Files
Antrean-Reguler/application/views/pasien/form_pasien.php
2025-05-14 12:02:52 +07:00

223 lines
14 KiB
PHP

<section class="content-header">
<h1>
<small></small>
</h1>
<ol class="breadcrumb">
<li><a href="<?php echo base_url()?>index.php"><i class="fa fa-dashboard"></i> Dashboard</a></li>
<li><a href="<?php echo base_url()?>index.php/ps_pasien">Data Pasien</a></li>
<li class="active"><?php echo $title;?></li>
</ol>
</section>
<section class="content">
<div class="row">
<div class="col-xs-12">
<div class="box">
<div class="box-header with-border">
<h3 class="box-title"><?php echo $title; ?></h3>
</div>
<div class="box-body">
<?php if(validation_errors()){ ?>
<div class="alert alert-danger alert-dismissable">
<button type="button" class="close" data-dismiss="alert" aria-hidden="true">&times;</button>
<h4><i class="icon fa fa-ban"></i> Alert!</h4>
<?php echo validation_errors() ?>
</div>
<?php }
$setdisabled ="";
$setidedit ="";
$settgl_daftar ="";
$settgl_periksa ="";
$setbarcode ="";
$setno_antrian ="";
$setno_klinik ="";
$setno_rm ="";
$setklinik ="";
$setshift ="";
$setket_online ="";
$setket_konsul ="";
$setket_fasttrack ="";
$setpembayaran ="";
if ($actionform=="prosesview"){
$setdisabled="disabled=''";
}
if ($actionform!="prosesadd"){
$setidedit =$mp->row('pp_id');
$settgl_daftar =$mp->row('pp_tanggal_datang');
$settgl_periksa =$mp->row('pp_tanggal_periksa');
$setbarcode =$mp->row('pp_barcode');
$setno_antrian =$mp->row('pp_nomor_antrian');
$setno_klinik =$mp->row('pp_nomor_antrian_klinik');
$setno_rm =$mp->row('pp_rekamedik');
$setklinik =$mp->row('pp_klinik_id');
$setshift =$mp->row('pp_shift');
$setket_online =$mp->row('pp_pendaftaran_online');
$setket_konsul =$mp->row('pp_konsul');
$setket_fasttrack =$mp->row('pp_fasttrack');
$setpembayaran =$mp->row('pp_pembayaran');
}
?>
<form class="form-horizontal" id="form" action="<?php echo(base_url()); ?>index.php/ps_pasien/<?php echo $actionform; ?>" method="post" autocomplete="off">
<div class="box-body">
<div class="form-group">
<label for="tgldaftar" class="col-sm-2 control-label">Tanggal Daftar</label>
<div class="col-sm-6">
<input type="hidden" name="id" value="<?php echo $setidedit;?>"/>
<input id="tgldaftar" class="form-control" disabled="" name="tgldaftar" type="text" placeholder="Masukan Tanggal Daftar" autocomplete="off" value="<?php echo $settgl_daftar;?>"/>
</div>
</div>
</div>
<div class="box-body">
<div class="form-group">
<label for="tglperiksa" class="col-sm-2 control-label">Tanggal Periksa</label>
<div class="col-sm-6">
<input id="tglperiksa" class="form-control" disabled="" name="tglperiksa" type="text" placeholder="Masukan Tanggal Periksa" autocomplete="off" value="<?php echo $settgl_periksa;?>"/>
</div>
</div>
</div>
<div class="box-body">
<div class="form-group">
<label for="nobarcode" class="col-sm-2 control-label">No Barcode</label>
<div class="col-sm-6">
<input id="nobarcode" class="form-control" disabled="" name="nobarcode" type="text" placeholder="Masukan Barcode" autocomplete="off" value="<?php echo $setbarcode;?>"/>
</div>
</div>
</div>
<div class="box-body">
<div class="form-group">
<label for="noantrian" class="col-sm-2 control-label">No Antrian</label>
<div class="col-sm-6">
<input id="noantrian" class="form-control" disabled="" name="noantrian" type="text" placeholder="Masukan Nomor Antrian" autocomplete="off" value="<?php echo $setno_antrian;?>"/>
</div>
</div>
</div>
<div class="box-body">
<div class="form-group">
<label for="noklinik" class="col-sm-2 control-label">No Klinik</label>
<div class="col-sm-6">
<input id="noklinik" class="form-control" disabled="" name="noklinik" type="text" placeholder="Belum Mendapatkan Antrian Klinik" autocomplete="off" value="<?php echo $setno_klinik;?>"/>
</div>
</div>
</div>
<div class="box-body">
<div class="form-group">
<label for="norek" class="col-sm-2 control-label">No Rekamedik</label>
<div class="col-sm-6">
<input id="norek" class="form-control" <?php echo $setdisabled; ?> name="norek" type="number" placeholder="Masukan Nomor Rekamedik" autocomplete="off" value="<?php echo $setno_rm;?>"/>
</div>
</div>
</div>
<div class="box-body">
<div class="form-group">
<label for="klinik" class="col-sm-2 control-label">Klinik</label>
<div class="col-sm-6">
<select disabled="" <?php //echo $setdisabled; ?> onchange="list_shift()" id="klinik" name="klinik" class="form-control select" >
<option value="">Pilih Klinik</option>
<?php
foreach ($mk as $dat) {
$select="";
if($setklinik==$dat->mk_id){$select="selected='selected'";}
echo "<option value='".$dat->mk_id."'".$select.">".$dat->mk_nama."</option>";
}
?>
</select>
</div>
</div>
</div>
<script>
var url_data="<?php echo base_url();?>index.php/";
function list_shift(a){
document.getElementById("shift").value = "0";
var items="";
var pilih="selected='selected'";
$("#shift").html("");
$.ajax({
type: "POST",
url: url_data+"ps_pasien/datashift",
dataType: "json",
data: "idklinik="+$('#klinik').val(),
success: function(result) {
items+="<option value='"+''+"' >"+'Pilih Shift'+"</option>";
$.each(result, function(index, value) {
items+=value.datashift;
});
$("#shift").html(items);
}
});
}
</script>
<div class="box-body">
<div class="form-group">
<label for="shift" class="col-sm-2 control-label">Shift</label>
<div class="col-sm-6">
<select disabled="" <?php //echo $setdisabled; ?> id="shift" name="shift" class="form-control select">
<option value=""> Pilih Shift </option>
<?php
foreach ($mk as $dat) {
$select="";
if($setklinik==$dat->mk_id){
$jumshift=$dat->mk_shift;
$jamshift=$dat->mk_jam_shift;
$pecahjamshift = explode("|",$jamshift);
$numpecah = 0;
for($i=1;$i<=$jumshift;$i++){
if($i==$setshift){$select="selected='selected'";
}else{$select="";}
echo "<option value='$i' $select >Shift $i &plusmn Mulai Pukul $pecahjamshift[$numpecah] </option>";
$numpecah++;
}
}
}
?>
</select>
</div>
</div>
</div>
<div class="box-body">
<div class="form-group">
<label class="col-sm-2 control-label">Keterangan</label>
<div class="col-sm-6">
<label class="control-label">
<?php
$cek=0;
if ($setket_online){echo "<code>PENDAFTARAN ONLINE</code> ";$cek=1;}
if ($setket_fasttrack){echo "<code>FASTTRACK</code> ";$cek=1;}
if ($setket_konsul){echo "<code>KONSUL</code> ";$cek=1;}
if ($cek==0){echo "<b>TIDAK ADA KETERANGAN</b>";}
?>
</label>
</div>
</div>
</div>
<div class="box-body">
<div class="form-group">
<label for="pembayaran" class="col-sm-2 control-label">Pembayaran</label>
<div class="col-sm-6">
<select disabled="" <?php //echo $setdisabled; ?> id="pembayaran" name="pembayaran" class="form-control select" >
<option value="">Pilih Pembayaran</option>
<option value="1" <?php if($setpembayaran==1){echo "selected='selected'";}?> >UMUM / JKMM / SPM / JAMPERSAL / T4</option>
<option value="2" <?php if($setpembayaran==2){echo "selected='selected'";}?> >JKN</option>
</select>
</div>
</div>
</div>
<div class="box-footer">
<a href="<?php echo base_url();?>index.php/ps_pasien" class="btn btn-default">Cancel</a>
<?php if ($actionform!="prosesview"){ ?>
<button type="submit" class="btn btn-warning">Submit</button>
<?php } ?>
</div>
</div>
</form>
</div>
</div>
</div>
</div>
</section>