stubs for prescription

[confetti] / templates / edit_prescription.sh

diff --git a/templates/edit_prescription.sh b/templates/edit_prescription.sh
new file mode 100755 (executable)
index 0000000..d4dce32
--- /dev/null
+++ b/templates/edit_prescription.sh
@@ -0,0 +1,72 @@
+# Copyright 2016 Paul Hänsch
+#
+# This file is part of Confetti.
+# 
+# Confetti is free software: you can redistribute it and/or modify
+# it under the terms of the GNU Affero General Public License as published by
+# the Free Software Foundation, either version 3 of the License, or
+# (at your option) any later version.
+# 
+# Confetti is distributed in the hope that it will be useful,
+# but WITHOUT ANY WARRANTY; without even the implied warranty of
+# MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE.  See the
+# GNU Affero General Public License for more details.
+# 
+# You should have received a copy of the GNU Affero General Public License
+# along with Confetti.  If not, see <http://www.gnu.org/licenses/>. 
+
+cat <<END_HTML
+<form class="prescription" action="?action=update_prescription" method="POST">
+
+<label for="insurance">$(l10n insurance)</label>
+<input id="insurance" name="insurance" value="" placeholder="$(l10n insurance)">
+<label for="name">$(l10n name)</label>
+<textarea id="name" name="name" placeholder="$(l10n name)"></textarea>
+<label for="bday">$(l10n bday)</label>
+<input id="bday" name="bday" value="" placeholder="$(l10n bday)">
+
+<label for="date">$(l10n date)</label>
+<input id="date" name="date" value="" placeholder="$(l10n date)">
+
+<label for="addcontrib">$(l10n addcontrib)</label>
+<input id="addcontrib" name="addcontrib" value="" placeholder="$(l10n addcontrib)">
+<input type="checkbox" id="contribconfirm" name="contribconfirm" value="true">
+<label for="contribconfirm">$(l10n contribconfirm)</label>
+
+<h2>$(l10n prescription_by_catalogue)</h2>
+<input type="radio" id="prescfirst" name="prescno" value="first">
+<label for="prescfirst">$(l10n prescfirst)</label>
+<input type="radio" id="prescfollow1" name="prescno" value="follow1">
+<label for="prescfollow1">$(l10n prescfollow1)</label>
+<input type="radio" id="prescfollow2" name="prescno" value="follow2">
+<label for="prescfollow2">$(l10n prescfollow2)</label>
+<input type="radio" id="prescother" name="prescno" value="other">
+<label for="prescother">$(l10n prescother)</label>
+<input type="radio" id="presccontinual" name="prescno" value="continual">
+<label for="presccontinual">$(l10n presccontinual)</label>
+
+<input type="checkbox" id="grouptherapy" name="grouptherapy" value="true">
+<label for="grouptherapy">$(l10n grouptherapy)</label>
+<input type="checkbox" id="housecall" name="housecall" value="true">
+<label for="housecall">$(l10n housecall)</label>
+<input type="checkbox" id="report" name="report" value="true">
+<label for="report">$(l10n report)</label>
+
+<label for="quantity">$(l10n quantity)</label>
+<input id="quantity" name="quantity" value="" placeholder="$(l10n quantity)">
+<label for="remidy">$(l10n remidy)</label>
+<textarea id="remidy" name="remidy" placeholder="$(l10n remidy)"></textarea>
+<label for="quantity_weekly">$(l10n quantity_weekly)</label>
+<input id="quantity_weekly" name="quantity_weekly" value="" placeholder="$(l10n quantity_weekly)">
+
+<label for="indicator">$(l10n indicator)</label>
+<input id="indicator" name="indicator" value="" placeholder="$(l10n indicator)">
+<label for="icd10">$(l10n icd10)</label>
+<input id="icd10" name="icd10" value="" placeholder="$(l10n icd10)">
+
+<input type="checkbox" id="prescreviewed" name="prescreviewed" value="true">
+<label for="prescreviewed">$(l10n prescreviewed)</label>
+
+
+</form>
+END_HTML