X-Git-Url: https://git.plutz.net/?p=confetti;a=blobdiff_plain;f=templates%2Fedit_prescription.sh;fp=templates%2Fedit_prescription.sh;h=4701ebb813a51f42671ce3e21325ade4960c93b3;hp=b9162582b9d2bfafae735d058999c9522c925361;hb=015242823eb4a79cf615bef6951b0af6bd0a5b01;hpb=c8980226006bdd5a9d518e7d3221dc3d527be321

diff --git a/templates/edit_prescription.sh b/templates/edit_prescription.sh
index b916258..4701ebb 100755
--- a/templates/edit_prescription.sh
+++ b/templates/edit_prescription.sh
@@ -21,6 +21,63 @@ cat <<END_HTML
 <form class="prescription" action="?action=update_prescription" method="POST">
 <input type="hidden" name="prescription" value="${mpx[prescription]}">
 
+<table class="type"><tbody>
+  <tr>
+    <th>$(l10n doctor)</th>
+    <th>$(l10n dentist)</th>
+    <th>$(l10n noprescription)</th>
+    <th>$(l10n altpractition)</th>
+  </tr>
+  <tr>
+    <td class="selfpaid doctor">
+      <input type=radio name=presctype id=doctor_selfpaid value=doctor_selfpaid>
+      <label for=doctor_selfpaid>$(l10n selfpaid)</label>
+    </td>
+    <td class="selfpaid dentist">
+      <input type=radio name=presctype id=dentist_selfpaid value=dentist_selfpaid>
+      <label for=dentist_selfpaid>$(l10n selfpaid)</label>
+    </td>
+    <td class="selfpaid noprescription">
+      <input type=radio name=presctype id=noprescription_selfpaid value=noprescription_selfpaid>
+      <label for=noprescription_selfpaid>$(l10n selfpaid)</label>
+    </td>
+    <td class="selfpaid altpractition">
+      <input type=radio name=presctype id=altpractition_selfpaid value=altpractition_selfpaid>
+      <label for=altpractition_selfpaid>$(l10n selfpaid)</label>
+    </td>
+  </tr>
+  <tr>
+    <td class="private doctor">
+      <input type=radio name=presctype id=doctor_private value=doctor_private>
+      <label for=doctor_private>$(l10n private)</label>
+    </td>
+    <td class="private dentist">
+      <input type=radio name=presctype id=dentist_private value=dentist_private>
+      <label for=dentist_private>$(l10n private)</label>
+    </td>
+    <td class="private noprescription">
+    </td>
+    <td class="private altpractition">
+      <input type=radio name=presctype id=altpractition_private value=altpractition_private>
+      <label for=altpractition_private>$(l10n private)</label>
+    </td>
+  </tr>
+  <tr>
+    <td class="compulsory doctor">
+      <input type=radio name=presctype id=doctor_compulsory value=doctor_compulsory>
+      <label for=doctor_compulsory>$(l10n compulsory)</label>
+    </td>
+    <td class="compulsory dentist">
+      <input type=radio name=presctype id=dentist_compulsory value=dentist_compulsory>
+      <label for=dentist_compulsory>$(l10n compulsory)</label>
+    </td>
+    <td class="compulsory noprescription">
+    </td>
+    <td class="compulsory altpractition">
+    </td>
+  </tr>
+</tbody></table>
+
 <fieldset class="baseinfo">
 <label for="insurance">$(l10n insurance)</label>
 <input id="insurance" name="insurance" value="${mpx[insurance]}" placeholder="$(l10n insurance)">
@@ -37,7 +94,7 @@ cat <<END_HTML
 </fieldset>
 
 <fieldset class="misc">
-<h1>$(l10n therapy_prescription)</h1>
+<h1 id="${mpx[prescription]}">$(l10n therapy_prescription)</h1>
 
 <label for="addcontrib">$(l10n addcontrib)</label>
 <input id="addcontrib" name="addcontrib" value="${mpx[addcontrib]}" placeholder="$(l10n addcontrib)">
@@ -94,11 +151,18 @@ cat <<END_HTML
 <input id="quantity_weekly1" name="quantity_weekly1" value="${mpx[quantity_weekly1]}" placeholder="$(l10n quantity_weekly)">
 
 <br>
+<p class="indicator_codes">
 <label for="indicator">$(l10n indicator)</label>
 <input id="indicator" name="indicator" value="${mpx[indicator]}" placeholder="$(l10n indicator)">
 <br>
 <label for="icd10">$(l10n icd10)</label>
 <input id="icd10" name="icd10" value="${mpx[icd10]}" placeholder="$(l10n icd10)">
+</p>
+<br>
+<p class="indicator_reading">
+<label for="indicator_reading">$(l10n indicator_reading)</label>
+<textarea id="indicator_reading" name="indicator_reading" placeholder="$(l10n indicator_reading)">${mpx[indicator_reading]}</textarea>
+</p>
 </fieldset>
 
 <fieldset class="controls">