extend($_SESSION['userrole'].'/layout/form.php') ?> section('content') ?> get('usercityid'); if ($usercityid == 1) { date_default_timezone_set('Asia/Makassar'); $valuevisitnumber = "value='BV'"; $locationdropdown = " "; } else if ($usercityid == 2) { date_default_timezone_set('Asia/Jakarta'); $valuevisitnumber = "value='SV'"; $locationdropdown = " "; } else { date_default_timezone_set('Asia/Makassar'); $valuevisitnumber = ""; $locationdropdown = " "; } $now = date('Y-m-d H:i'); $visitdate = $now; ?>

Order Creation

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		Reff ID
Payer Name

Tests

MR#	:
Patient Name	:
BirthDate	:
Sex	:
Address	:
Phone	:

endSection() ?> section('script') ?> endSection() ?>