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form_carga_datos_pacientes.php
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<?php
include 'session.php';
include 'conexion.php';
include 'funciones.php';
parse_str(decryptLink(),$query_params);extract($query_params);
if(empty($check)){
$_SESSION['mensaje']= "ACCESO RESTRINGIDO";
$_SESSION['url']= "logout.php";
header('Location: mensaje.php',true,303);
exit;
}
$sql = "SELECT * FROM mm_pacientes WHERE id=".$id;
$result = $conexion->query($sql);
$row = $result->fetch_array(MYSQLI_ASSOC);
if ($result->num_rows > 0) {
?>
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN"
"http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html >
<head>
<meta http-equiv="Content-Type" content="text/html; charset=UTF-8" />
<title>Pacientes</title>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1">
<link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.7/css/bootstrap.min.css">
<script src="https://ajax.googleapis.com/ajax/libs/jquery/3.3.1/jquery.min.js"></script>
<script src="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.7/js/bootstrap.min.js"></script>
</head>
<body id="main_body">
<div class="container">
<? include 'menu.php'; ?>
<div class="panel panel-info" style="margin-top: 10px;">
<div class="panel-heading ">
<h2>Pacientes</h2>
<p>Carga y modificación de pacientes.</p>
</div>
<div class="panel-body">
<form id="form_pacientes" class="input-sm" method="post" action="carga_datos_pacientes.php">
<input name="id" type="hidden" value="<?=$id;?>" />
<div class="row">
<div class="col-xs-6">
<p>
<label>Documento:</label>
<?
switch ($row['tipodocumento']) {
case 1:
echo "DNI";
break;
case 2:
echo "LC";
break;
case 3:
echo "LE";
break;
case 4:
echo "CI";
break;
}
echo " ".sprintf("%'.08d", $row['documento']);
?>
</p>
<p>
<label>Nombre y Apellido:</label>
<?
echo " ".$row['nombre']." ".$row['apellido'];
?>
</p>
</div>
<div class="col-xs-6">
<p><label >Sexo:</label><?=" ".$row['sexo'];?></p>
<p><label>Fecha nacimiento: </label><?=$row['fechanacimiento']; ?></p>
</div>
</div>
<div class="row">
<div class="col-xs-12">
<h4>Domicilio</h4>
<div class="form-group">
<label class="" for="element_7_1">Direccion</label>
<input id="element_7_1" name="direccion" class="form-control" value="<?= $row['direccion']; ?>" type="text" />
</div>
</div>
</div>
<div class="row">
<div class="col-xs-5">
<div class="form_group">
<label for="element_7_4">Provincia</label>
<select id="element_7_4" name="provincia" class="form-control">;
<?php
$conexion2 = new mysqli($host_db, $user_db, $pass_db, $db_name);
if ($conexion2->connect_error) {
die("La conexion falló: " . $conexion->connect_error);
}
$sql = "SELECT provincia_id as id, provincia_nombre as nombre FROM mm_provincias";
$result = $conexion2->query($sql);
while ($row2 = $result->fetch_array(MYSQLI_ASSOC)){
echo '<option value="'.$row2['id'].'" ';
if($row['provincia']==$row2['id']){echo 'selected="selected"';}
echo '>'.$row2['nombre'].'</option>';
}
mysqli_close($conexion2);
?>
</select>
</div>
</div>
<div class="col-xs-5">
<div class="form_group">
<label class="" for="element_7_3">Localidad</label>
<input id="element_7_3" name="localidad" class="form-control" value="<?= $row['localidad']; ?>" type="text" />
</div>
</div>
<div class="col-xs-2">
<div class="form-group">
<label for="element_7_5">CP</label>
<input id="element_7_5" name="codigopostal" class="form-control" maxlength="15" value="<?= $row['codigopostal']; ?>" type="text" />
</div>
</div>
</div>
<div class="row">
<div class="col-xs-4">
<div class="form-group">
<label for="element_8">Teléfono</label>
<input id="element_8" name="telefono" class="form-control" type="tel" maxlength="30" value="<?= $row['telefono']; ?>" />
</div>
</div>
<div class="col-xs-4">
<div class="form-group">
<label for="element_9">Celular</label>
<input id="element_9" name="celular" class="form-control" type="tel" maxlength="30" value="<?= $row['celular']; ?>" />
</div>
</div>
<div class="col-xs-4">
<div class="form-group">
<label for="element_14">Email</label>
<input id="element_14" name="email" class="form-control" value="<?= $row['email']; ?>" type="email" placeholder="email" />
</div>
</div>
</div>
<hr>
<div class="row">
<div class="col-xs-4">
<div class="form-group">
<label for="element_15" class="small">Grupo sanguineo</label>
<select class="form-control" id="element_15" name="gruposanguineo" required>
<option value="0" <? if($row['gruposanguineo']==1){echo 'selected="selected"';} ?>>--</option>
<option value="1" <? if($row['gruposanguineo']==1){echo 'selected="selected"';} ?>>A+</option>
<option value="2" <? if($row['gruposanguineo']==2){echo 'selected="selected"';} ?>>A-</option>
<option value="3" <? if($row['gruposanguineo']==3){echo 'selected="selected"';} ?>>B+</option>
<option value="4" <? if($row['gruposanguineo']==4){echo 'selected="selected"';} ?>>B-</option>
<option value="5" <? if($row['gruposanguineo']==5){echo 'selected="selected"';} ?>>AB+</option>
<option value="6" <? if($row['gruposanguineo']==6){echo 'selected="selected"';} ?>>AB-</option>
<option value="7" <? if($row['gruposanguineo']==7){echo 'selected="selected"';} ?>>0+</option>
<option value="8" <? if($row['gruposanguineo']==8){echo 'selected="selected"';} ?>>0-</option>
</select>
</div>
</div>
<div class="col-xs-4">
<div class="form-group">
<label for="element_16">Obra social</label>
<input id="element_16" name="obrasocial" class="form-control" value="<?= $row['obrasocial']; ?>" type="text" placeholder="obra social" />
</div>
</div>
<div class="col-xs-4">
<div class="form-group">
<label for="element_17">Numero de afiliado</label>
<input id="element_17" name="numeroafiliado" class="form-control" value="<?= $row['numeroafiliado']; ?>" type="text" placeholder="" />
</div>
</div>
</div>
<div class="row">
<div class="col-xs-4">
<div class="form-group">
<label for="element_13">Fecha fallecimiento</label>
<input id="element_13" name="fechafallecimiento" class="form-control" type="date" value="<?= ($row['fechafallecimiento']!='')?($row['fechafallecimiento']):''; ?>" placeholder="01/01/1950" />
</div>
</div>
<div class="col-xs-4">
<div class="form-group">
<label for="element_13">Fecha baja</label>
<input id="element_13" name="fechabaja" class="form-control" type="date" value="<?= ($row['fechabaja']!='')?($row['fechabaja']):''; ?>" placeholder="01/01/2019" />
</div>
</div>
</div>
<hr>
<h5>Responsable</h5>
<div class="row">
<div class="col-xs-12">
<div class="form-group">
<label for="element_19">Nombre y Apellido</label>
<input id="element_19" name="responsable_nombre" class="form-control" type="text" maxlength="30" value="<?= $row['responsable_nombre']; ?>" required/>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-4">
<div class="form-group">
<label for="element_19">Tipo y númer de documento</label>
<input id="element_19" name="responsable_doc" class="form-control" type="text" maxlength="11" value="<?= $row['responsable_doc']; ?>" required />
</div>
</div>
<div class="col-xs-4">
<div class="form-group">
<label for="element_20">Teléfono</label>
<input id="element_20" name="responsable_tel" class="form-control" type="tel" maxlength="20" value="<?= $row['responsable_tel']; ?>" required />
</div>
</div>
<div class="col-xs-4">
<div class="form-group">
<label for="element_21">Email</label>
<input disabled id="element_21" name="responsable_email" class="form-control" value="" type="email" placeholder="email" />
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12">
<div class="form-group">
<label for="element_22">Dirección completa</label>
<input id="element_23" name="responsable_dir" class="form-control" type="text" maxlength="50" value="<?= $row['responsable_dir']; ?>" required/>
</div>
</div>
</div>
<hr>
<div class="row">
<div class="col-xs-12">
<div class="form-group">
<label for="element_18">Comentarios</label>
<textarea class="form-control" rows="5" id="element_18" name="comentarios" placeholder="comentarios" value="<?= $row['comentarios']; ?>"><?= $row['comentarios']; ?></textarea>
</div>
</div>
</div>
<hr>
<div class="row">
<div class="col-xs-1">
<button id="saveForm" class="btn btn-default" type="submit">Cargar</button>
</div>
</div>
</form>
</div>
<div class="panel-footer">
Clinical
</div>
</div>
</div>
</body>
</html>
<?
}else{
echo "Error al intentar cargar datos del usuario.";
}
mysqli_close($conexion);
exit;
?>