><h1>Patient Admission Form <?php echo $status; ?></h1></u></b>
</div>
<div class="text_1" style="display:flex; gap:200px;">
<div class="first_line">
<h4> Registration No. : 20 </h4>
</div>
<div class=""><h4>Date Of Admission:</h4>
</div>
<div class=""><h4>Center:</h4>
</div>
</div>
<div class=""><h4> Part A: Socio: Demographic Information :</h4>
</div>
<div class="text_2" style="display:flex; gap:70px;">
<div class=""><h4 class=""> Name of the Patient : <input type="text" class="bottom-textbox" style="margin-left:20px; width:800px;"></h4>
</div>
<div class=""><h4> Gender: Male/Female</h4>
</div>
</div>
<div class=""><h4 class=""> Address:<input type="text" class="bottom-textbox" style="margin-left:20px;width:1200px;"></h4>
</div>
<div class="" ><h4> Is this a rural area Yes/No.</h4>
</div>
<div class="text_1" style="display:flex; gap:40px;">
<div class=""><h4 class=""> City/Town/Village: <input type="text" class="bottom-textbox" style="margin-left:20px; width:300px;"></h4>
</div>
<div class=""><h4 class="">State:<input type="text" class="bottom-textbox" style="margin-left:20px; width:300px;"></h4>
</div>
<div class=""><h4 class="">pin:<input type="text" class="bottom-textbox" style="margin-left:20px; width:300px;"></h4>
</div>
</div>
<div class="text_1" style="display:flex; gap:40px;">
<div class=""><h4 class=""> Phone:<input type="text" class="bottom-textbox" style="margin-left:20px; width:300px;"></h4>
</div>
<div class=""><h4 class="">Mobile:<input type="text" class="bottom-textbox" style="margin-left:20px; width:300px;"></h4>
</div>
<div class=""><h4 class="">Email:<input type="text" class="bottom-textbox" style="margin-left:20px; width:300px;"></h4>
</div>
</div>
<div class="text_1" style="display:flex; gap:50px;">
<div class=""><h4 class=""> Date Of Birth:<input type="text" class="bottom-textbox" style="margin-left:20px; width:300px;"></h4>
</div>
<div class=""><h4 class="">Age:<input type="text" class="bottom-textbox" style="margin-left:20px; width:300px;"></h4>
</div>
<div class=""><h4 class="">Religion:<input type="text" class="bottom-textbox" style="margin-left:20px; width:300px;"></h4>
</div>
</div>
<div class=""><h4>Educational Qualification:</h4>
<input type="checkbox" name="Illitreate" value="Illitreate" /> Illitreate
<input type="checkbox" name="literate"
value="literate" /> literate(read and write)
<input type="checkbox" name="primary education"
value="primary education" /> primary education
<input type="checkbox" name="middle"
value="middle" /> middle
</div>
<div class=""><h4> Code No. Occupation: </h4>
</div>
<div class=""><h4> Code No.</h4>
</div>
<div class="text_1" style="display:flex; gap:90px;">
<div class=""><h4 class=""> Income Per Months Rs.:self:<input type="text" class="bottom-textbox" style="margin-left:20px; width:300px;"></h4>
</div>
<div class=""><h4 class="">Marital Status:<input type="text" class="bottom-textbox" style="margin-left:20px; width:300px;"></h4>
</div>
</div>
<div class=""><h4> Code No.</h4>
</div>
<div class=""><h4> Living arrangement :</h4>
</div>
<div class=""><h4> Name of family member/Support person accompanied the patient:</h4>
</div>
<div class=""><h4 class=""> Address:<input type="text" class="bottom-textbox" style="margin-left:30px;width:1200px;"></h4>
</div>
<div class="text_1" style="display:flex; gap:40px;">
<div class=""><h4 class=""> Phone:<input type="text" class="bottom-textbox" style="margin-left:20px; width:300px;"></h4>
</div>
<div class=""><h4 class="">Mobile:<input type="text" class="bottom-textbox" style="margin-left:20px; width:300px;"></h4>
</div>
<div class=""><h4 class="">Email:<input type="text" class="bottom-textbox" style="margin-left:20px; width:300px;"></h4>
</div>
</div>
<div class=""><h4> Referred by:</h4>
</div>
<div class=""><h4> Reason for Addication Code No:</h4>
</div>
<div class=""><h4> Code No.:<input type="text" class="bottom-textbox" style="margin-left:20px; width:300px;"></h4>
</div>
<div class=""><h4 class=""> Name Of The Patient:<input type="text" class="bottom-textbox" style="margin-left:30px;width:1000px;"></h4>
</div>
<div class=""><h4 class=""> Type of addiction:<input type="text" class="bottom-textbox" style="margin-left:30px;width:1000px;"></h4>
</div>
</div>
<hr>
<div class="" style="display:flex; gap:200px;" >
<h2 style="margin-left:200px;">PHYSICAL EXAMINATION</h2>
<h2>LAST CONSUMPTION</h2>
</div>
<hr>
<?php
}
} else {
// Display a message if no data is found
?>
<div colspan="7">No Data Found..</div>
<?php
}
?>
</body>
</html>
Linux 65-254-81-4.cprapid.com 5.14.0-284.11.1.el9_2.x86_64 #1 SMP PREEMPT_DYNAMIC Tue May 9 05:49:00 EDT 2023 x86_64
Apache
65.254.81.4