| Server IP : 162.214.74.102 / Your IP : 216.73.216.192 Web Server : Apache System : Linux dedi-4363141.lrsys.com.br 3.10.0-1160.119.1.el7.tuxcare.els25.x86_64 #1 SMP Wed Oct 1 17:37:27 UTC 2025 x86_64 User : lrsys ( 1015) PHP Version : 5.6.40 Disable Function : exec,passthru,shell_exec,system MySQL : ON | cURL : ON | WGET : ON | Perl : ON | Python : ON | Sudo : ON | Pkexec : ON Directory : /home/lrsys/www/lrsys_apps/dialogo/application/plugins/module_med_scheduling/views/history/ |
Upload File : |
<div class="wrapper wrapper-content">
{$action = 'create'}
{$title_action = $_L['Scheduling_History_Add']}
{if (!empty($history))}
{$action = 'update'}
{$title_action = $_L['Scheduling_History_Edit']}
{/if}
<form id='form-history' class="form-horizontal" method="post" action="{$_url}module_med_scheduling/Procedure/{$action}">
<div class="row">
<div class="col-md-3 col-sm-12">
<div class="ibox float-e-margins">
<div class="ibox-content">
<label>{$_L['Name']}</label><br/>
{if isset($patients->account)}{$patients->account}{/if}
</div>
</div>
</div>
<div class="col-md-3 col-sm-12">
<div class="ibox float-e-margins">
<div class="ibox-content">
<label>{$_L['Scheduling Age']}</label><br/>
{$patients->age}
</div>
</div>
</div>
<div class="col-md-3 col-sm-12">
<div class="ibox float-e-margins">
<div class="ibox-content">
<label>{$_L['Phone']}</label><br/>
{$patients->phone} {if $patients->phone != '' && $patients->cell_phone !=''} | {else}{$_L['Uninformed']}{/if} {$patients->cell_phone}
</div>
</div>
</div>
<div class="col-md-3 col-sm-12">
<div class="ibox float-e-margins">
<div class="ibox-content">
<label>{$_L['Email']}</label><br/>
{if $patients->email != ''}{$patients->email}{else}{$_L['Uninformed']}{/if}
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-3 col-sm-12">
<div class="ibox float-e-margins">
<div class="ibox-content">
<label>{$_L['Date']}</label><br/>
{date( $_c['df'], strtotime($scheduling->date))}
</div>
</div>
</div>
<div class="col-md-3 col-sm-12">
<div class="ibox float-e-margins">
<div class="ibox-content">
<label>{$_L['Hour']}</label><br/>
{$scheduling->hour_start} - {$scheduling->hour_finish}
</div>
</div>
</div>
<div class="col-md-3 col-sm-12">
<div class="ibox float-e-margins">
<div class="ibox-content">
<label>{$_L['Type']}</label><br/>
{$type->name}
</div>
</div>
</div>
<div class="col-md-3 col-sm-12">
<div class="ibox float-e-margins">
<div class="ibox-content">
<label>{$_L['Requester']}</label><br/>
{if $scheduling->requester_id!=null}
{$requester->account}
{else}
{$_L['Uninformed']}
{/if}
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-12">
<div class="ibox float-e-margins">
<div class="ibox-content" id="ibox_form">
<div class="alert alert-danger" id="emsg">
<span id="emsgbody"></span>
</div>
{foreach $forms as $form}
<fieldset class="history-form-content">
{* <legend data-form="form_id" class="form-title">{$form->title}</legend>*}
<h2 class="form-title" data-form="form_id">{$form->title} <input class="form-title-checkbox" type="checkbox" data-toggle="toggle" data-size="small" data-on="{$_L['Yes']}" data-off="{$_L['No']}" id="" name="formId_{$form->id}" value="Y"></h2>
<div class="row history-form">
{if count($form->questions) > 0 }
{foreach $form->questions as $question}
<div class="col-md-12 col-sm-12 col-xs-12">
<label class="control-label" for="title">
{$question->question} <small class="red">{if $question->required == 1}*{/if}</small>
</label>
{if $question->alias == 'multiple_choice'}
{if count($question['options']) > 0}
<select name="">
<option value="">{$_L['Select an option']}</option>
{foreach $question->options as $option}
<option value="{$option->name}">{$option->name}</option>
{/foreach}
</select>
{/if}
{elseif $question->alias == 'long_text'}
<textarea id="story" name="story" rows="5" cols="33"></textarea>
{elseif $question->alias == 'bollean'}
<input type="checkbox" data-toggle="toggle" data-size="small" data-on="{$_L['Yes']}" data-off="{$_L['No']}" id="questionId_{$question->id}" name="questionId_{$question->id}" value="Y">
{elseif $question->alias == 'stars'}
<input type="text" name="questionId_{$question->id}" id="questionId_{$question->id}" class="form-control {if $question->required == 1}required{/if}" {if $question->required == 1}required='required'{/if} value="" >
{elseif $question->alias == 'scale'}
<input type="text" name="questionId_{$question->id}" id="questionId_{$question->id}" class="form-control {if $question->required == 1}required{/if}" {if $question->required == 1}required='required'{/if} value="" >
{else}
<input type="text" name="questionId_{$question->id}" id="questionId_{$question->id}" class="form-control {if $question->required == 1}required{/if}" {if $question->required == 1}required='required'{/if} value="" >
{/if}
</div>
{/foreach}
{else}
<div class="alert alert-danger" id="emsg">
<span id="emsgbody">Nenhuma pergunta cadastrada</span>
</div>
{/if}
</div>
</fieldset>
{/foreach}
<div class="row" style="margin-top:20px">
<div class=" col-md-12 form-group">
<div class="col-lg-10">
{if !empty($procedure->id)}
<input type="hidden" id="procedureId" name="id" value="{$procedure->id}">
{/if}
<button class="md-btn md-btn-primary waves-effect waves-light" type="submit" id="submit">
<i class="fa fa-check"></i> {$_L['Submit']}
</button>
| <a href="{$_url}module_med_scheduling/procedure/listProcedure">{$_L['Or Cancel']}</a>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</form>
</div>