git.plutz.net Git - confetti/blob - templates/edit_prescription.sh

   1 # Copyright 2016 Paul Hänsch
   2 #
   3 # This file is part of Confetti.
   4 #
   5 # Confetti is free software: you can redistribute it and/or modify
   6 # it under the terms of the GNU Affero General Public License as published by
   7 # the Free Software Foundation, either version 3 of the License, or
   8 # (at your option) any later version.
   9 #
  10 # Confetti is distributed in the hope that it will be useful,
  11 # but WITHOUT ANY WARRANTY; without even the implied warranty of
  12 # MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE.  See the
  13 # GNU Affero General Public License for more details.
  14 #
  15 # You should have received a copy of the GNU Affero General Public License
  16 # along with Confetti.  If not, see <http://www.gnu.org/licenses/>.
  17
  18 check(){ [ "$1" = "$2" ] && printf checked}
  19 [ -z $mpx[presctype] ] && mpx[presctype]=doctor_compulsory
  20
  21 cat <<END_HTML
  22 <form class="prescription" action="?action=update_prescription" method="POST">
  23 <input type="hidden" name="prescription" value="${mpx[prescription]}">
  24
  25 <label class=presctype>$(l10n doctor):</label>
  26 <input type=radio name=presctype id=doctor_selfpaid value=doctor_selfpaid $(check "$mpx[presctype]" doctor_selfpaid)>
  27 <label for=doctor_selfpaid>$(l10n selfpaid)</label>
  28 <input type=radio name=presctype id=doctor_private value=doctor_private $(check "$mpx[presctype]" doctor_private)>
  29 <label for=doctor_private>$(l10n private)</label>
  30 <input type=radio name=presctype id=doctor_compulsory value=doctor_compulsory $(check "$mpx[presctype]" doctor_compulsory)>
  31 <label for=doctor_compulsory>$(l10n compulsory)</label>
  32 <br>
  33
  34 <label class=presctype>$(l10n dentist):</label>
  35 <input type=radio name=presctype id=dentist_selfpaid value=dentist_selfpaid $(check "$mpx[presctype]" dentist_selfpaid)>
  36 <label for=dentist_selfpaid>$(l10n selfpaid)</label>
  37 <input type=radio name=presctype id=dentist_private value=dentist_private $(check "$mpx[presctype]" dentist_private)>
  38 <label for=dentist_private>$(l10n private)</label>
  39 <input type=radio name=presctype id=dentist_compulsory value=dentist_compulsory $(check "$mpx[presctype]" dentist_compulsory)>
  40 <label for=dentist_compulsory>$(l10n compulsory)</label>
  41 <br>
  42
  43 <label class=presctype>$(l10n noprescription):</label>
  44 <input type=radio name=presctype id=noprescription_selfpaid value=noprescription_selfpaid $(check "$mpx[presctype]" noprescription_selfpaid)>
  45 <label for=noprescription_selfpaid>$(l10n selfpaid)</label>
  46 <br>
  47
  48 <label class=presctype>$(l10n altpractition):</label>
  49 <input type=radio name=presctype id=altpractition_selfpaid value=altpractition_selfpaid $(check "$mpx[presctype]" altpractition_selfpaid)>
  50 <label for=altpractition_selfpaid>$(l10n selfpaid)</label>
  51 <input type=radio name=presctype id=altpractition_private value=altpractition_private $(check "$mpx[presctype]" altpractition_private)>
  52 <label for=altpractition_private>$(l10n private)</label>
  53 <br>
  54
  55 <fieldset class="baseinfo">
  56 <label for="insurance">$(l10n insurance)</label>
  57 <input id="insurance" name="insurance" value="${mpx[insurance]}" placeholder="$(l10n insurance)">
  58 <br>
  59 <label for="name">$(l10n name)</label>
  60 <label for="bday">$(l10n bday)</label>
  61 <br>
  62 <textarea id="name" name="name" placeholder="$(l10n name)">${mpx[name]}</textarea>
  63 <input id="bday" name="bday" value="${mpx[bday]}" placeholder="$(l10n bday)">
  64
  65 <br>
  66 <label for="date">$(l10n date)</label>
  67 <input id="date" name="date" value="${mpx[date]}" placeholder="$(l10n date)">
  68 </fieldset>
  69
  70 <fieldset class="misc">
  71 <h1 id="${mpx[prescription]}">$(l10n therapy_prescription)</h1>
  72
  73 <label for="addcontrib">$(l10n addcontrib)</label>
  74 <input id="addcontrib" name="addcontrib" value="${mpx[addcontrib]}" placeholder="$(l10n addcontrib)">
  75 <label for="contribconfirm">$(l10n contribconfirm)</label>
  76 <input id="contribconfirm" name="contribconfirm" value="${mpx[contribconfirm]}" placeholder="$(l10n contribconfirm)">
  77 <input type="checkbox" id="contribreceipt" name="contribreceipt" value="true" ${mpx[contribreceipt]:+checked}>
  78 <label for="contribreceipt">$(l10n contribreceipt)</label>
  79 </fieldset>
  80
  81 <input type="checkbox" id="prescreviewed" name="prescreviewed" value="true" ${mpx[prescreviewed]:+checked}>
  82 <label for="prescreviewed">$(l10n prescreviewed)</label>
  83
  84 <fieldset class="catalogue">
  85 <h2>$(l10n prescription_by_catalogue)</h2>
  86 <input type="radio" id="prescfirst" name="prescno" value="first" $(check "$mpx[prescno]" first)>
  87 <label for="prescfirst">$(l10n prescfirst)</label>
  88 <br>
  89 <input type="radio" id="prescfollow1" name="prescno" value="follow1" $(check "$mpx[prescno]" follow1)>
  90 <label for="prescfollow1">$(l10n prescfollow1)</label>
  91 <br>
  92 <input type="radio" id="prescfollow2" name="prescno" value="follow2" $(check "$mpx[prescno]" follow2)>
  93 <label for="prescfollow2">$(l10n prescfollow2)</label>
  94 <br>
  95 <input type="radio" id="prescother" name="prescno" value="other" $(check "$mpx[prescno]" other)>
  96 <label for="prescother">$(l10n prescother)</label>
  97 <br>
  98 <input type="radio" id="presccontinual" name="prescno" value="continual" $(check "$mpx[prescno]" continual)>
  99 <label for="presccontinual">$(l10n presccontinual)</label>
 100
 101 <br>
 102 <input type="checkbox" id="grouptherapy" name="grouptherapy" value="true" ${mpx[grouptherapy]:+checked}>
 103 <label for="grouptherapy">$(l10n grouptherapy)</label>
 104 <br>
 105 <input type="checkbox" id="housecall" name="housecall" value="true" ${mpx[housecall]:+checked}>
 106 <label for="housecall">$(l10n housecall)</label>
 107 <br>
 108 <input type="checkbox" id="report" name="report" value="true" ${mpx[report]:+checked}>
 109 <label for="report">$(l10n report)</label>
 110 </fieldset>
 111
 112 <fieldset class="description">
 113 <label for="quantity">$(l10n quantity)</label>
 114 <label for="remidy">$(l10n remidy)</label>
 115 <label for="quantity_weekly">$(l10n quantity_weekly)</label>
 116 <p>
 117 <input id="quantity" name="quantity" value="${mpx[quantity]}" placeholder="$(l10n quantity)">
 118 <textarea id="remidy" name="remidy" placeholder="$(l10n remidy)">${mpx[remidy]}</textarea>
 119 <input id="quantity_weekly" name="quantity_weekly" value="${mpx[quantity_weekly]}" placeholder="$(l10n quantity_weekly)">
 120 </p>
 121
 122 $( for n in {0..10}; do
 123   if [ "$n" -eq 0 -o -n "${mpx[quantity$n]}" -o -n "${mpx[remidy$n]}" -o -n "${mpx[quantity_weekly$n]}" ]; then
 124     printf '<input class="trailbtn" type="checkbox" checked="checked" />'
 125   else
 126     printf '<input class="trailbtn" type="checkbox" />'
 127   fi
 128   printf '<p class="trailbox">
 129     <input class="quantity" name="quantity" placeholder="%s" value="%s">
 130     <textarea class="remidy" name="remidy" placeholder="%s">%s</textarea>
 131     <input class="quantity_weekly" name="quantity_weekly" placeholder="%s" value="%s">
 132     </p>
 133   ' "$(l10n quantity)" "${mpx[quantity$n]}" \
 134     "$(l10n remidy)" "${mpx[remidy$n]}" \
 135     "$(l10n quantity_weekly)" "${mpx[quantity_weekly$n]}"
 136 done )
 137
 138 <br>
 139 <p class="indicator_codes">
 140 <label for="indicator">$(l10n indicator)</label>
 141 <input id="indicator" name="indicator" value="${mpx[indicator]}" placeholder="$(l10n indicator)">
 142 <br>
 143 <label for="icd10">$(l10n icd10)</label>
 144 <input id="icd10" name="icd10" value="${mpx[icd10]}" placeholder="$(l10n icd10)">
 145 </p>
 146 <br>
 147 <p class="indicator_reading">
 148 <label for="indicator_reading">$(l10n indicator_reading)</label>
 149 <textarea id="indicator_reading" name="indicator_reading" placeholder="$(l10n indicator_reading)">${mpx[indicator_reading]}</textarea>
 150 </p>
 151 <br>
 152 <p class="issuer">
 153   <label>$(l10n issuer)</label>
 154   <input type="radio" name="issuer_select" value="list" id="issuer_select_list" checked /><label for="issuer_select_list">$(l10n issuer_from_list)</label><!--
 155   --><input type="radio" name="issuer_select" value="other" id="issuer_other"><label for="issuer_other">$(l10n issuer_other)</label>
 156   <select class="item" name="issuer">
 157     <option value="" disabled="disabled" $([ -z "${mpx[issuer]}" ] && printf 'selected' )>$(l10n issuer)...</option>
 158     $(list_prescription_issuers |while read f; do
 159       [ "$f" = "$mpx[issuer]" ] \
 160       && printf '<option value="%s" selected>%s</option>' "$f" "$f" \
 161       || printf '<option value="%s">%s</option>' "$f" "$f"
 162     done)
 163   </select>
 164   <input type="text" name="issuer_other" value="" placeholder="$(l10n issuer)..." />
 165 </p>
 166 </fieldset>
 167
 168 <fieldset class="controls">
 169 <button type="submit" name="action" value="save">$(l10n save)</button>
 170 <button type="submit" name="action" value="cancel">$(l10n cancel)</button>
 171 <button type="submit" name="action" value="delete">$(l10n delete)</button>
 172 </fieldset>
 173
 174 </form>
 175 END_HTML