164 lines
8.4 KiB
PHP
Executable File
164 lines
8.4 KiB
PHP
Executable File
<div id="div_ente_requete">
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<INPUT class="sr-only" TYPE="text" id="codePrestataire" name="codePrestataire" value="<?= $_SESSION['codePrestataire_C'] ?>">
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<INPUT class="sr-only" TYPE="text" id="codeTypePrestataire" name="codeTypePrestataire" value="<?= $_SESSION['codeTypePrestataire_C'] ?>">
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<input class="sr-only" type="text" id="codeMedecin" name="codeMedecin">
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<table class="table table-responsive table-condensed" style='font-size:7pt;'>
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<tbody>
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<tr>
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<td width="5%">Prestataire</td>
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<td width="13%"> <INPUT style='tfont-size:7pt;' class="form-control" type="text" value="<?= $this->nettoyer($_SESSION['prestataire_C']) ?>" readonly> </td>
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<td width="5%" align="center"> Période du </td>
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<td width="13%" colspan="3"> <INPUT style='text-align:center; font-size:7pt;' class="form-control datepicker" TYPE="text" id="dateConsultation1" NAME="dateConsultation1" value="<?= $_SESSION['debutRequeteFr_C'] ?>" required></td>
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<td width="5%" align="center" > au </td>
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<td width="13%" colspan="3"> <INPUT style='text-align:center; font-size:7pt;' class="form-control datepicker" TYPE="text" id="dateConsultation2" NAME="dateConsultation2" value="<?= $_SESSION['finRequeteFr_C'] ?>" required> </td>
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<td width="5%" align="center" >N° Adhér.</td>
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<td width="13%" colspan="3"> <INPUT style='text-align:center; font-size:7pt;' class="form-control" TYPE="text" id="numeroAdherent" name="numeroAdherent" > </td>
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<td width="5%" align="center" >N° Bénéf.</td>
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<td width="13%" colspan="3"> <INPUT style='text-align:center; font-size:7pt;' class="form-control" TYPE="text" id="numeroBeneficiaire" name="numeroBeneficiaire"></td>
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</tr>
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<tr>
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<td> Médecin </td>
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<td>
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<button type="button" class="form-control btn btn-primary" data-bs-toggle="modal" data-bs-target="#popRechercheMedecin" style='font-size:7pt;' ><span id="nomMedecin" name="nomMedecin"> Rechercher Médecin... </span></button>
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</td>
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<td align="center"> Bon Cons. </td>
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<td width="6%"> <INPUT style='text-align:center; font-size:7pt;' class="form-control" type="number" id="numeroBonConsultation1" name="numeroBonConsultation1" value="0" > </td>
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<td width="1%" align="center"> - </td>
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<td width="6%"> <INPUT style='text-align:center; font-size:7pt;' class="form-control" type="number" id="numeroBonConsultation2" name="numeroBonConsultation2" value="0" > </td>
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<td align="center"> Ord. </td>
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<td width="6%"> <INPUT style='text-align:center; font-size:7pt;' class="form-control" type="number" id="numeroBonOrdonnance1" name="numeroBonOrdonnance1" value="0" > </td>
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<td width="1%" align="center"> - </td>
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<td width="6%"> <INPUT style='text-align:center; font-size:7pt;' class="form-control" type="number" id="numeroBonOrdonnance2" name="numeroBonOrdonnance2" value="0" > </td>
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<td align="center"> Bon Hosp. </td>
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<td width="6%"> <INPUT style='text-align:center; font-size:7pt;' class="form-control" type="number" id="numeroBonHospitalisation1" name="numeroBonHospitalisation1" value="0" > </td>
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<td width="1%" align="center"> - </td>
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<td width="6%"> <INPUT style='text-align:center; font-size:7pt;' class="form-control" type="number" id="numeroBonHospitalisation2" name="numeroBonHospitalisation2" value="0" > </td>
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<td align="center"> Bon Opt. </td>
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<td width="6%"> <INPUT style='text-align:center; font-size:7pt;' class="form-control" type="number" id="numeroBonOptique1" name="numeroBonOptique1" value="0" > </td>
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<td width="1%" align="center"> - </td>
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<td width="6%"> <INPUT style='text-align:center; font-size:7pt;' class="form-control" type="number" id="numeroBonOptique2" name="numeroBonOptique2" value="0" > </td>
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</tr>
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<tr>
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<td> Type </td>
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<td> <INPUT style='tfont-size:7pt;' class="form-control" type="text" value="<?= $this->nettoyer($_SESSION['typeprestataire_C']) ?>" readonly> </td>
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<td align="center"> N° Décpte</td>
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<td> <INPUT style='text-align:center; font-size:7pt;' class="form-control" type="number" id="numeroDecompte1" name="numeroDecompte1" value="0" > </td>
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<td align="center"> - </td>
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<td> <INPUT style='text-align:center; font-size:7pt;' class="form-control" type="number" id="numeroDecompte2" name="numeroDecompte2" value="0" > </td>
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<td align="center"> Rais. </td>
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<td colspan="3">
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<SELECT class="form-control" id="codeRaisonConsultation" NAME="codeRaisonConsultation" style='font-size:7pt;'>
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<?php liste_options_consultation($raison, ""); ?>
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</SELECT>
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</td>
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<td align="center"> Hosp / Cbre </td>
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<td>
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<SELECT class="form-control" id="hospitalisation" NAME="hospitalisation" style='font-size:7pt;'>
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<?php liste_options_consultation($ouinonhospit, ""); ?>
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</SELECT>
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</td>
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<td align="center"> / </td>
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<td> <INPUT style='text-align:center; font-size:7pt;' class="form-control" TYPE="text" id="numeroChambre" name="numeroChambre" > </td>
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<td align="center"> Chir / Fact </td>
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<td>
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<SELECT class="form-control" id="chirurgie" NAME="chirurgie" style='font-size:7pt;'>
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<?php liste_options_consultation($ouinonchirurgie, ""); ?>
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</SELECT>
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</td>
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<td align="center"> / </td>
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<td>
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<SELECT class="form-control" id="facture" NAME="facture" style='font-size:7pt;'>
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<?php liste_options_consultation($ouinonfacture, ""); ?>
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</SELECT>
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</td>
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</tr>
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<tr>
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<td> Adhér.</td>
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<td colspan="5"> <INPUT style='tfont-size:7pt;' class="form-control" type="text" id="adherent" name="adherent" > </td>
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<td align="center"> Bénéf.</td>
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<td colspan="11"> <INPUT style='font-size:7pt;' class="form-control" type="text" id="beneficiaire" name="beneficiaire" > </td>
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</tr>
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<tr>
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<td> </td>
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<td colspan="5"> <button style='font-size:10pt;' type="button" class="form-control btn btn-primary" onclick="javascript:requetes_feuilles_maladie();">Afficher résultats..</button> </td>
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<td colspan="5">
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<input class="form-control" style="text-align: center; font-size:10pt;" type="text" id="nbligne" name="nbligne" value="Result : 0" readonly>
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</td>
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<td colspan="7"> <button style='font-size:10pt;' type="button" class="form-control btn btn-primary" onclick="javascript:requetes_feuilles_maladie_export();">Exporter vers Excel..</button> </td>
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</tr>
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</tbody>
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</table>
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<div class="modal fade" id="popRechercheMedecin" role="dialog">
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<div class="modal-dialog modal-lg">
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<div class="modal-content">
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<div class="modal-header">
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<button id="btn_close_pop" name="btn_close_pop" type="button" class="close" data-bs-dismiss="modal">Fermer / Close</button>
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<h4 class="modal-title">Rechercher un Médecin... / Search a Doctor...</h4>
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</div>
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<div class="modal-body">
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<div id="div_listemedecins" onkeypress="javascript:ctrlkeypress_medecin_requete(event);">
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<table class="table table-striped table-bordered table-hover table-condensed table-responsive" style='font-size:10pt;'>
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<thead>
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<tr>
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<th style="text-align:center" width="15%" > Code </th>
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<th width="50%" style="text-align:center" >Nom contenant... / Name containing...</th>
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<th colspan="2" style="text-align:center" > Spécialité </th>
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</tr>
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</thead>
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<tbody>
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<tr>
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<td><input type="text" class="form-control" id="noOrdreMedecin" name="noOrdreMedecin" autofocus style='font-size:10pt;' ></td>
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<td><input type="text" class="form-control" id="nomsearch" name="nomsearch" autofocus style='font-size:10pt;' ></td>
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<td><input type="button" class = "form-control btn btn-info" style='font-size:10pt;' value="Rechercher... / Search..." onclick="javascript:afficher_pop_recherche_medecin_requete();" /></td>
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<td><input type="button" class = "form-control btn btn-info" style='font-size:10pt;' value="Ré-initialiser..." onclick="javascript:reinitialiser_medecin();" /></td>
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</tr>
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</tbody>
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</table>
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</div>
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</div>
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<div class="modal-footer">
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<button id="close_pop" name="close_pop" type="button" class="btn btn-default" data-bs-dismiss="modal">Fermer / Close</button>
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</div>
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</div>
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</div>
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</div>
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</div>
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<div id="div_detail_requete">
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</div>
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<div id="div_export_a">
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</div>
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