-
Notifications
You must be signed in to change notification settings - Fork 0
/
Copy pathPatientSearch.html
97 lines (88 loc) · 2.29 KB
/
PatientSearch.html
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
<?php
session_start();
if(!isset($_SESSION['id']))
{
header("Location: http://localhost/Login.html");
}
?>
<!DOCTYPE html>
<html>
<head>
<link
href = "./style.css"
type = "text/css"
rel = "stylesheet">
<title>MCS-Patient Search</title>
</head>
<body bgcolor="#BFF1EF">
<form action="Units.php">
<input type="submit" value="Main Menu">
</form>
<form class="logout" action="Logout.php">
<input type="submit" value="Logout">
</form>
<div id="User">
<?php
$USER = $_SESSION["uName"];
echo "Signed in as: $USER";
?>
</div>
<form method="post" action="PatientSearch.php">
<section class="panel searchpanel">
<h1>Identify a Medical Record</h1>
<h3>Patient Name</h3>
<table id="search">
<tr>
<td class="right">First:</td>
<td><input type="text" name="First" value=""></td>
</tr>
<tr>
<td class="right">Last:</td>
<td><input type="text" name="Last" value=""></td>
</tr>
</table>
<h3>Home Address</h3>
<table id="search">
<tr>
<td class="right">City:</td>
<td><input type="text" name="City" value=""></td>
</tr>
<tr>
<td class="right">Street Name:</td>
<td><input type="text" name="StreetName" value=""></td>
</tr>
<tr>
<td class="right">Street Number:</td>
<td><input type="text" name="StreetNumber" value=""></td>
</tr>
<tr>
<td class="right">Postal Code:</td>
<td><input type="text" name="Postal" value=""></td>
</tr>
</table>
<br><br><br><br><br><br><br><br>
<h3>Patient Information</h3>
<table id="search">
<tr>
<td class="right">Patient ID:</td>
<td><input type="text" name="PID" value=""></td>
</tr>
<tr>
<td class="right">Phone Number:</td>
<td><input type="phone" name="Phone" value=""></td>
</tr>
<tr>
<td class="right">Social Insurance Number:</td>
<td><input type="text" name="SIN" value=""></td>
</tr>
<tr>
<td class="right">Health Card Number:</td>
<td><input type="text" name="HCN" value=""></td>
</tr>
</table>
<br><br>
<input type="submit" value="Search"><br>
</section>
</form>
</body>
</html>