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<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN"
"http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<title>Untitled Document</title>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">
</head>
<body>
<table width="100%" border="0" cellspacing="0" cellpadding="5">
<tr>
<td><div align="center" class="TabTitle">Illness Assessment</div></td>
</tr>
<tr>
<td><table width="100%" border="0" align="center" cellpadding="5" cellspacing="0">
<tbody>
<tr>
<td width="14%"><?php
$query="SELECT Lst FROM tbllst1l order by Num";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllAbPainProblem' id='IllAbPainProblem' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\"><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Lst]\"".($row['IllAbd']==$nt['Lst']?' selected':'').">$nt[Lst]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?></td>
<td width="38%">
<div align="left">
Abdomonial pain / problem
</div></td>
<td width="5%"><div align="left">
<?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllHypovolemia' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\" id='IllHypovolemia'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['IllHypov']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?>
</div></td>
<td width="37%">
<div align="left">
Hypovolemia/shock</div></td>
</tr>
<tr>
<td><?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllAirwayObstruction' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\" id='IllAirwayObstruction'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['IllAir']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?></td>
<td>
<div align="left">
Airway Obstruction </div></td>
<td><div align="left">
<?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllInhalationinjury' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\" id='IllInhalationinjury'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['PriComp']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?>
</div></td>
<td>
<div align="left">
Inhalation injury </div></td>
</tr>
<tr>
<td><?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllAllergicReaction' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\" id='IllAllergicReaction'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['IllAllergic']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?></td>
<td>
<div align="left">
Allergic Reaction </div></td>
<td><div align="left">
<?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllPoisoningDrugIngestion' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\" id='IllPoisoningDrugIngestion'><option></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['PriComp']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?>
</div></td>
<td>
<div align="left">
Poisoning Drug Ingestion </div></td>
</tr>
<tr>
<td><?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllAlteredconsciousness' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\" id='IllAlteredconsciousness'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['IllAlter']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?></td>
<td>
<div align="left">
Altered level of consciousness </div></td>
<td><div align="left">
<?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllPregnancyOBDelivery' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\" id='IllPregnancyOBDelivery'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['PriComp']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?>
</div></td>
<td>
<div align="left">
Pregnancy/OB Delivery</div></td>
</tr>
<tr>
<td><?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllBehavioralpsychiatric' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\" id='IllBehavioralpsychiatric'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['IllBehave']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?></td>
<td>
<div align="left">
Behavioral/Psychiatric</div></td>
<td><div align="left">
<?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllRespiratoryDistress' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\" id='IllRespiratoryDistress'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['PriComp']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?>
</div></td>
<td>
<div align="left">
Respiratory Distress </div></td>
</tr>
<tr>
<td><?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllCardiacArrest' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\" id='IllCardiacArrest'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['IllCArrest']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?></td>
<td><div align="left">
Cardiac arrest </div></td>
<td><?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllSeizure' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\" id='IllSeizure'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['PriComp']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?></td>
<td><div align="left">
Seizure</div></td>
</tr>
<tr>
<td><?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllCardiacRythym' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\" id='IllCardiacRythym'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['IllCRhythem']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?></td>
<td><div align="left">
Cardiac Rythym </div></td>
<td><?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllSmokeInhalation' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\" id='IllSmokeInhalation'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['PriComp']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?></td>
<td><div align="left">
Smoke Inhalation </div></td>
</tr>
<tr>
<td><?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllChestpain' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\" id='IllChestpain'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['IllChest']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?></td>
<td><div align="left">
Chest pain/discomfort </div></td>
<td><?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllStroke' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\" id='IllStroke'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['PriComp']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?></td>
<td><div align="left">
Stroke/CVA</div></td>
</tr>
<tr>
<td><?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllChestpain' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\" id='IllChestpain'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['IllChest']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?></td>
<td>Diabetic symptoms</td>
<td><?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllSyncope' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\" id='IllSyncope'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['PriComp']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?></td>
<td>Syncope/Fainting</td>
</tr>
<tr>
<td><?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllHyperthermia' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\" id='IllHyperthermia'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['PriComp']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?></td>
<td>
<div align="left">
Hyperthermia</div></td>
<td><div align="left">
<?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllOther' onChange=\"UpdatePatientDatabase(this.value,this.id);showIllOtherTextbox();\" id='IllOther'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['PriComp']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?>
</div></td>
<td>
<div align="left">Other </div></td>
</tr>
<tr>
<td><?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllHyperventilation' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\" id='IllHyperventilation'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['PriComp']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?></td>
<td><div align="left">
Hyperventilation</div></td>
<td><?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllUnknown' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\" id='IllUnknown'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['PriComp']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?></td>
<td><div align="left">Unknown
<input type="text" name="IllOtherDes" id="IllOtherDes" style="display:none;" value="<? echo $row[IllOtherDes];?>" onchange="UpdatePatientDatabase(this.value,this.id);"></div></td>
</tr>
<tr>
<td><?php
$query="SELECT Description FROM tbllstonset order by Description";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllHypothermia' onChange=\"UpdatePatientDatabase(this.value,this.id);displayMessage('messages/illness_assessment.php',this.id,this.value);return false\" id='IllHypothermia'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[Description]\"".($row['PriComp']==$nt['Description']?' selected':'').">$nt[Description]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?></td>
<td><div align="left">
Hypothermia</div></td>
<td><select name="IllnessAssessmentNA" id="IllnessAssessmentNA" onChange="UpdatePatientDatabase(this.value,this.id);">
<option>N/A</option>
<option>Clear Selection</option>
</select></td>
<td><div align="left">Not Applicable
</div></td>
</tr>
<tr>
<td colspan="4"><div align="center">Primary Illness
<?php
$query="SELECT Des, DesID FROM tbllstillness order by Des";
$result = mysql_query($query, GetMyConnection() );
echo "<select name='IllnessAssessmentPrimary' onChange=\"UpdatePatientDatabase(this.value,this.id);\" id='IllnessAssessmentPrimary'><option value=''></option>";
// printing the list box select command
while($nt=mysql_fetch_array($result)){//Array or records stored in $nt
echo "<option value=\"$nt[DesID]\"".($row['PriComp']==$nt['DesID']?' selected':'').">$nt[Des]</option>";
/* Option values are added by looping through the array */
}
echo "</select>";// Closing of list box
?>
</div></td>
</tr>
</tbody>
</table></td>
</tr>
</table>
<table border="0" cellspacing="0" cellpadding="0" class="bottombuttons">
<tr>
<td align="left"><input name="Button" type='Button' onClick='tabbar3.goToPrevTab()' value='Prev'> <input name="Button" type='Button' onClick='tabbar3.goToNextTab()' value='Next'><br><br>
<div style="position:relative;
width:200px;height:24px;background-color:white; border:solid blue 1px">
<input type="text"
style="position:absolute;left:2px;top:2px;height:20px;wid th:28px;border:solid
black 0px" maxLength="2"/>
<span
style="position:absolute;left:24px;top:2px;width:3px;heig ht:20px"[color=blue]
>/</span>[/color]
<input type="text"
style="position:absolute;left:30px;top:2px;height:20px;wi dth:28px;border:solid
black 0px" maxLength="2"/>
</div></td>
</tr>
</table>
</body>
</html>
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