date("Y", $diff) - $base_year, "months_total" => (date("Y", $diff) - $base_year) * 12 + date("n", $diff) - 1, "months" => date("n", $diff) - 1, "days_total" => floor($diff_secs / (3600 * 24)), "days" => date("j", $diff) - 1, "hours_total" => floor($diff_secs / 3600), "hours" => date("G", $diff), "minutes_total" => floor($diff_secs / 60), "minutes" => (int) date("i", $diff), "seconds_total" => $diff_secs, "seconds" => (int) date("s", $diff) ); } //$a = datediff("1979-02-07", "2009-08-24"); //echo 'umur '.$a['years'].' tahun '.$a['months'].' bulan'; */ ?>

Identitas Pasien

Nama Lengkap Pasien	name="NAMA" size="30" value="NAMA?>" id="AWAL" />	Jenis Kelamin : JENISKELAMIN=="L" || $m_pasien->JENISKELAMIN=="l" || $_POST['JENISKELAMIN'] =="1")echo "Checked";?>/> Laki-laki JENISKELAMIN=="P" || $_POST['JENISKELAMIN'] =="2")echo "Checked";?>/> Perempuan Status Perkawinan : STATUS=="1" || $_POST['KAWIN']=="1")echo "Checked";?>/> Belum Kawin STATUS=="2" || $_POST['KAWIN']=="2")echo "Checked";?> /> Kawin STATUS=="3" || $_POST['KAWIN']=="3")echo "Checked";?>/> Janda / Duda Pendidikan Terakhir : PENDIDIKAN=="1" || $_POST['PENDIDIKAN']=="1" )echo "Checked";?> /> SD PENDIDIKAN=="2" || $_POST['PENDIDIKAN']=="2" )echo "Checked";?> /> SLTP PENDIDIKAN=="3" || $_POST['PENDIDIKAN']=="3" )echo "Checked";?> /> SMU PENDIDIKAN=="4" || $_POST['PENDIDIKAN']=="4" )echo "Checked";?> /> D3/Akademik PENDIDIKAN=="5" || $_POST['PENDIDIKAN']=="5" )echo "Checked";?> /> Universitas Agama : AGAMA=="1" || $_POST['AGAMA']=="1" )echo "Checked";?> /> Islam AGAMA=="2" || $_POST['AGAMA']=="2" )echo "Checked";?>/> Kristen Protestan AGAMA=="3" || $_POST['AGAMA']=="3" )echo "Checked";?>/> Katholik AGAMA=="4" || $_POST['AGAMA']=="4" )echo "Checked";?>/> Hindu AGAMA=="5" || $_POST['AGAMA']=="5" )echo "Checked";?>/> Budha AGAMA=="6" || $_POST['AGAMA']=="6" || $_POST['AGAMA']=="7" )echo "Checked";?>/> Lain - lain
Tempat Tanggal Lahir	Tempat ex : 1999/09/29
Umur Pasien
Alamat Pasien
Kelurahan
Kecamatan
Kota
No Telepon / HP Pasien
No KTP
Nama Suami / Orang Tua Pasien
Pekerjaan Pasien / Orang Tua