163 lines
6.6 KiB
PHP
Executable File
163 lines
6.6 KiB
PHP
Executable File
<?php
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$this->titre = "INTER-SANTE - proforma hospitalisation";
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$idProforma = (isset($_SESSION['p_idProforma_C']) && $idBeneficiaire > "0") ? $_SESSION['p_idProforma_C'] : '0';
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$dateDebutProforma = (isset($_SESSION['p_dateDebutProforma_C']) && $idBeneficiaire > "0") ? dateLang($_SESSION['p_dateDebutProforma_C'], $_SESSION['p_lang']) : dateLang(date('Y-m-d'), $_SESSION['p_lang']);
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$numeroEntentePrealable = (isset($_SESSION['p_dateDebutProforma_C']) && $idBeneficiaire > "0") ? $_SESSION['p_numeroEntentePrealable_C'] : "0";
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$numero = ($idProforma > "0") ? ' N°: '.$idProforma : "";
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$datejour = $this->datejour;
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$estcouvert = ($_SESSION['p_dateEcheancePolice_C']>=$datejour);
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$estsorti = "0";
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$dateSortieBeneficiaire = $_SESSION['p_dateSortieBeneficiaire_P'];
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if( $dateSortieBeneficiaire > "2000-01-01")
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{
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$estsorti = ($dateSortieBeneficiaire<=$datejour);
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$estcouvert = ($estcouvert && ($dateSortieBeneficiaire>$datejour));
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}
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$dateEffetCouvert = $_SESSION['p_dateEffetCouvert_P'];
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$codeEtatBeneficiaire = $_SESSION['p_codeEtatBeneficiaire_P'];
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$etatbeneficiaireEng = $_SESSION['p_etatbeneficiaireEng_P'];
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$etatbeneficiaire = $_SESSION['p_etatbeneficiaire_P'];
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?>
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<legend> <?= _("Proforma d'hospitalisation chirurgicale").$numero ?> </legend>
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<input class="sr-only" id="nomForm" name="nomForm" type="text" value= "proformahospitalisation" >
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<div id="div_proforma"></div>
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<input class="sr-only" id="idProformaHospitalisation" name="idProformaHospitalisation" type="text" value= "<?= $idProforma; ?>" >
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<input class="sr-only" id="numeroEntentePrealable" name="numeroEntentePrealable" type="text" value= "<?=$numeroEntentePrealable;?>">
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<input class="sr-only" id="idBeneficiaire" name="idBeneficiaire" type="text" value= "<?=$idBeneficiaire?>" >
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<table class="table table-condensed" style="font-size:10pt; padding:0px;">
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<tbody>
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<tr>
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<td width="15%" > <?= _("No Patient") ?> </td>
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<td width="25%">
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<input id="numeroBeneficiaire" name="numeroBeneficiaire" style="font-size:12pt; height:30px;" class="form-control" type="text" value="<?= $numeroBeneficiaire ;?>" readonly>
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</td>
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<td width="11%" align="center"> <?= _("Nom et Prénoms") ?> </td>
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<td colspan="3">
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<input id="nomAssure" name="nomAssure" style="font-size:12pt; height:30px;" class="form-control" type="text" value="<?= $beneficiaire ;?>" readonly>
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</td>
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<td width="8%" align="center"> <?= _("Lien") ?> </td>
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<td width="12%">
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<input id="codeLienParente" name="codeLienParente" style="font-size:12pt; height:30px;" class="form-control" type="text" value="<?= $codeLienParente ;?>" readonly>
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</td>
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</tr>
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<tr>
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<td > <?= _("No Adhérent") ?> </td>
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<td >
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<input id="noAdherent" name="noAdherent" style="font-size:12pt; height:30px;" class="form-control" type="text" value="<?= $noAdherent ;?>" readonly>
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</td>
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<td align="center"> <?= _("Adhérent") ?> </td>
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<td colspan="5">
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<input id="nomAdherent" name="nomAdherent" style="font-size:12pt; height:30px;" class="form-control" type="text" value="<?= $nomAdherent ;?>" readonly>
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</td>
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</tr>
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<tr>
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<td > <?= _("Police") ?> </td>
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<td >
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<input id="nomPolice" name="nomPolice" style="font-size:12pt; height:30px;" class="form-control" type="text" value="<?= $nomPolice ;?>" readonly>
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</td>
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<td align="center"> <?= _("Collège") ?> </td>
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<td colspan="5">
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<input id="nomCollege" name="nomCollege" style="font-size:12pt; height:30px;" class="form-control" type="text" value="<?= $nomCollege ;?>" readonly>
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</td>
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</tr>
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<div id="div_couverture">
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</div>
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<tr>
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<td > <?= _("Type Hospitalisation") ?> </td>
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<td colspan="7">
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<SELECT class="form-control" id="optionHospitalisation" NAME="optionHospitalisation" style='font-size:10pt;' disabled>
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<?php liste_options($typeHospitalisation,"option-3"); ?>
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</SELECT>
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</td>
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</tr>
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<?php
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$codeActeChambre = (isset($_SESSION['p_codeActeChambre_C']) && $idBeneficiaire > "0") ? $_SESSION['p_codeActeChambre_C'] : "";
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$codeMedecinProforma = (isset($_SESSION['p_codeMedecinProforma_C']) && $idBeneficiaire > "0") ? $_SESSION['p_codeMedecinProforma_C'] : "";
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$codeAffectionProforma = isset($_SESSION['p_codeAffection_C']) ? $_SESSION['p_codeAffection_C'] : "";
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?>
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<tr>
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<td class="required"> <?= _("Type Chambre") ?> </td>
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<td >
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<SELECT class="form-select" id="codeActeChambre" NAME="codeActeChambre" required style='font-size:10pt; height:30px !important;' onChange="javascript:messageSituationProformaHospit();" required >
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<?php liste_options($actesChambre,$codeActeChambre); ?>
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</SELECT>
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</td >
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<td align="center" class="required"> <?= _("Début") ?> </td>
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<td colspan="3">
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<INPUT class="form-control datepicker" TYPE="text" id="dateDebut" name="dateDebut" style='font-size:10pt;' value="<?= $dateDebutProforma ?>" required onChange="javascript:verifierDate();" required >
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</td>
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<td align="center" class="required"> <?= _("Durée (J)") ?> </td>
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<td>
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<input class="form-control" type="number" id="duree" name="duree" style="font-size:10pt;" Value="<?= (isset($_SESSION['p_dureeProforma_C']) && $idBeneficiaire > "0") ? $_SESSION['p_dureeProforma_C'] : "0" ?>" min="0">
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</td>
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</tr>
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<tr>
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<td class="required"> <?= _("Renseignement Clinique") ?> </td>
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<td colspan="7"><input id="motif" name="motif" style="font-size:10pt;" class="form-control" value="<?= (isset($_SESSION['p_motifProforma_C']) && $idBeneficiaire > "0") ? $_SESSION['p_motifProforma_C'] : "" ?>" type="text" required AUTOCOMPLETE="OFF" placeholder="<?= _("Obligatoire avant d'enregistrer la proforma...")?>"></td>
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</tr>
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<tr >
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<td class="required"> <?= _("Médecin") ?> </td>
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<td colspan="7">
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<SELECT id="codeMedecin" class="form-control selectpicker" data-live-search="true" NAME="codeMedecin" style='font-size:10pt;height:30px !important;' required>
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<?php liste_options($medecins, $codeMedecinProforma); ?>
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</SELECT>
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</td>
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</tr>
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<tr>
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<td > <?= _("Affection") ?> </td>
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<td colspan="7">
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<SELECT id="codeAffection" NAME="codeAffection" class="form-control selectpicker" data-live-search="true" style='font-size:10pt;'>
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<?php liste_options($affections, $codeAffectionProforma); ?>
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</SELECT>
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</td>
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</tr>
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<tr><td colspan="8" height='15'> </td></tr>
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<tr>
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<td colspan="8">
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<div id="div_reponse" >
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</div>
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</td>
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</tr>
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</tbody>
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</table>
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<div id="div_statutacte">
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</div>
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<div id="div_messages">
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</div>
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