Files
simrs-jatim/ranap/form_f2.php
2024-04-19 14:04:41 +07:00

374 lines
21 KiB
PHP

<?php
$sql_rsm_pulang = "SELECT * FROM t_kajianawalmedis WHERE IDXRANAP = '".$id_admission."'";
$get_rsm_pulang = $db->query($sql_rsm_pulang);
$found = $get_rsm_pulang->numRows();
$dat_rp = $get_rsm_pulang->fetchAll()[0];
$IDXF2 = ($found > 0) ? $dat_rp['IDXF2'] : null;
?>
<form ame="kajian_awal_medis" method="post" id="kajian_awal_medis">
<input type="hidden" name="input[IDXF2]" value="<?php echo $IDXF2;?>" />
<input type="hidden" name="input[IDXRANAP]" id="idx_kajian" value="<?php echo $id_admission;?>" />
<input type="hidden" name="input[NOMR]" id="nomr_kajian" value="<?php echo $nomr;?>" />
<input type="hidden" name="input[TANGGALMASUK]" value="<?php echo $masukrs;?>" />
<fieldset class="fieldset">
<label class="col-form-label col-sm-12 pt-0" style="text-align:center"><h5>KAJIAN AWAL MEDIS RAWAT INAP<br>( Diisi Dengan Temuan Positif )</h5></label>
<div class="row">
<fieldset class="form-group">
<div class="row">
<div class="col-sm-6">
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Keluhan Utama</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<textarea name="input[KELUHANUTAMA]" cols="60" rows="5" class="form-control required" tabindex="1" required><?=$dat_rp['KELUHANUTAMA']?></textarea>
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Pemeriksaan Fisik :</label>
<div class="col-sm-8 pt-0" style="text-align:left">
&nbsp;
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Kesadaran</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[KESADARAN]" cols="60" rows="5" class="form-control text" value="<?=$dat_rp['KESADARAN']?>" tabindex="3" required>
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Pernafasan : Frekuensi</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<div class="input-group">
<input type="text" class="form-control mask-decimal" name="input[NAFAS]" value="<?=$dat_rp['NAFAS']?>" tabindex="4" required>
<div class="input-group-append">
<span class="input-group-text " id="basic-addon2">/menit</span>
</div>
</div>
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Nadi : Frekuensi</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<div class="input-group">
<input type="text" class="form-control mask-decimal" name="inpur[NADI]" value="<?=$dat_rp['NADI']?>" tabindex="6" required>
<div class="input-group-append">
<span class="input-group-text " id="basic-addon2">/menit</span>
</div>
</div>
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Tekanan Darah Lengan Kanan</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<div class="input-group">
<input type="text" class="form-control mask-decimal" name="input[DARAHKANAN]" value="<?=$dat_rp['DARAHKANAN']?>" tabindex="8" required>
<div class="input-group-append">
<span class="input-group-text " id="basic-addon2">mmHg</span>
</div>
</div>
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Suhu (&deg;Celcius) : Aksila</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<div class="input-group">
<input type="text" class="form-control mask-decimal" name="input[AKSILA]" value="<?=$dat_rp['AKSILA']?>" tabindex="10">
<div class="input-group-append">
<span class="input-group-text " id="basic-addon2">&deg;C</span>
</div>
</div>
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Kulit</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[KULIT]" cols="60" rows="5" class="form-control text" value="<?=$dat_rp['KULIT']?>" tabindex="12">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Telinga</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[TELINGA]" cols="60" rows="5" class="form-control text" value="<?=$dat_rp['TELINGA']?>" tabindex="14">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Rongga Mulut dan Tenggorokan</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[MULUT]" id="mulut" class="form-control text" value="<?=$dat_rp['MULUT']?>" tabindex="16">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Bagian Kepala Lain</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[KEPALALAIN]" class="form-control text" value="<?=$dat_rp['KEPALALAIN']?>" tabindex="18">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Kelenjartiroid</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[KELENJARTIROID]" class="form-control text" value="<?=$dat_rp['KELENJARTIROID']?>" tabindex="20">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Thoraks</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[THORAKS]" class="form-control text" value="<?=$dat_rp['THORAKS']?>" tabindex="22">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Paru</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[PARU]" class="form-control text" value="<?=$dat_rp['PARU']?>" tabindex="24">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Abdomen</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[ABDOMEN]" class="form-control text" value="<?=$dat_rp['ABDOMEN']?>" tabindex="26">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Lien</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[LIEN]" class="form-control text" value="<?=$dat_rp['LIEN']?>" tabindex="28">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Punggung</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[PUNGGUNG]" class="form-control text" value="<?=$dat_rp['PUNGGUNG']?>" tabindex="30">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Kelamin</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[KELAMIN]" class="form-control text" value="<?=$dat_rp['KELAMIN']?>" tabindex="32">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">&nbsp;</label>
<div class="col-sm-8 pt-0" style="text-align:left">
&nbsp;
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Pemeriksaan Tambahan :</label>
<div class="col-sm-8 pt-0" style="text-align:left">
&nbsp;
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Laboratorium</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<textarea name="input[LABORATORIUM]" cols="60" rows="5" class="form-control text" tabindex="35"><?=$dat_rp['LABORATORIUM']?></textarea>
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Lain-lain</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<textarea name="input[TAMBAHANLAIN]" cols="60" rows="5" class="form-control text" tabindex="37"><?=$dat_rp['TAMBAHANLAIN']?></textarea>
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Permasalahan :</label>
<div class="col-sm-8 pt-0" style="text-align:left">
&nbsp;
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Medis</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<textarea name="input[MASALAHMEDIS]" cols="60" rows="5" class="form-control text" tabindex="39"><?=$dat_rp['MASALAHMEDIS']?></textarea>
</div>
</div>
</div>
<div class="col-sm-6">
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Riwayat Penyakit</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<textarea name="input[RIWAYATPENYAKIT]" cols="60" rows="5" class="form-control text" placeholder="(Riwayat penyakit sekarang, riwayat penyakit dahulu, riwayat pengobatan, riwayat penyakit keluarga, dll)" tabindex="2" required><?=$dat_rp['RIWAYATPENYAKIT']?></textarea>
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">&nbsp;</label>
<div class="col-sm-8 pt-0" style="text-align:left">
&nbsp;
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">&nbsp;</label>
<div class="col-sm-8 pt-0" style="text-align:left">
&nbsp;
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Jenis</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[NAFASJENIS]" cols="60" rows="5" class="form-control text" value="<?=$dat_rp['NAFASJENIS']?>" tabindex="5">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Jenis</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[NADIJENIS]" cols="60" rows="5" class="form-control text" value="<?=$dat_rp['NADIJENIS']?>" tabindex="7">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Tekanan Darah Lengan Kiri</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<div class="input-group">
<input type="text" class="form-control mask-decimal" name="input[DARAHKIRI]" value="<?=$dat_rp['DARAHKIRI']?>" tabindex="9">
<div class="input-group-append">
<span class="input-group-text " id="basic-addon2">mmHg</span>
</div>
</div>
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Suhu (&deg;Celcius) : Rektal</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<div class="input-group">
<input type="text" class="form-control mask-decimal" name="input[REKTAL]" value="<?=$dat_rp['REKTAL']?>" tabindex="11">
<div class="input-group-append">
<span class="input-group-text " id="basic-addon2">&deg;C</span>
</div>
</div>
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Kepala</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" class="form-control" name="input[KEPALA]" value="<?=$dat_rp['KEPALA']?>" tabindex="13">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Hidung</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[HIDUNG]" class="form-control text" value="<?=$dat_rp['HIDUNG']?>" tabindex="15">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Mata</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[MATA]" cols="60" rows="5" class="form-control text" value="<?=$dat_rp['MATA']?>" tabindex="17"><BR>
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Leher</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[LEHER]" class="form-control text" value="<?=$dat_rp['LEHER']?>" tabindex="19">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Bagian Leher Lain</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[LEHERLAIN]" class="form-control text" value="<?=$dat_rp['LEHERLAIN']?>" tabindex="21">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Jantung</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[JANTUNG]" class="form-control text" value="<?=$dat_rp['JANTUNG']?>" tabindex="23">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Bagian Thoraks Lain</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[THORAKSLAIN]" cols="60" rows="5" class="form-control text" value="<?=$dat_rp['THORAKSLAIN']?>" tabindex="25">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Hati</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[HATI]" class="form-control text" value="<?=$dat_rp['HATI']?>" tabindex="27">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Bagian Abdomen Lain</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[ABDOMENLAIN]" class="form-control text" value="<?=$dat_rp['ABDOMENLAIN']?>" tabindex="29">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Ekstremitas</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[EKSTREMITAS]" class="form-control text" value="<?=$dat_rp['EKSTREMITAS']?>" tabindex="31">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Rectum</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[RECTUM]" class="form-control text" value="<?=$dat_rp['RECTUM']?>" tabindex="33">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Sistim Syaraf</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="text" name="input[SYARAF]" class="form-control text" value="<?=$dat_rp['SYARAF']?>" tabindex="34">
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">&nbsp;</label>
<div class="col-sm-8 pt-0" style="text-align:left">
&nbsp;
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Radiologi</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<textarea name="input[RADIOLOGI]" cols="60" rows="5" class="form-control text" tabindex="36"><?=$dat_rp['RADIOLOGI']?></textarea>
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">Diagnosis Medis</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<textarea name="input[DIAGNOSISMEDIS]" cols="60" rows="5" class="form-control text" tabindex="38"><?=$dat_rp['DIAGNOSISMEDIS']?></textarea>
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">&nbsp;</label>
<div class="col-sm-8 pt-0" style="text-align:left">
&nbsp;
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right"> Keperawatan</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<textarea name="input[MASALAHKEPERAWATAN]" cols="60" rows="5" class="form-control text" tabindex="40"><?=$dat_rp['MASALAHKEPERAWATAN']?></textarea>
</div>
</div>
<div class="form-group row">
<label class="col-form-label col-sm-4 pt-0" style="text-align:right">&nbsp;</label>
<div class="col-sm-8 pt-0" style="text-align:left">
<input type="button" name="Submit" id="simpankajianmedis" value="Simpan" class="btn btn-primary" tabindex="41"/>
</div>
</div>
</div>
</div>
</fieldset>
</div>
</fieldset>
</form>
<div id="valid_kajian_awal"></div>
<script>
$(document).ready(function(){
$.get("<?php echo _BASE_;?>ranap/save_kajian_awal.php",{get_data:true,NOMR:$("#nomr_kajian").val(),IDXRANAP:$("#idx_kajian").val()},function(data)
{
$("#valid_kajian_awal").html(data.html);
},"json");
$('#simpankajianmedis').click(function(){
$.post('<?php echo _BASE_;?>ranap/save_kajian_awal.php',$('#kajian_awal_medis').serialize()+"&save=1",function(data){
Toast.fire({title:data.message,type:data.type,onClose : function(){
window.location.reload();
}});
},"json");
});
});
</script>