kenyanprince wrote on Thursday, May 05, 2016:
When I click on the add button on “Referral Source” in demographics and type a source and then click add it nothing happens on the pop up that comes and I have to click cancel, therefore cannot add referral sources.
Below is the code for the page interface/patient_file/summary/demographics_full.php
| <?php if ($GLOBALS['concurrent_layout']) { ?> <?php } else { ?> <?php } ?> <?php xl('Current Patient','e'); ?> | <?php xl('Save','e'); ?> | <?php if ($GLOBALS['concurrent_layout']) { ?> <?php } else { ?> <?php } ?> <?php xl('Cancel','e'); ?> |
function end_cell() {
global $item_count, $cell_count;
if ($item_count > 0) {
echo “”;
$item_count = 0;
}
}
function end_row() {
global $cell_count, $CPR;
end_cell();
if ($cell_count > 0) {
for (; $cell_count < $CPR; ++$cell_count) echo “
echo “\n”;
$cell_count = 0;
}
}
function end_group() {
global $last_group;
if (strlen($last_group) > 0) {
end_row();
echo " \n";
echo “\n”;
}
}
$last_group = ‘’;
$cell_count = 0;
$item_count = 0;
$display_style = ‘block’;
$group_seq=0; // this gives the DIV blocks unique IDs
?>
<?php xl("Demographics", "e" )?>
<ul class="tabNav">
<?php display_layout_tabs('DEM', $result, $result2); ?>
</ul>
<div class="tabContainer">
<?php display_layout_tabs_data_editable('DEM', $result, $result2); ?>
</div>
<?php xl("Insurance", "e" )?>
<?php
if (! $GLOBALS['simplified_demographics']) {
$insurance_headings = array(xl("Primary Insurance Provider"), xl("Secondary Insurance Provider"), xl("Tertiary Insurance provider"));
$insurance_info = array();
$insurance_info[1] = getInsuranceData($pid,"primary");
$insurance_info[2] = getInsuranceData($pid,"secondary");
$insurance_info[3] = getInsuranceData($pid,"tertiary");
?>
<?php echo ($GLOBALS['phone_country_code'] == '1') ? xl('Zip Code','e') : xl('Postal Code','e') ?>
:
subscriber_postal_code value="<?php echo $result3{"subscriber_postal_code"}?>">
<?php include $GLOBALS['fileroot']."/library/options_listadd.inc"; ?>
<div id="INSURANCE" >
<ul class="tabNav">
<?php
foreach (array('primary','secondary','tertiary') as $instype) {
?><li <?php echo $instype == 'primary' ? 'class="current"' : '' ?>><a href="/play/javascript-tabbed-navigation/"><?php $CapInstype=ucfirst($instype); xl($CapInstype,'e'); ?></a></li><?php
}
?>
</ul>
<div class="tabContainer">
<?php
for($i=1;$i<=3;$i++) {
$result3 = $insurance_info[$i];
?>
<div class="tab <?php echo $i == 1 ? 'current': '' ?>" style='height:auto;width:auto'> <!---display icky, fix to auto-->
<table border="0">
<tr>
<td valign=top width="430">
<table border="0">
<tr>
<td valign='top'>
<span class='required'><?php echo $insurance_headings[$i -1]." "?></span>
</td>
<td class='required'>:</td>
<td>
<a href="../../practice/ins_search.php" class="iframe medium_modal css_button" onclick="ins_search(<?php echo $i?>)">
<span><?php echo xl('Search/Add') ?></span>
</a>
<select name="i<?php echo $i?>provider">
<option value=""><?php xl('Unassigned','e'); ?></option>
<?php
foreach ($insurancei as $iid => $iname) {
echo "<option value='" . $iid . "'";
if (strtolower($iid) == strtolower($result3{"provider"}))
echo " selected";
echo ">" . $iname . "</option>\n";
}
?>
</select>
</td>
</tr>
<tr>
<td>
<span class='required'><?php xl('Plan Name','e'); ?> </span>
</td>
<td class='required'>:</td>
<td>
<input type='entry' size='20' name='i<?php echo $i?>plan_name' value="<?php echo $result3{"plan_name"} ?>"
onchange="capitalizeMe(this);" />
</td>
</tr>
<tr>
<td>
<span class='required'><?php xl('Effective Date','e'); ?></span>
</td>
<td class='required'>:</td>
<td>
<input type='entry' size='16' id='i<?php echo $i ?>effective_date' name='i<?php echo $i ?>effective_date'
value='<?php echo $result3['date'] ?>'
onkeyup='datekeyup(this,mypcc)' onblur='dateblur(this,mypcc)'
title='yyyy-mm-dd' />
<img src='../../pic/show_calendar.gif' align='absbottom' width='24' height='22' id='img_i<?php echo $i ?>effective_date' border='0' alt='[?]' style='cursor:pointer' title='<?php xl('Click here to choose a date','e'); ?>'>
</td>
</tr>
<tr>
<td><span class=required><?php xl('Policy Number','e'); ?></span></td>
<td class='required'>:</td>
<td><input type='entry' size='16' name='i<?php echo $i?>policy_number' value="<?php echo $result3{"policy_number"}?>"
onkeyup='policykeyup(this)'></td>
</tr>
<tr>
<td><span class=required><?php xl('Group Number','e'); ?></span></td>
<td class='required'>:</td>
<td><input type=entry size=16 name=i<?php echo $i?>group_number value="<?php echo $result3{"group_number"}?>" onkeyup='policykeyup(this)'></td>
</tr>
<tr<?php if ($GLOBALS['omit_employers']) echo " style='display:none'"; ?>>
<td class='required'><?php xl('Subscriber Employer (SE)','e'); ?><br><span style='font-weight:normal'>
(<?php xl('if unemployed enter Student','e'); ?>,<br><?php xl('PT Student, or leave blank','e'); ?>) </span></td>
<td class='required'>:</td>
<td><input type=entry size=25 name=i<?php echo $i?>subscriber_employer
value="<?php echo $result3{"subscriber_employer"}?>"
onchange="capitalizeMe(this);" /></td>
</tr>
<tr<?php if ($GLOBALS['omit_employers']) echo " style='display:none'"; ?>>
<td><span class=required><?php xl('SE Address','e'); ?></span></td>
<td class='required'>:</td>
<td><input type=entry size=25 name=i<?php echo $i?>subscriber_employer_street
value="<?php echo $result3{"subscriber_employer_street"}?>"
onchange="capitalizeMe(this);" /></td>
</tr>
<tr<?php if ($GLOBALS['omit_employers']) echo " style='display:none'"; ?>>
<td colspan="3">
<table>
<tr>
<td><span class=required><?php xl('SE City','e'); ?>: </span></td>
<td><input type=entry size=15 name=i<?php echo $i?>subscriber_employer_city
value="<?php echo $result3{"subscriber_employer_city"}?>"
onchange="capitalizeMe(this);" /></td>
<td><span class=required><?php echo ($GLOBALS['phone_country_code'] == '1') ? xl('SE State','e') : xl('SE Locality','e') ?>: </span></td>
<td>
<?php
// Modified 7/2009 by BM to incorporate data types
generate_form_field(array('data_type'=>$GLOBALS['state_data_type'],'field_id'=>('i'.$i.'subscriber_employer_state'),'list_id'=>$GLOBALS['state_list'],'fld_length'=>'15','max_length'=>'63','edit_options'=>'C'), $result3['subscriber_employer_state']);
?>
</td>
</tr>
<tr>
<td><span class=required><?php echo ($GLOBALS['phone_country_code'] == '1') ? xl('SE Zip Code','e') : xl('SE Postal Code','e') ?>: </span></td>
<td><input type=entry size=15 name=i<?php echo $i?>subscriber_employer_postal_code value="<?php echo $result3{"subscriber_employer_postal_code"}?>"></td>
<td><span class=required><?php xl('SE Country','e'); ?>: </span></td>
<td>
<?php
// Modified 7/2009 by BM to incorporate data types
generate_form_field(array('data_type'=>$GLOBALS['country_data_type'],'field_id'=>('i'.$i.'subscriber_employer_country'),'list_id'=>$GLOBALS['country_list'],'fld_length'=>'10','max_length'=>'63','edit_options'=>'C'), $result3['subscriber_employer_country']);
?>
</td>
</tr>
</table>
</td>
</tr>
</table>
</td>
<td valign=top>
<table border="0">
<tr>
<td><span class=required><?php xl('Relationship','e'); ?></span></td>
<td class=required>:</td>
<td colspan=3><?php
// Modified 6/2009 by BM to use list_options and function
generate_form_field(array('data_type'=>1,'field_id'=>('i'.$i.'subscriber_relationship'),'list_id'=>'sub_relation','empty_title'=>' '), $result3['subscriber_relationship']);
?>
<a href="javascript:popUp('browse.php?browsenum=<?php echo $i?>')" class=text>(<?php xl('Browse','e'); ?>)</a></td>
<td></td><td></td><td></td><td></td>
</tr>
<tr>
<td width=120><span class=required><?php xl('Subscriber','e'); ?> </span></td>
<td class=required>:</td>
<td colspan=3><input type=entry size=10 name=i<?php echo $i?>subscriber_fname value="<?php echo $result3{"subscriber_fname"}?>" onchange="capitalizeMe(this);" />
<input type=entry size=3 name=i<?php echo $i?>subscriber_mname value="<?php echo $result3{"subscriber_mname"}?>" onchange="capitalizeMe(this);" />
<input type=entry size=10 name=i<?php echo $i?>subscriber_lname value="<?php echo $result3{"subscriber_lname"}?>" onchange="capitalizeMe(this);" /></td>
<td></td><td></td><td></td><td></td>
</tr>
<tr>
<td><span class=bold><?php xl('D.O.B.','e'); ?> </span></td>
<td class=required>:</td>
<td><input type='entry' size='11' id='i<?php echo $i?>subscriber_DOB' name='i<?php echo $i?>subscriber_DOB' value='<?php echo $result3['subscriber_DOB'] ?>' onkeyup='datekeyup(this,mypcc)' onblur='dateblur(this,mypcc)' title='yyyy-mm-dd' /><img src='../../pic/show_calendar.gif' align='absbottom' width='24' height='22' id='img_i<?php echo $i; ?>dob_date' border='0' alt='[?]' style='cursor:pointer' title='<?php xl('Click here to choose a date','e'); ?>'></td>
<td><span class=bold><?php xl('Sex','e'); ?>: </span></td>
<td><?php
// Modified 6/2009 by BM to use list_options and function
generate_form_field(array('data_type'=>1,'field_id'=>('i'.$i.'subscriber_sex'),'list_id'=>'sex'), $result3['subscriber_sex']);
?>
</td>
<td></td><td></td> <td></td><td></td>
</tr>
<tr>
<td class=leftborder><span class=bold><?php xl('S.S.','e'); ?> </span></td>
<td class=required>:</td>
<td><input type=entry size=11 name=i<?php echo $i?>subscriber_ss value="<?php echo trim($result3{"subscriber_ss"})?>"></td>
</tr>
<tr>
<td><span class=required><?php xl('Subscriber Address','e'); ?> </span></td>
<td class=required>:</td>
<td><input type=entry size=20 name=i<?php echo $i?>subscriber_street value="<?php echo $result3{"subscriber_street"}?>" onchange="capitalizeMe(this);" /></td>
<td><span class=required><?php echo ($GLOBALS['phone_country_code'] == '1') ? xl('State','e') : xl('Locality','e') ?>: </span></td>
<td>
<?php
// Modified 7/2009 by BM to incorporate data types
generate_form_field(array('data_type'=>$GLOBALS['state_data_type'],'field_id'=>('i'.$i.'subscriber_state'),'list_id'=>$GLOBALS['state_list'],'fld_length'=>'15','max_length'=>'63','edit_options'=>'C'), $result3['subscriber_state']);
?>
</td>
</tr>
<tr>
<td class=leftborder><span class=required><?php xl('City','e'); ?></span></td>
<td class=required>:</td>
<td><input type=entry size=11 name=i<?php echo $i?>subscriber_city value="<?php echo $result3{"subscriber_city"}?>" onchange="capitalizeMe(this);" /></td><td class=leftborder><span class='required'<?php if ($GLOBALS['omit_employers']) echo " style='display:none'"; ?>><?php xl('Country','e'); ?>: </span></td><td>
<?php
// Modified 7/2009 by BM to incorporate data types
generate_form_field(array('data_type'=>$GLOBALS['country_data_type'],'field_id'=>('i'.$i.'subscriber_country'),'list_id'=>$GLOBALS['country_list'],'fld_length'=>'10','max_length'=>'63','edit_options'=>'C'), $result3['subscriber_country']);
?>
</td>
<td colspan=2>
</td><td></td>
</tr>
<tr>
<td><span class=bold><?php xl('Subscriber Phone','e'); ?></span></td>
<td class=required>:</td>
<td><input type='text' size='20' name='i<?php echo $i?>subscriber_phone' value='<?php echo $result3["subscriber_phone"] ?>' onkeyup='phonekeyup(this,mypcc)' /></td>
<td colspan=2><span class=bold><?php xl('CoPay','e'); ?>: <input type=text size="6" name=i<?php echo $i?>copay value="<?php echo $result3{"copay"}?>"></span></td>
<td colspan=2>
</td><td></td><td></td>
</tr>
<tr>
<td colspan=0><span class='required'><?php xl('Accept Assignment','e'); ?></span></td>
<td class=required>:</td>
<td colspan=2>
<select name=i<?php echo $i?>accept_assignment>
<option value="TRUE" <?php if (strtoupper($result3{"accept_assignment"}) == "TRUE") echo "selected"?>><?php xl('YES','e'); ?></option>
<option value="FALSE" <?php if (strtoupper($result3{"accept_assignment"}) == "FALSE") echo "selected"?>><?php xl('NO','e'); ?></option>
</select>
</td>
<td></td><td></td>
<td colspan=2>
</td><td></td>
</tr>
<tr>
<td><span class='bold'><?php xl('Secondary Medicare Type','e'); ?></span></td>
<td class='bold'>:</td>
<td colspan='6'>
<select name=i<?php echo $i?>policy_type>
</select>
</td>
</tr>
</table>
</td>
</tr>
</table>
</div>
<?php } //end insurer for loop ?>
</div>
<?php include $GLOBALS['fileroot']."/library/options_listadd.inc"; ?>