-
Notifications
You must be signed in to change notification settings - Fork 0
/
Copy pathdoctor_prescriptions.php
754 lines (734 loc) · 59.6 KB
/
doctor_prescriptions.php
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500
501
502
503
504
505
506
507
508
509
510
511
512
513
514
515
516
517
518
519
520
521
522
523
524
525
526
527
528
529
530
531
532
533
534
535
536
537
538
539
540
541
542
543
544
545
546
547
548
549
550
551
552
553
554
555
556
557
558
559
560
561
562
563
564
565
566
567
568
569
570
571
572
573
574
575
576
577
578
579
580
581
582
583
584
585
586
587
588
589
590
591
592
593
594
595
596
597
598
599
600
601
602
603
604
605
606
607
608
609
610
611
612
613
614
615
616
617
618
619
620
621
622
623
624
625
626
627
628
629
630
631
632
633
634
635
636
637
638
639
640
641
642
643
644
645
646
647
648
649
650
651
652
653
654
655
656
657
658
659
660
661
662
663
664
665
666
667
668
669
670
671
672
673
674
675
676
677
678
679
680
681
682
683
684
685
686
687
688
689
690
691
692
693
694
695
696
697
698
699
700
701
702
703
704
705
706
707
708
709
710
711
712
713
714
715
716
717
718
719
720
721
722
723
724
725
726
727
728
729
730
731
732
733
734
735
736
737
738
739
740
741
742
743
744
745
746
747
748
749
750
751
752
753
754
<!DOCTYPE html>
<html lang="en" dir="ltr">
<head>
<meta charset="utf-8">
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<meta name="viewport" content="width=device-width, initial-scale=1, shrink-to-fit=no">
<title>Reports - Rx Clinic</title><!-- Prevent the demo from appearing in search engines -->
<meta name="robots" content="noindex"><!-- Simplebar -->
<link type="text/css" href="assets/vendor/simplebar.min.css" rel="stylesheet"><!-- App CSS -->
<link type="text/css" href="assets/css/app.css" rel="stylesheet">
<link type="text/css" href="assets/css/app.rtl.css" rel="stylesheet"><!-- Material Design Icons -->
<link type="text/css" href="assets/css/vendor-material-icons.css" rel="stylesheet">
<link type="text/css" href="assets/css/vendor-material-icons.rtl.css" rel="stylesheet">
<!-- Font Awesome FREE Icons -->
<link type="text/css" href="assets/css/vendor-fontawesome-free.css" rel="stylesheet">
<link type="text/css" href="assets/css/vendor-fontawesome-free.rtl.css" rel="stylesheet"><!-- ion Range Slider -->
<link type="text/css" href="assets/css/vendor-ion-rangeslider.css" rel="stylesheet">
<link type="text/css" href="assets/css/vendor-ion-rangeslider.rtl.css" rel="stylesheet"><!-- Flatpickr -->
<link type="text/css" href="assets/css/vendor-flatpickr.css" rel="stylesheet">
<link type="text/css" href="assets/css/vendor-flatpickr.rtl.css" rel="stylesheet">
<link type="text/css" href="assets/css/vendor-flatpickr-airbnb.css" rel="stylesheet">
<link type="text/css" href="assets/css/vendor-flatpickr-airbnb.rtl.css" rel="stylesheet"><!-- Vector Maps -->
<link type="text/css" href="assets/vendor/jqvmap/jqvmap.min.css" rel="stylesheet">
</head>
<body class="layout-default">
<div class="preloader"></div>
<div class="mdk-drawer-layout js-mdk-drawer-layout" data-push data-responsive-width="992px" data-fullbleed>
<div class="mdk-drawer-layout__content">
<!-- Header Layout -->
<div class="mdk-header-layout js-mdk-header-layout" data-has-scrolling-region>
<!-- Header -->
<div id="header" class="mdk-header js-mdk-header m-0" data-fixed data-effects="waterfall"
data-retarget-mouse-scroll="false">
<div class="mdk-header__content">
<div class="navbar navbar-expand-sm navbar-main navbar-light bg-white pr-0" id="navbar"
data-primary>
<div class="container-fluid p-0">
<!-- Navbar toggler --><button
class="navbar-toggler navbar-toggler-custom d-lg-none d-flex mr-navbar"
type="button" data-toggle="sidebar"><span
class="material-icons">short_text</span></button><!-- Navbar Brand --><a
href="#" class="navbar-brand flex "><span>Reports</span></a>
<ul class="nav navbar-nav d-none d-md-flex">
<li class="nav-item dropdown"><a href="#notifications_menu"
class="nav-link dropdown-toggle" data-toggle="dropdown"
data-caret="false"><i
class="material-icons nav-icon navbar-notifications-indicator">notifications</i></a>
<div id="notifications_menu"
class="dropdown-menu dropdown-menu-right navbar-notifications-menu">
<div class="dropdown-item d-flex align-items-center py-2"><span
class="flex navbar-notifications-menu__title m-0">Notifications</span><a
href="javascript:void(0)" class="text-muted"><small>Clear
all</small></a></div>
<div class="navbar-notifications-menu__content" data-simplebar>
<div class="py-2">
<div class="dropdown-item d-flex">
<div class="mr-3">
<div class="avatar avatar-sm"
style="width: 32px; height: 32px;"><img
src="assets/images/profilew.png" alt="Avatar"
class="avatar-img rounded-circle">
</div>
</div>
<div class="flex"><a href="">Dr. Dentist</a> approved your <a href="">appointment.</a><br><small
class="text-muted">1 hr
ago</small></div>
</div>
<div class="dropdown-item d-flex">
<div class="mr-3">
<div class="avatar avatar-sm"
style="width: 32px; height: 32px;"><img
src="assets/images/profilew.png" alt="Avatar"
class="avatar-img rounded-circle">
</div>
</div>
<div class="flex"><a href="">Dr. Dentist</a> cancelled your <a href="">appointment.</a><br><small
class="text-muted">1 day
ago</small></div>
</div>
<div class="dropdown-item d-flex">
<div class="mr-3">
<div class="avatar avatar-sm"
style="width: 32px; height: 32px;"><img
src="assets/images/profilew.png" alt="Avatar"
class="avatar-img rounded-circle">
</div>
</div>
<div class="flex"><a href="">Dr. Dentist</a> declined your <a href="">appointment.</a><br><small
class="text-muted">3 days
ago</small></div>
</div>
</div>
</div><a href="javascript:void(0);"
class="dropdown-item text-center navbar-notifications-menu__footer">View
All</a>
</div>
</li>
<li class="nav-item"><a href="#events-drawer" data-toggle="sidebar"
class="nav-link d-flex align-items-center"><i
class="material-icons nav-icon">event_note</i><span
class="badge badge-warning text-primary-dark rounded-circle badge-notifications">1</span></a>
</li>
</ul>
<div class="dropdown"><a href="#" data-toggle="dropdown" data-caret="false"
class="dropdown-toggle navbar-toggler navbar-toggler-company border-left d-flex align-items-center ml-navbar"><span
class="mr-3"><img src="assets/images/profilew.png" width="43" height="43"
alt="avatar"></span></span></a>
<div id="company_menu"
class="dropdown-menu dropdown-menu-right navbar-company-menu">
<div
class="dropdown-item d-flex align-items-center py-2 navbar-company-info py-3">
<span class="mr-3"><img src="assets/images/profilew.png" width="43"
height="43" alt="avatar"></span><span
class="flex d-flex flex-column"><strong style="font-size: 1.125rem;">Ms. User Wan</strong><small
class="text-muted">@msuserwan</small></span>
</div>
<div class="dropdown-divider"></div>
<a class="dropdown-item d-flex align-items-center py-2"
href="doctor_myprofile.php"><span class="material-icons mr-2">person</span>My
Profile</a>
<a class="dropdown-item d-flex align-items-center py-2"
href="doctor_changepassword.php"><span class="material-icons mr-2">lock</span>Change Password</a>
<!-- <a class="dropdown-item d-flex align-items-center py-2"
href="changepasswordadmin.php"><span
class="material-icons mr-2">lock</span>Change Password</a> -->
</div>
</div>
</div>
</div>
</div>
</div><!-- // END Header -->
<!-- Header Layout Content -->
<div class="mdk-header-layout__content mdk-header-layout__content--fullbleed mdk-header-layout__content--scrollable page">
<div class="container-fluid page__container">
<div class="z-0">
<ul class="nav nav-tabs nav-tabs-custom" role="tablist">
<li class="nav-item"><a href="#tab-queue" class="nav-link active" data-toggle="tab" role="tab" aria-controls="tab-queue" aria-selected="true"><span class="nav-link__count">List of Done Consultations</span>Total (23) </a></li>
<!-- <li class="nav-item"><a href="#tab-earlier" class="nav-link" data-toggle="tab"
role="tab" aria-selected="false"><span
class="nav-link__count">Students</span>Total (519)
</a></li> -->
</ul>
<div class="card">
<div class="tab-content">
<div class="tab-pane active show fade" id="tab-queue">
<div class="table-responsive border-bottom" data-toggle="lists" data-lists-values='["js-lists-values-employee-name", "js-lists-values-employee-title", "js-lists-values-employee-service", "js-lists-values-employee-doctor"]'>
<div class="search-form search-form--light m-3"><input type="text" class="form-control search" placeholder="Search Student Patient ID, Name or Service"><button class="btn" type="button" role="button"><i class="material-icons">search</i></button>
</div>
<table class="table mb-0 thead-border-top-0">
<thead>
<tr>
<th style="width: 100px;">
<a href="javascript:void(0)" class="sort" data-sort="js-lists-values-employee-title">Patient
No.</a>
</th>
<th style="width: 180px;">
<a href="javascript:void(0)" class="sort" data-sort="js-lists-values-employee-name">Patient
Name</a>
</th>
<th style="width: 150px;">
<a href="javascript:void(0)" class="sort" data-sort="js-lists-values-employee-service">Service</a>
</th>
<th style="width: 150px;">
<a href="javascript:void(0)" class="sort" data-sort="js-lists-values-employee-doctor">Doctor</a>
</th>
<th style="width: 150px;">Date & Time</th>
<th style="width: 120px;">Diagnosis</th>
<th style="width: 200px;">Action</th>
</tr>
</thead>
<tbody class="list" id="staff02">
<tr>
<td><span class="badge d-block badge-soft-primary"><strong class="js-lists-values-employee-title">2022-0016</strong></span>
</td>
<td>
<div class="media align-items-center">
<div class="avatar avatar-xs mr-2"><img src="assets/images/profilem.png" alt="Avatar" class="avatar-img rounded-circle">
</div>
<div class="media-body d-flex flex-column"><strong class="js-lists-values-employee-name">Juan Dela
Cruz</strong></div>
</div>
</td>
<td><span class="js-lists-values-employee-service">Cardiology</span>
</td>
<td><span class="js-lists-values-employee-doctor">Dr. Number
Wan</span></td>
<td>07/08/22 9:00 AM</td>
<td>Normal</td>
<!-- <td><span class="badge badge-success">ACTIVE</span></td> -->
<td>
<div class="button-list">
<button type="button" class="btn btn-primary" data-toggle="modal" data-target="#modal-info"><i class="material-icons">remove_red_eye</i></button>
<button type="button" class="btn btn-warning" data-toggle="modal" data-target="#modal-edit"><i class="material-icons">edit</i></button>
<!-- <button type="button" class="btn btn-danger" data-toggle="modal" data-target="#modal-delete"><i class="material-icons">delete</i></button> -->
</div>
</td>
</tr>
<tr>
<td><span class="badge d-block badge-soft-primary"><strong class="js-lists-values-employee-title">2022-0017</strong></span>
</td>
<td>
<div class="media align-items-center">
<div class="avatar avatar-xs mr-2"><img src="assets/images/profilew.png" alt="Avatar" class="avatar-img rounded-circle">
</div>
<div class="media-body d-flex flex-column"><strong class="js-lists-values-employee-name">Maria
Clara</strong></div>
</div>
</td>
<td><span class="js-lists-values-employee-service">Otolaryngology</span>
</td>
<td><span class="js-lists-values-employee-doctor">Dr. Number
Too</span></td>
<td>09/08/22 9:00 AM</td>
<td>Normal</td>
<!-- <td><span class="badge badge-success">ACTIVE</span></td> -->
<td>
<div class="button-list">
<button type="button" class="btn btn-primary" data-toggle="modal" data-target="#modal-info"><i class="material-icons">remove_red_eye</i></button>
<button type="button" class="btn btn-warning" data-toggle="modal" data-target="#modal-edit"><i class="material-icons">edit</i></button>
<!-- <button type="button" class="btn btn-danger" data-toggle="modal" data-target="#modal-delete"><i class="material-icons">delete</i></button> -->
</div>
</td>
</tr>
<tr>
<td><span class="badge d-block badge-soft-primary"><strong class="js-lists-values-employee-title">2022-0018</strong></span>
</td>
<td>
<div class="media align-items-center">
<div class="avatar avatar-xs mr-2"><img src="assets/images/jhong.jpg" alt="Avatar" class="avatar-img rounded-circle">
</div>
<div class="media-body d-flex flex-column"><strong class="js-lists-values-employee-name">Crisostomo
Ibarra</strong></div>
</div>
</td>
<td><span class="js-lists-values-employee-service">Family
Medicine</span></td>
<td><span class="js-lists-values-employee-doctor">Dr. Number
Wan</span></td>
<td>10/08/22 9:00 AM</td>
<td>Normal</td>
<!-- <td><span class="badge badge-success">ACTIVE</span></td> -->
<td>
<div class="button-list">
<button type="button" class="btn btn-primary" data-toggle="modal" data-target="#modal-info"><i class="material-icons">remove_red_eye</i></button>
<button type="button" class="btn btn-warning" data-toggle="modal" data-target="#modal-edit"><i class="material-icons">edit</i></button>
<!-- <button type="button" class="btn btn-danger" data-toggle="modal" data-target="#modal-delete"><i class="material-icons">delete</i></button> -->
</div>
</td>
</tr>
<tr>
<td><span class="badge d-block badge-soft-primary"><strong class="js-lists-values-employee-title">2022-0019</strong></span>
</td>
<td>
<div class="media align-items-center">
<div class="avatar avatar-xs mr-2"><img src="assets/images/steve.png" alt="Avatar" class="avatar-img rounded-circle">
</div>
<div class="media-body d-flex flex-column"><strong class="js-lists-values-employee-name">Steve
Harrington</strong></div>
</div>
</td>
<td><span class="js-lists-values-employee-service">Gastroenterology</span>
</td>
<td><span class="js-lists-values-employee-doctor">Dr. Number
Too</span></td>
<td>11/08/22 9:00 AM</td>
<td>Normal</td>
<!-- <td><span class="badge badge-success">ACTIVE</span></td> -->
<td>
<div class="button-list">
<button type="button" class="btn btn-primary" data-toggle="modal" data-target="#modal-info"><i class="material-icons">remove_red_eye</i></button>
<button type="button" class="btn btn-warning" data-toggle="modal" data-target="#modal-edit"><i class="material-icons">edit</i></button>
<!-- <button type="button" class="btn btn-danger" data-toggle="modal" data-target="#modal-delete"><i class="material-icons">delete</i></button> -->
</div>
</td>
</tr>
<tr>
<td><span class="badge d-block badge-soft-primary"><strong class="js-lists-values-employee-title">2022-0020</strong></span>
</td>
<td>
<div class="media align-items-center">
<div class="avatar avatar-xs mr-2"><img src="assets/images/profilew.png" alt="Avatar" class="avatar-img rounded-circle">
</div>
<div class="media-body d-flex flex-column"><strong class="js-lists-values-employee-name">Eleven
Hopper</strong></div>
</div>
</td>
<td><span class="js-lists-values-employee-service">General
Dentistry</span>
<td><span class="js-lists-values-employee-doctor">Dr. Number
Wan</span></td>
</td>
<td>12/08/22 9:00 AM</td>
<td>Normal</td>
<!-- <td><span class="badge badge-success">ACTIVE</span></td> -->
<td>
<div class="button-list">
<button type="button" class="btn btn-primary" data-toggle="modal" data-target="#modal-info"><i class="material-icons">remove_red_eye</i></button>
<button type="button" class="btn btn-warning" data-toggle="modal" data-target="#modal-edit"><i class="material-icons">edit</i></button>
<!-- <button type="button" class="btn btn-danger" data-toggle="modal" data-target="#modal-delete"><i class="material-icons">delete</i></button> -->
</div>
</td>
</tr>
</tbody>
</table>
</div>
<div class="card-body text-right">Showing 5 <span class="text-muted">of
23</span><a href="#" class="text-muted-light"><i class="material-icons ml-1">arrow_forward</i></a></div>
</div>
</div>
</div>
</div>
</div>
</div><!-- // END header-layout__content -->
</div><!-- // END header-layout -->
</div><!-- // END drawer-layout__content -->
<!--MODALS-->
<!-- Success Alert Modal -->
<div id="modal-success" class="modal fade" tabindex="-1" role="dialog" aria-hidden="true">
<div class="modal-dialog modal-dialog-centered modal-sm">
<div class="modal-content bg-success">
<div class="modal-body text-center p-4"><i class="material-icons icon-40pt text-white mb-2">check</i>
<h4 class="text-white">Approved!</h4>
<p class="text-white mt-3">You accepted an appointment.</p><button type="button" class="btn btn-light my-2" data-dismiss="modal">Continue</button>
</div><!-- // END .modal-body -->
</div><!-- // END .modal-content -->
</div><!-- // END .modal-dialog -->
</div><!-- // END .modal -->
<!-- Danger Alert Modal -->
<div id="modal-danger" class="modal fade" tabindex="-1" role="dialog" aria-hidden="true">
<div class="modal-dialog modal-dialog-centered modal-sm">
<div class="modal-content bg-danger">
<div class="modal-body text-center p-4"><i class="material-icons icon-40pt text-white mb-2">clear</i>
<h4 class="text-white">Declined!</h4>
<p class="text-white mt-3">You declined an appointment.</p><button type="button" class="btn btn-light my-2" data-dismiss="modal">Continue</button>
</div><!-- // END .modal-body -->
</div><!-- // END .modal-content -->
</div><!-- // END .modal-dialog -->
</div><!-- // END .modal -->
<!-- Danger Delete Modal -->
<div id="modal-delete" class="modal fade" tabindex="-1" role="dialog" aria-hidden="true">
<div class="modal-dialog modal-dialog-centered modal-sm">
<div class="modal-content bg-danger">
<div class="modal-body text-center p-4"><i class="material-icons icon-40pt text-white mb-2">delete</i>
<h4 class="text-white">Deleted!</h4>
<p class="text-white mt-3">You deleted a report.</p><button type="button" class="btn btn-light my-2" data-dismiss="modal">Continue</button>
</div><!-- // END .modal-body -->
</div><!-- // END .modal-content -->
</div><!-- // END .modal-dialog -->
</div><!-- // END .modal -->
<!-- Edit Modal -->
<!-- Login Modal -->
<div id="modal-edit" class="modal fade" tabindex="-1" role="dialog" aria-labelledby="modal-large-title" aria-hidden="true">
<div class="modal-dialog modal-lg" role="document">
<div class="modal-content">
<div class="modal-body">
<div class="px-3">
<div class="d-flex justify-content-center mt-2 mb-4 navbar-light"><a href="index.php" class="navbar-brand" style="min-width: 0"><img class="navbar-brand-icon" src="assets/img/rxcliniclogowithoutline.png" width="50" alt="Stack"><span>Edit
Report Details</span></a></div>
<form action="#">
<div class="page-separator">
<div class="page-separator__text">CONSULTATION DETAILS</div>
</div>
<div class="row">
<div class="col-lg-4">
<div class="form-group"><label class="text-label" for="select01">Service:</label>
<select id="select01" data-toggle="select" class="form-control" disabled>
<option>Cardiology</option>
<option>Otolaryngology</option>
<option>Endocrinology</option>
<option>Family Medicine</option>
<option>Gastroenterology</option>
<option>General Dentistry</option>
<option>General Medicine</option>
<option>Internal Medicine</option>
<option>Mental Health</option>
<option>Nephrology</option>
<option>Neurology</option>
<option>Nutritionist-Dietitian</option>
<option>Family Medicine</option>
<option>Obstetrics and Gynecology</option>
<option>Oncology</option>
<option>Opthalmology</option>
<option>Pediatrics</option>
<option>Pulmonology</option>
<option>Rehabilitation Medicine</option>
<option>Rheumatology</option>
<option>Urology</option>
</select>
</div>
</div>
<div class="col-lg-4">
<div class="form-group"><label class="text-label" for="flatpickrSample01">Date:</label><input id="flatpickrSample01" type="text" class="form-control" placeholder="Flatpickr example" data-toggle="flatpickr" value="Aug 09, 2022" disabled></div>
</div>
<div class="col">
<div class="form-group"><label class="text-label" for="select01">Service:</label>
<select id="select01" data-toggle="select" class="form-control" disabled>
<option selected="">8:00 AM - 9:00 AM</option>
<option>9:00 AM - 10:00 AM</option>
<option>10:00 AM - 11:00 AM</option>
<option>11:00 AM - 12:00 PM</option>
<option>12:00 PM - 1:00 PM</option>
<option>1:00 PM - 2:00 PM</option>
<option>2:00 PM - 3:00 PM</option>
<option>3:00 PM - 4:00 PM</option>
<option>4:00 PM - 5:00 PM</option>
</select>
</div>
</div>
</div>
<div class="page-separator">
<div class="page-separator__text">DIAGNOSIS DETAILS</div>
</div>
<div class="row">
<div class="col-lg-4">
<div class="form-group"><label class="text-label" for="fname">Diagnosis:</label><input id="fname" type="text" required="" class="form-control" placeholder="First name" value="Ligma"></div>
</div>
<div class="col-lg-8">
<div class="form-group"><label class="text-label" for="desc">Diagnosis Description:</label><textarea id="desc" rows="4" class="form-control" placeholder=""></textarea></div>
</div>
</div>
<div class="page-separator">
<div class="page-separator__text">PRESCRIPTION DETAILS</div>
</div>
<form action="index.php" novalidate>
<div class="row">
<div class="col">
<div class="form-group"><label class="text-label" for="fname">Prescription
Code:</label><input id="fname" type="text" class="form-control"
placeholder="Prescription Code" value="PK-2022-2207-0012" disabled>
</div>
</div>
</div>
<div class="row">
<div class="col">
<div class="form-group"><label class="text-label" for="fname">First
Name:</label><input id="fname" type="text" class="form-control"
placeholder="First name" value="Juan" disabled></div>
</div>
<div class="col">
<div class="form-group"><label class="text-label" for="lname">Middle
Name:</label><input id="lname" type="text" class="form-control"
placeholder="Middle name" value="" disabled></div>
</div>
<div class="col">
<div class="form-group"><label class="text-label" for="lname">Last
Name:</label><input id="lname" type="text" class="form-control"
placeholder="Last name" value="Dela Cruz" disabled></div>
</div>
</div>
<div class="row">
<div class="col">
<div class="form-group"><label class="text-label"
for="fname">Address:</label><input id="fname" type="text"
class="form-control" placeholder="Address" value="3435 Batumbakal Street, New York, Cubao" disabled></div>
</div>
</div>
<div class="row">
<div class="col-lg-3">
<div class="form-group"><label class="text-label" for="fname">Age:</label><input
id="fname" type="number" class="form-control" placeholder="Age"
value="32" disabled></div>
</div>
<div class="col-lg-3">
<div class="form-group"><label class="text-label" for="select01">Sex:</label>
<select id="select01" data-toggle="select" class="form-control" disabled>
<option selected="" disabled>M</option>
<option>F</option>
</select>
</div>
</div>
<div class="col-lg-6">
<div class="form-group"><label class="text-label"
for="flatpickrSample01">Date:</label><input id="flatpickrSample01"
type="text" class="form-control" placeholder="Flatpickr example"
data-toggle="" value="Aug 09, 2022" disabled></div>
</div>
</div>
</form>
<div class="page-separator">
<div class="page-separator__text">Medical Prescription (Rx)</div>
</div>
<form action="index.php" novalidate>
<div class="row">
<div class="col-lg-4">
<div class="form-group"><label class="text-label"
for="fname">Medicine/Drug:</label><input id="fname" type="text"
class="form-control" placeholder="Medicine/Drug" value=""></div>
</div>
<div class="col-lg-2">
<div class="form-group"><label class="text-label"
for="fname">Inscription:</label><input id="fname" type="text"
class="form-control" placeholder="Inscription" value=""></div>
</div>
<div class="col">
<div class="col">
<div class="form-group"><label class="text-label"
for="desc">Instruction/s:</label><textarea id="desc" rows="4"
class="form-control" placeholder=""></textarea><input id="fname"
type="text" class="form-control" placeholder="Special Instruction/s"
value="Refill: "></div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-6">
<div class="avatar avatar-xxl avatar-4by3 d-block">
<img src="assets/images/signature.webp" alt="Avatar"
class="avatar-img rounded">
</div>
</div>
</div>
<div class="row">
<div class="col-lg-5">
<div class="form-group"><label class="text-label" for="select01">Doctor:</label>
<select id="select01" data-toggle="select" class="form-control" disabled>
<option selected="">Dr. Number Wan</option>
<option>Dr. Number Too</option>
<option>Dr. Number Trii</option>
<option>Dr. Number Fowr</option>
</select>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-2">
<div class="form-group"><label class="text-label" for="fname">Lic
No.:</label><input id="fname" type="text" class="form-control"
placeholder="Inscription" value="1234" disabled></div>
</div>
</div>
<div class="row">
<div class="col-lg-2">
<div class="form-group"><label class="text-label" for="fname">PTR
No.:</label><input id="fname" type="text" class="form-control"
placeholder="Inscription" value="1234567" disabled></div>
</div>
</div>
</form>
<div class="modal-footer"><button type="button" class="btn btn-light" data-dismiss="modal">Cancel</button><button type="button" class="btn btn-primary" data-toggle="modal" data-target="#modal-add">Save
Changes</button></div>
</div>
</div><!-- // END .modal-body -->
</div><!-- // END .modal-content -->
</div><!-- // END .modal-dialog -->
</div><!-- // END .modal -->
<!-- Info Modal -->
<div id="modal-info" class="modal fade" tabindex="-1" role="dialog" aria-labelledby="modal-large-title" aria-hidden="true">
<div class="modal-dialog modal-lg" role="document">
<div class="modal-content">
<div class="modal-body">
<div class="px-3">
<div class="d-flex justify-content-center mt-0 mb-0 navbar-light"><a href="#" class="navbar-brand" style="min-width: 0"><img class="navbar-brand-icon" src="assets/img/rxlogowithname.png" width="250" alt="Stack"></a></div><br><br>
<div class="d-flex justify-content-center mt-0 mb-0 navbar-light"><span><strong>REPORT DETAILS</strong></span></div>
<!-- <div class="page-separator"></div> -->
<div class="modal-body">
<div class="page-separator">
<div class="page-separator__text">CONSULTATION DETAILS</div>
</div>
<p><strong>Service: </strong>Cardiology</p>
<p><strong>Date: </strong>08/09/2022, 8:00 AM - 9:00 AM</p>
<div class="page-separator">
<div class="page-separator__text">DIAGNOSIS DETAILS</div>
</div>
<div class="row">
<div class="col-lg-4">
<p><strong>Diagnosis: </strong>Ligma</p>
</div>
<div class="col-lg-8">
<p><strong>Description: </strong>Coronary heart disease is the term that describes what happens when your heart's blood supply is blocked or interrupted by a build-up of fatty substances in the coronary arteries. Over time, the walls of your arteries can become furred up with fatty deposits.</p>
</div>
</div>
<div class="page-separator">
<div class="page-separator__text">PRESCRIPTION DETAILS</div>
</div>
<p><strong>Prescription Code: </strong>PR-2022-2207-0012</p>
<div class="row">
<div class="col-lg-6">
<p><strong>Patient: </strong>Juan Dela Cruz</p>
</div>
<div class="col-lg-3">
<p><strong>Age: </strong>27</p>
</div>
<div class="col-lg-3">
<p><strong>Sex: </strong>M</p>
</div>
</div>
<p><strong>Address: </strong>3435 Batumbakal St., New York, Cubao</p>
<p><strong>Date: </strong>Aug 08, 2022</p>
<br>
<div class="avatar avatar-l avatar-1by1">
<img src="assets/images/rx.png" alt="Avatar" class="avatar-img rounded">
</div><br><br>
<p><strong>ibuprofen (Motrin® or Advil®)</strong></p>
<p>Take 400–600 mg every 6–8 hours. Ibuprofen will help with
pain relief and as an anti-inflammatory.</p>
<div class="avatar avatar-xxl avatar-4by3">
<img src="assets/images/signature.webp" alt="Avatar" class="avatar-img rounded">
</div>
<p><strong>Dr. Den T. Ista</strong></p>
<p><strong>Lic No.: </strong>1234</p>
<p><strong>PTR No.: </strong>1234567</p>
<!-- <br>
<div class="alert alert-soft-success d-flex" role="alert"><i class="material-icons mr-3">check_circle</i>
<div class="text-body">Your appointment is now <strong>APPROVED</strong>. Please proceed to the clinic according to the schedule.</div>
</div> -->
<div class="modal-footer"><a href="index_patient.php"><button type="button" class="btn btn-primary" data-dismiss="modal">Add Lab Results</button></a><a href="#"><button type="button" class="btn btn-primary" data-dismiss="modal">Add Medical Certificate</button></a></div>
</div><!-- // END .modal-body -->
</div>
</div><!-- // END .modal-body -->
<!-- // END .modal-footer -->
</div><!-- // END .modal-content -->
</div><!-- // END .modal-dialog -->
</div><!-- // END .modal -->
<div class="mdk-drawer js-mdk-drawer" id="default-drawer" data-align="start">
<div class="mdk-drawer__content">
<div class="sidebar sidebar-dark sidebar-left simplebar" data-simplebar>
<div class="d-flex align-items-center sidebar-p-a border-bottom sidebar-account flex-shrink-0"><a
href="#" class="flex d-flex align-items-center text-underline-0 text-body"><span
class="mr-3"><img src="assets/img/rxcliniclogowithoutline.png" width="43" height="43"
alt="avatar"></span><span class="flex d-flex flex-column"><strong
style="font-size: 25px">Rx Clinic</strong><small
class="text-muted text-uppercase"
style="color: rgba(255,255,255,.54)"></small></span></a>
</div>
<!-- <div
class="sidebar-stats row no-gutters align-items-center text-center border-bottom flex-shrink-0">
<div class="sidebar-stats__col col">
<div class="sidebar-stats__title">Total Patients</div>
<div class="sidebar-stats__value">542</div>
</div>
<div class="sidebar-stats__col col border-left">
<div class="sidebar-stats__title">Total Appointments</div>
<div class="sidebar-stats__value">719</div>
</div>
</div> -->
<!-- <div class="py-4 text-center flex-shrink-0"><a style="min-width: 157px;" href="/signup.php"
class="btn btn-primary">Create <i class="material-icons ml-1">add</i></a></div> -->
<ul class="nav nav-tabs sidebar-tabs flex-shrink-0" role="tablist">
<li class="nav-item"><a class="nav-link active show" id="sm-menu-tab" href="#sm-menu"
data-toggle="tab" role="tab" aria-controls="sm-menu" aria-selected="true">Menu</a></li>
<!-- <li class="nav-item"><a class="nav-link" href="#sm-account" data-toggle="tab">Manage</a></li> -->
<!-- <li class="nav-item"><a class="nav-link" href="#sm-settings" data-toggle="tab">Settings</a></li> -->
</ul>
<div class="tab-content">
<div id="sm-menu" class="tab-pane show active" role="tabpanel" aria-labelledby="sm-menu-tab">
<ul class="sidebar-menu flex">
<li class="sidebar-menu-item"><a class="sidebar-menu-button" href="doctor_index.php"><i
class="sidebar-menu-icon sidebar-menu-icon--left material-icons">donut_small</i><span
class="sidebar-menu-text">Dashboard</span></a></li>
<li class="sidebar-menu-item"><a class="sidebar-menu-button" href="doctor_consultations.php"><i
class="sidebar-menu-icon sidebar-menu-icon--left material-icons">date_range</i><span
class="sidebar-menu-text">My Consultations</span><span
class="badge badge-warning rounded-circle badge-notifications ml-auto"
style="padding: .1875rem .375rem;">2</span></a></li>
<li class="sidebar-menu-item"><a class="sidebar-menu-button" href="doctor_mypatients.php"><i
class="sidebar-menu-icon sidebar-menu-icon--left material-icons">person</i><span
class="sidebar-menu-text">My Patients</span></a></li>
<li class="sidebar-menu-item active"><a class="sidebar-menu-button" href="#"><i
class="sidebar-menu-icon sidebar-menu-icon--left material-icons">description</i><span
class="sidebar-menu-text">Reports</span></a></li>
<li class="sidebar-menu-item"><a class="sidebar-menu-button" href="doctor_transactions.php"><i
class="sidebar-menu-icon sidebar-menu-icon--left material-icons">payment</i><span
class="sidebar-menu-text">Transactions</span></a></li>
</ul>
</div>
</div>
<div class="mt-auto sidebar-p-a sidebar-b-t d-flex flex-column flex-shrink-0">
<a class="sidebar-link mb-2" href="doctor_schedules.php">Schedule<i
class="sidebar-menu-icon ml-2 material-icons icon-16pt">schedule</i></a>
<a class="sidebar-link mb-2" href="doctor_verification.php">Doctor Verification<i
class="sidebar-menu-icon ml-2 material-icons icon-16pt">check_circle</i></a>
<a class="sidebar-link" href="logindoctorpage.php"><strong>LOG OUT</strong><i
class="sidebar-menu-icon ml-2 material-icons icon-20pt">exit_to_app</i></a>
</div>
</div>
</div>
</div>
</div><!-- // END drawer-layout -->
<div class="mdk-drawer js-mdk-drawer" id="events-drawer" data-align="end">
<div class="mdk-drawer__content">
<div class="sidebar sidebar-light sidebar-left simplebar" data-simplebar>
<small class="text-dark-gray px-3 py-1"><strong>Sunday, 07 Aug</strong></small>
<div class="list-group list-group-flush">
<div class="list-group-item bg-light">
<div class="row">
<div class="col-auto d-flex flex-column"><small>9:00 AM</small><small
class="text-dark-gray">1 hr</small></div>
<div class="col">
<div class="d-flex flex-column flex"><a href="#" class="text-body"><strong
class="text-15pt">Dental Check-up</strong></a><small
class="text-muted d-flex align-items-center"><i
class="material-icons icon-16pt mr-1">person</i>Dr. Dentist</small>
</div>
<div class="avatar-group mt-2">
<div class="avatar avatar-xs"><img src="assets/images/profilew.png" alt="Avatar"
class="avatar-img rounded-circle"></div>
<!-- <div class="avatar avatar-xs"><img
src="assets/images/256_jeremy-banks-798787-unsplash.jpg" alt="Avatar"
class="avatar-img rounded-circle"></div>
<div class="avatar avatar-xs"><img
src="assets/images/256_daniel-gaffey-1060698-unsplash.jpg" alt="Avatar"
class="avatar-img rounded-circle"></div> -->
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div><!-- App Settings FAB -->
<div id="app-settings">
<app-settings></app-settings>
</div><!-- jQuery -->
<script src="assets/vendor/jquery.min.js"></script><!-- Bootstrap -->
<script src="assets/vendor/popper.min.js"></script>
<script src="assets/vendor/bootstrap.min.js"></script><!-- Simplebar -->
<script src="assets/vendor/simplebar.min.js"></script><!-- DOM Factory -->
<script src="assets/vendor/dom-factory.js"></script><!-- MDK -->
<script src="assets/vendor/material-design-kit.js"></script><!-- Range Slider -->
<script src="assets/vendor/ion.rangeSlider.min.js"></script>
<script src="assets/js/ion-rangeslider.js"></script><!-- App -->
<script src="assets/js/toggle-check-all.js"></script>
<script src="assets/js/check-selected-row.js"></script>
<script src="assets/js/dropdown.js"></script>
<script src="assets/js/sidebar-mini.js"></script>
<script src="assets/js/app.js"></script><!-- App Settings(safe to remove) -->
<script src="assets/js/app-settings.js"></script><!-- List.js -->
<script src="assets/vendor/list.min.js"></script>
<script src="assets/js/list.js"></script><!-- Dragula -->
<script src="assets/vendor/dragula/dragula.min.js"></script>
<script src="assets/js/dragula.js"></script>
</body>
</body>
</html>