= $this->extend($_SESSION['userrole'].'/layout/form.php') ?> = $this->section('content') ?> get('usercityid'); if ($usercityid == 1) { date_default_timezone_set('Asia/Makassar'); } else if ($usercityid == 2) { date_default_timezone_set('Asia/Jakarta'); } $now = date('Y-m-d H:i'); $visitdate = $now; $usercityid = session()->get('usercityid'); if ($usercityid == 1) { $placeholdervisitnumber = "placeholder='BV........'"; $locationdropdown = " "; } else if ($usercityid == 2){ $placeholdervisitnumber = "placeholder='SV........'"; $locationdropdown = " "; } ?>
Patient Information
| MR# |
|
||
| Patient Name | |||
| BirthDate | |||
| Sex | |||
| Address | |||
| Phone# | |||
Order Information
| Visit# | id="visitnumber" class="form-control form-control-sm" oninput="this.value = this.value.toUpperCase();"> | Visit Date | |
| Location | |||
| Payer Name | |||
Tests
| =$i+1;?> |