zskk_bg
/
yuanchengpasc


			
							123456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869707172737475767778798081828384858687888990919293949596979899100101102103104105106107108109110111112113114115116117118119120121122123124125126127128129130131132133134135136137138139140141142143144145146147148149150151152153154155156157158159160161162163164165166167168169170171172173174175
							<!DOCTYPE html>
<html>
    <head>
        <title>TODO supply a title</title>
        {include file="../application/manage/view/commons/headers.html" }

        <script >

            // 保存信息
            function save(){
                var data=$("#myform").serialize();
                $.ajax({
                        url:"/manage/remoteapplication/save",
                        data:data,type:"get",
                        success:function(rs){
                            if(rs.indexOf("insert_ok")>=0){
                                    document.location.href="edit?id="+rs.split(";")[1];
                            }else if(rs=="success"){
                                alert('保存成功');
                                document.location.reload();
                            }else{
                                    alert("保存失败！");
                            }
                        },error:function(e,e1,e2){
                            alert(e2);
                        }
                });
            }

            $(function(){


            });
            
            
        </script>
        
        
    </head>
    <body >
        <form id="myform"  action="" method="get" >
            <input name="id" type="hidden" value="{if  isset($remote_application) }{$remote_application.id}{/if}" />
        <table class="editform" width="99%" border="0" style="margin: 5px auto;" cellpadding="1" cellspacing="1" >
            <tr>
                    <th width="105" height="38" align="right" >属性&nbsp;</th>
                    <th colspan="3" >信息</th>
            </tr>
            <tr>
                <th height="32" align="right" >申请的目标医院：</th>
                <td colspan="3" >
                    <input readonly="true" type="text" size="55" value="{if  isset($remote_application) }{$remote_application.remote_institution_name}{/if}" />
                </td>
            </tr>
            <tr>
                <th height="32" align="right" >申请的目标医生：</th>
                <td colspan="3" >
                    <input readonly="true" type="text" size="55" value="{if  isset($remote_application) }{$remote_application.remote_doctor_name}{/if}" />
                </td>
            </tr>
            <tr>
                <th height="32" align="right" >发起申请医院：</th>
                <td colspan="3" >
                    <input readonly="true" type="text" size="55" value="{if  isset($remote_application) }{$remote_application.local_institution_name}{/if}" />
                </td>
            </tr>
            <tr>
                <th height="32" align="right" >发起时间：</th>
                <td colspan="3" >
                    <input readonly="true"  type="text" size="55" value="{if  isset($remote_application) }{$remote_application.req_date_time}{/if}" />
                </td>
            </tr>
            <tr>
                <th height="32" align="right" >申请医生：</th>
                <td colspan="3" >
                    <input readonly="true" type="text" size="55" value="{if  isset($remote_application) }{$remote_application.req_doctor_name}{/if}" />
                </td>
            </tr>
            <tr>
                <th height="32" align="right" >主诉：</th>
                <td colspan="3" >
                    <textarea name="illness_desc" id="" style="width: 413px;height: 50px;">{if  isset($remote_application) }{$remote_application.illness_desc}{/if}</textarea>
                </td>
            </tr>
            <tr>
                <th height="32" align="right" >临床症状：</th>
                <td colspan="3" >
                    <textarea name="clin_symp" id="" style="width: 413px;height: 50px;">{if  isset($remote_application) }{$remote_application.clin_symp}{/if}</textarea>
                </td>
            </tr>
            <tr>
                <th height="32" align="right" >体征：</th>
                <td colspan="3" >
                    <textarea name="phys_sign" id="" style="width: 413px;height: 50px;">{if  isset($remote_application) }{$remote_application.phys_sign}{/if}</textarea>
                </td>
            </tr>
            <tr>
                <th height="32" align="right" >临床诊断：</th>
                <td colspan="3" >
                    <textarea name="clin_diag" id="" style="width: 413px;height: 50px;">{if  isset($remote_application) }{$remote_application.clin_diag}{/if}</textarea>
                </td>
            </tr>
            <tr>
                <th height="32" align="right" >既往史：</th>
                <td colspan="3" >
                    <textarea name="anamnesis" id="" style="width: 413px;height: 50px;">{if  isset($remote_application) }{$remote_application.anamnesis}{/if}</textarea>
                </td>
            </tr>
            <tr>
                <th height="32" align="right" >家族史：</th>
                <td colspan="3" >
                    <textarea name="family_ill" id="" style="width: 413px;height: 50px;">{if  isset($remote_application) }{$remote_application.family_ill}{/if}</textarea>
                </td>
            </tr>
            <tr>
                <th height="32" align="right" >婚姻史：</th>
                <td colspan="3" >
                    <textarea name="marrital" id="" style="width: 413px;height: 50px;">{if  isset($remote_application) }{$remote_application.marrital}{/if}</textarea>
                </td>
            </tr>
            <tr>
                <th height="32" align="right" >是否急诊：</th>
                <td colspan="3" >
                    <input name="is_urgent"  type="radio" size="35" value="1" {if isset($remote_application) && $remote_application.is_urgent=='1' }checked="check"{/if} /><label>是</label>
                    <input name="is_urgent"  type="radio" size="35" value="0" {if isset($remote_application) && $remote_application.is_urgent=='0' }checked="check"{/if} /><label>否</label>
                </td>
            </tr>
            <tr>
                <th height="32" align="right" >远程申请状态：</th>
                <td colspan="3" >
                    <select name="application_status" >
                        <option value="1" {if isset($remote_application) && $remote_application.application_status=='1' }selected{/if}>未申请</option>
                        <option value="2" {if isset($remote_application) && $remote_application.application_status=='2' }selected{/if}>已申请，待接受</option>
                        <option value="3" {if isset($remote_application) && $remote_application.application_status=='3' }selected{/if}>诊断中</option>
                        <option value="4" {if isset($remote_application) && $remote_application.application_status=='4' }selected{/if}>诊断完成，待确认</option>
                        <option value="5" {if isset($remote_application) && $remote_application.application_status=='5' }selected{/if}>已确认</option>
                        <option value="6" {if isset($remote_application) && $remote_application.application_status=='6' }selected{/if}>已打印</option>
                        <option value="7" {if isset($remote_application) && $remote_application.application_status=='7' }selected{/if}>驳回</option>
                    </select>
                </td>
            </tr>
            <tr>
                <th height="32" align="right" >备注：</th>
                <td colspan="3" >
                    <textarea name="remark" id="" style="width: 413px;height: 50px;">{if  isset($remote_application) }{$remote_application.remark}{/if}</textarea>
                </td>
            </tr>
            <tr>
            <th height="32" >&nbsp;</th>
            <td>
                <a type="button" class="easyui-linkbutton" data-options="iconCls:'icon-save'" icon="icon-save" onclick="save()" >保存</a>
                <a type="button" class="easyui-linkbutton" data-options="iconCls:'icon-cancel'" onclick="window.parent.closeEditWin('reload');" >关闭</a>
            </td>
            </tr>
            <tr >
                    <th height="32" >&nbsp;</th>
                    <td colspan="3" >
                    &nbsp;
                    </td>
            </tr>
        </table>
        </form>
        
        
    </body>
</html>