-
Notifications
You must be signed in to change notification settings - Fork 1
/
Copy pathsearchPatientBySSN.php
115 lines (115 loc) · 6.32 KB
/
searchPatientBySSN.php
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
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
<?php
$SSN = $_GET['SSN'];
$connection = mysqli_connect("localhost", "root", "", "ihs");
$ses_sql=mysqli_query($connection, "SELECT * FROM Patient WHERE SSN='$SSN'");
$row = mysqli_fetch_assoc($ses_sql);
?>
<div class="row">
<div class="col-md-3 col-xs-3">
<label for="searchpat">Search Patient:</label>
</div>
<div class="col-md-3 col-xs-1">
<input id="searchpat" type="text" name="searchpat" placeholder="search ssn">
</div>
<div class="col-md-1 col-md-offset-1 col-xs-1 col-xs-offset-6">
<button id="searchpatbtn" type="button" class="btn btn-primary btn-sm" onclick="getModalPatient($('searchpat').value)"><span id="searchIcon" class="fa fa-search"></span></button>
</div>
</div>
<hr>
<div class="row cusrow">
<div class="col-md-2 col-xs-4">
<label for="name">SSN: </label>
</div>
<div class="col-md-2 col-xs-4 col-xs-offset-4">
<input class="inStyle" type="text" name="name" id="resultSSN" value="<?php echo($row['SSN']); ?>">
</div>
</div>
<div class="row cusrow">
<div class="col-md-2 col-xs-4">
<label for="name">Patient Name: </label>
</div>
<div class="col-md-2 col-xs-4 col-xs-offset-4">
<input class="inStyle" type="text" name="name" id="patName" value="<?php echo($row['name']); ?>">
</div>
</div>
<div class="row">
<div class="col-md-2 col-xs-4">
<label for="name">Patient Surname: </label>
</div>
<div class="col-md-2 col-xs-4 col-xs-offset-4">
<input class="inStyle" type="text" name="name" id="patSurname" value="<?php echo($row['surname']); ?>">
</div>
</div>
<div class="row">
<div class="col-md-2 col-xs-4">
<label for="name">Father's Name: </label>
</div>
<div class="col-md-2 col-xs-4 col-xs-offset-4">
<input class="inStyle" type="text" name="name" id="fathers_name" value="<?php echo($row['fathers_name']); ?>">
</div>
</div>
<div class="row">
<div class="col-md-2 col-xs-4">
<label for="name">Mother's Name: </label>
</div>
<div class="col-md-2 col-xs-4 col-xs-offset-4">
<input class="inStyle" type="text" name="name" id="mothers_name" value="<?php echo($row['mothers_name']); ?>">
</div>
</div>
<div class="row">
<div class="col-md-2 col-xs-4">
<label for="name">Gender: </label>
</div>
<div class="col-md-2 col-xs-4 col-xs-offset-4">
<input class="inStyle" type="text" name="name" id="sex" value="<?php echo($row['sex']); ?>">
</div>
</div>
<div class="row cusrow">
<div class="col-md-2 col-xs-4">
<label for="name">Date of birth: </label>
</div>
<div class="col-md-2 col-xs-4 col-xs-offset-4">
<input class="inStyle" type="date" name="name" id="birth" value="<?php echo($row['birth']); ?>">
</div>
</div>
<div class="row">
<div class="col-md-2 col-xs-4">
<label for="name">Home Address: </label>
</div>
<div class="col-md-2 col-xs-4 col-xs-offset-4">
<input class="inStyle" type="text" name="name" id="residence" value="<?php echo($row['residence']); ?>">
</div>
</div>
<div class="row">
<div class="col-md-2 col-xs-4">
<label for="name">Phone Number: </label>
</div>
<div class="col-md-2 col-xs-4 col-xs-offset-4">
<input class="inStyle" type="text" name="name" id="phone_home" value="<?php echo($row['phone_home']); ?>">
</div>
</div>
<div class="row">
<div class="col-md-2 col-xs-4">
<label for="name">Mobile Number: </label>
</div>
<div class="col-md-2 col-xs-4 col-xs-offset-4">
<input class="inStyle" type="text" name="name" id="phone_cell" value="<?php echo($row['phone_cell']); ?>">
</div>
</div>
<div class="row">
<div class="col-md-2 col-xs-4">
<label for="name">Work Number: </label>
</div>
<div class="col-md-2 col-xs-4 col-xs-offset-4">
<input class="inStyle" type="text" name="name" id="phone_work" value="<?php echo($row['phone_work']); ?>">
</div>
</div>
<div class="row cusrow">
<div class="col-md-2">
<label for="issues">Critical Issues:</label>
</div>
<div class="col-md-10">
<textarea name="issues" id="issues" olaceholder="Critical Health Issues" cols="40" rows="10"> <?php echo($row['health_info']); ?></textarea>
</div>
</div>
</div>